Measuring Traumatic Experiences in a Sample of Ethiopian Adults: Psychometric Properties of the Life Events Checklist-5

Engida Girma; Amantia Ametaj; Melkam Alemayehu; Barkot Milkias; Mahlet Yared; Supriya Misra; Anne Stevenson; Karestan C Koenen; Bizu Gelaye; Solomon Teferra

doi:10.1016/j.ejtd.2022.100298

Measuring Traumatic Experiences in a Sample of Ethiopian Adults: Psychometric Properties of the Life Events Checklist-5

Eur J Trauma Dissociation. 2022 Nov;6(4):100298. doi: 10.1016/j.ejtd.2022.100298. Epub 2022 Aug 30.

Authors

Engida Girma¹, Amantia Ametaj², Melkam Alemayehu¹, Barkot Milkias¹, Mahlet Yared¹, Supriya Misra³, Anne Stevenson^{2

4

5}, Karestan C Koenen^{2

4}, Bizu Gelaye^{2

4

6}, Solomon Teferra¹

Affiliations

¹ Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
² Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
³ Department of Public Health, San Francisco State University, San Francisco, CA, USA.
⁴ Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA.
⁵ Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁶ The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Abstract

Background: Traumatic events. e.g., road traffic accidents, violent conflicts, natural and human-made disasters, are common in sub-Saharan Africa. However, validated trauma screening tools to assess trauma at the individual level are lacking in many sub-Saharan African countries, such as Ethiopia, which limits accurate diagnosis and effective care provision.

Objective: We sought to measure trauma exposure among cases and controls and evaluate the psychometric properties of the Life Event Checklist for DSM-5 (LEC-5) among Ethiopian adults.

Method: This study included 4,183 participants (2,255 cases with a clinical diagnosis of psychosis and 1,928 controls without a history of psychosis) from the Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study. We conducted exploratory factor analysis (EFA) to group the items into factors/subscales, and confirmatory factor analysis (CFA) to investigate the best model fit in Ethiopia.

Result: 48.7% of participants reported exposure to at least one traumatic event. Physical assault (19.6%), sudden violent death (12.0%), and sudden accidental death (10.9%) were the three most common traumatic experiences. Cases were twice as likely to report experiences of traumatic events compared to controls (p<0.001). EFA revealed a four-factor/subscale model. CFA results indicated a theoretically-driven seven-factor model to be the preferred model by the goodness of fit (comparative fit index of 0.965 and Tucker-Lewis index of 0.951) and accuracy (root mean square error of approximation of 0.019).

Conclusion: Exposure to traumatic events was common in Ethiopia, even more so for individuals with a diagnosis of psychotic disorders. The LEC-5 demonstrated good construct validity for measuring traumatic events among Ethiopian adults. Future studies that examine criterion validity and test-retest reliability of the LEC-5 in Ethiopia are warranted.

Keywords: Confirmatory Factor Analysis; Exploratory Factor Analysis; Life Events Checklist – 5; Psychometric Properties; Severe Mental Illness; Traumatic Events.

Abstract

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