Treatment seeking traumatized refugees in the west have diverse traumatic symptomatology. Some of their complaints include social isolation, cognitive impairment, psychosis-like symptoms, and impairment in family and occupational roles. There are no validated symptom or function measures for refugees other than those for PTSD, anxiety, and depression. This creates extensive problems in treatment monitoring and identification of appropriate treatment goals for this population with complex trauma. The psychometric properties of the HoNOS were evaluated by applying Rasch analysis to pre and post-treatment data from 448 consecutive patients at three Danish psychiatric clinics for refugees. A10-item HoNOS version (physical problems and daily function items excluded) of pre-treatment data fit the Rasch model well. A cross validation showed excellent fit of the post-treatment data to the 10-item model, indicating excellent psychome tric properties for treatment monitoring. Furthermore, no serious differential item functioning was found for the effects of gender, culture, and need for translation. Notably, the 10-item HoNOS was uni-dimensional in the refugee group which is contrary to findings using non-traumatized psychiatric populations. Assessment of general functioning is a prerequisite for better service utilization and better thriving of this patient group.
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29th Annual Meeting of the International Society for the Study of Traumatic Stress (ISTSS), 2013