Examines the underlying factor structure of the diagnosis of post-traumatic stress disorder (PTSD) to determine whether refugee subjects from another culture would generate a PTSD factor structure similar to that of Caucasian samples. Study participants were 209 Khmer adolescents from two cities — Portland, Oregon, and Salt Lake City, Utah — who had experienced as children the terrors of the Pol Pot regime in Cambodia. The diagnosis of PTSD was based on American Psychiatric Association criteria, and symptom data were collected with the adolescent section of the Diagnostic Interview for Children and Adolescents. The results revealed that the symptoms with the strongest relation to PTSD diagnosis were intrusive thoughts, avoidance of thoughts of trauma, avoidance of situational reminders, and physiological reactivity. In addition, the study demonstrated that PTSD as a result of massive war trauma appeared to transcend the formidable barriers of culture and language in the Khmer population – suggesting that careful assessments of PTSD in Southeast Asian refugees can be reliable and yield clinically valid findings. Rather than robbing the refugee of the moral meaning of war and resettlement, the study’s results highlight the enduring tragedy of these experiences for the refugee patient who seeks help.
