The Arabic Impact of Event Scale-Revised: Psychometric properties in a sample of Syrian refugees

Middle East conflicts have produced a large number of people who suffer from post traumatic stress disorder symptoms. Despite that, there are no short, easily administered self-report validated questionnaire to assess war exposure to posttraumatic stress disorder (PTSD) in Arabic. Only recently has IES-R been translated into “Classical Arabic”, the language used by highly educated populations, which is too difficult for participants grounded in their particular “dialect”. The aim of this work was to validate the Arabic version of IESR, developed specifically for use in a refugee camp during the Syrian conflict. IES-R is a self-report questionnaire for adults measuring the subjective response to a specific traumatic event. It has 22 items; 7 were added to the original Horowitz IES to better assess the DSM criteria for PTSD: intrusion, avoidance, hyperarousal. The original English version has been translated in Arabic and then back-translated to English. Two hundred eighty-eight Syrian refugees were tested. The results of the confirmatory factor analysis supported a four-factor solution (intrusion, avoidance-numbing, hyperarousal, and sleep disturbance). Bootstrap resampling were applied to assess the overall fit of the competing models. Total IES-R scores of our war-exposed civilians was reliable and symmetrically distributed around the average score of 44.72 (± 11.87) largely above the best cut-off for a probable diagnosis of PTSD. The average items score of 2.06 (± 0.54) was similar to values observed in other seriously traumatized groups. In conclusion, the Arabic version of IES-R seems to be a good measure of post-trauma for both research and intervention studies.