Factor structure and measurement invariance of the brief symptom inventory in survivors of torture and severe trauma

Sumithra Raghavan, Fordham University


The cultural and ethnic landscape of the United States is becoming increasingly diverse, with legal immigration rates as high as 400,000 individuals per year (Batalova & Terrezas, 2011). Within this group of immigrants is a subset of refugees, many of whom are fleeing persecution and torture and seeking safety in the United States (US). As this population grows within the US, mental health professionals are challenged to implement culturally and ethically appropriate strategies to assess and treat individuals from diverse backgrounds (Okawa, 2006). Culture can exert a powerful and often misunderstood influence on psychological assessment (Kirmayer, 1998), and few structured measures have been demonstrated to have adequate cross-cultural validity for use with diverse and vulnerable populations such as survivors of torture (Campbell, 2007). This study examined the factor structure of psychological distress as measured by the Brief Symptom Inventory (BSI, Derogatis & Meliseratos, 1983) in a sample of survivors of torture whose regions of origin include Tibet, West Africa and India. Additionally, the present study examined the equivalency of underlying construct(s) across these cultures through tests of measurement invariance. Results indicated that partial metric invariance was established for a three-factor model of psychological distress consisting of Traumatic Distress, Anxiety and Dysphoria factors. The invariance model provided a good fit to the Tibetan-Punjabi subsample pair and the Tibetan-West African subsample pair, demonstrating that scores on the BSI are comparable across these groups. However, the model provided a poor fit to the West-African-Punjabi pair, which may be a result of methodological and conceptual biases and genuine cultural differences between those groups. Results further demonstrated cross-cultural differences in the manifestation of psychological distress, particularly with regards to symptoms of suicidal ideation, belligerence, feeling that one's thoughts are being controlled, dissociation and a sense of resentment. The results of this research suggest that the extracted Traumatic Distress factor of the BSI may be useful in both research and treatment settings in assessing post-traumatic symptoms in diverse populations.

Subject Area

Clinical psychology|Quantitative psychology

Recommended Citation

Raghavan, Sumithra, "Factor structure and measurement invariance of the brief symptom inventory in survivors of torture and severe trauma" (2013). ETD Collection for Fordham University. AAI3598858.