Translation and validation of the Chinese ICD-11 International Trauma Questionnaire (ITQ) for the Assessment of Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD)

Background: Two stress-related disorders have been proposed for inclusion in the revised ICD-11: Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). The International Trauma Questionnaire (ITQ) is a bespoke measure of PTSD and CPTSD and has been widely used in English-speaking countries.

Objective: The primary aim of this study was to develop a Chinese version of the ITQ and assess its content, construct, and concurrent validity.

Methods: Six mental health practitioners and experts rated the Chinese translated and back-translated items to assess content validity. A sample of 423 Chinese young adults completed the ITQ, the WHO Adverse Childhood Experiences International Questionnaire, and the Hospital Anxiety and Depression Scale. Among them, 31 participants also completed the English and Chinese versions of the ITQ administered in random order at retest. Four alternative confirmatory factor analysis models were tested using data from participants who reported at least one adverse childhood experience (ACE; N = 314).

Results: The Chinese ITQ received excellent ratings on relevance and appropriateness. Test–retest reliability and semantic equivalence across English and Chinese versions were acceptable. The correlated first-order six-factor model and a second-order two-factor (PTSD and DSO) both provided an acceptable model fit. The six ITQ symptoms clusters were all significantly correlated with anxiety, depression, and the number of ACEs.

Conclusions: The Chinese ITQ generates scores with acceptable psychometric properties and provides evidence for including PTSD and CPTSD as separate diagnoses in ICD-11.

• This study provides the first Chinese translation and validation of the ITQ with a Chinese young adult sample in Hong Kong.

• The latent structure of the Chinese ITQ was best supported by a six-correlated first-factor model; a two-factor second-order model was also acceptable.

• Each of the six PTSD/CPTSD symptom clusters correlated significantly positively with two criterion variables – anxiety and depression.

• Cumulative exposure to adverse childhood experiences was significantly associated with PTSD/CPTSD symptoms.