Journal of Immigrant and Minority Health

, Volume 21, Issue 2, pp 271–277 | Cite as

Psychometric Properties of the Multidimensional Loss Scale with Refugee Women-at-Risk Recently Arrived in Australia

  • Lyn VromansEmail author
  • Robert D. Schweitzer
  • Mark Brough
  • Ignacio Correa-Velez
  • Kate Murray
  • Caroline Lenette
Original Paper


Refugee women-at-risk represent a distinct and vulnerable refugee population. We investigated the psychometric properties of the Multidimensional Loss Scale (MLS) with 104 women-at-risk, recently-arrived in Australia. Cross-sectional survey included: the MLS (indexing loss events and loss distress); Harvard Trauma Questionnaire (Indexing Trauma Events and Trauma Symptoms), and; Hopkins Symptom Checklist-37 (indexing anxiety, depression, and somatization symptoms). Exploratory factor analyses of MLS loss distress revealed a six-factor model (loss of symbolic self; loss of home; loss of interdependence; loss of past aspirations; interpersonal loss, and; loss of intrapersonal integrity). Cronbach alphas indicated satisfactory internal consistency for loss events (0.83) and distress (0.88). Correlations supported convergent validity of loss distress with trauma symptoms (r = 0.41) and divergent validity with anxiety (r = 0.09), Depression (r = 0.29), and somatic (r = 0.24) symptoms. Findings support MLS use in assessment of loss and associated distress with refugee women-at-risk.


Loss Refugees Women-at-risk Psychometric properties Assessment 



Funding was provided by Australian Research Council (ARC) Linkage Grant, ACCESS Community Services, and Australian Catholic University (Grant No. LP140100609).

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no conflict of interest.


  1. 1.
    United Nations High Commissioner for Refugees: UNHCR’s Strategic directions 2017–2021. Geneva: UNHCR; 2017. Accessed 17 Jan 2017.
  2. 2.
    Harris DL. Counting our losses. Reflecting on change, loss, and transition in everyday life. New York: Routledge; 2011.CrossRefGoogle Scholar
  3. 3.
    Oxford University Press: the Oxford English Dictionary online; Oxford University Press; 2017 Accessed 23 October 2017.
  4. 4.
    United Nations High Commissioner for Refugees: Conclusion on Refugee Women. No. 60 (XL). Geneva: UNHCR; 1989. Accessed 19 June 2016.
  5. 5.
    United Nations High Commissioner for Refugees: Proposed executive committee conclusion on women at risk: Follow-up paper. Geneva: UNHCR; 2006. Accessed 19 June 2016.
  6. 6.
    United Nations High Commissioner for Refugees: UNHCR Resettlement Handbook. Geneva: UNHCR; 2011. Accessed 29 March 2017.
  7. 7.
    Vromans L, Schweitzer RD, Brough M. The multidimensional loss scale: validating a cross-cultural instrument for measuring loss. J Nerv Ment Dis. 2012;200:349–57.CrossRefGoogle Scholar
  8. 8.
    Eisenbruch M. Cross cultural aspects of bereavement. 1: a conceptual framework for comparative analysis. Cult Med Psychiatr. 1984;8:283–309.CrossRefGoogle Scholar
  9. 9.
    Eisenbruch M. From post-traumatic stress disorder to cultural bereavement: Diagnosis of Southeast Asian refugees. Soc Sci Med. 1991;33:673 – 80.CrossRefGoogle Scholar
  10. 10.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (3). Washington: APA; 1987.Google Scholar
  11. 11.
    Green BL. Traumatic loss: conceptual and empirical links between trauma and bereavement. J Person Interperson Loss. 2000;5:1–17.CrossRefGoogle Scholar
  12. 12.
    Nickerson A, Liddell B, Maccallum F, Steel Z, Silove D, Bryant R. Posttraumatic Stress disorder and prolonged grief in refugees exposed to trauma and loss. BMC Psychiatr. 2014;14:106.CrossRefGoogle Scholar
  13. 13.
    Vromans L, Schweitzer RD, Brough M, Correa-Velez I, Murray K, Lenette C. Contributions of loss events to loss distress and trauma symptoms in recently-resettled refugee women-at-risk. J Loss Trauma. 2017;4:357–70.CrossRefGoogle Scholar
  14. 14.
    Fisher S. Occupation of the womb: Forced impregnation as genocide. Duke Law J. 1996;46:91–133.CrossRefGoogle Scholar
  15. 15.
    Bartolomei L, Eckert R, Pittaway E. (2014). “What happens there… follows us here”: resettled but still at risk: refugee women and girls in Australia. Refuge 30: 45–56.Google Scholar
  16. 16.
    Seguin M, Lewis R, Amirejibi T, Razmadze M, Makhashvili N, Roberts B. Our flesh is here but our soul stayed there: a qualitative study on resource loss due to war and displacement among internally-displaced women in the Republic of Georgia. Soc Sci Med. 2016;150:239–47.CrossRefGoogle Scholar
  17. 17.
    Allotey P. Traveling with excess baggage: health problems of refugee women in Western Australia. Women Health. 1998;28:63–81.CrossRefGoogle Scholar
  18. 18.
    Manderson L, Kelaher M, Markovic M, McManus K. A woman without a man is a woman at risk in Australian Humanitarian programs. J Refugee Stud. 1998;11:3.CrossRefGoogle Scholar
  19. 19.
    Eaton L, Louw L. Culture and Self in South Africa: Individualism/Collectivism Predictions. J Soc Psychol. 2000;140:210–8.CrossRefGoogle Scholar
  20. 20.
    James W. Principles of psychology. Chicago: University of Chicago Press; 1980.Google Scholar
  21. 21.
    Mollica RF, McDonald L, Massagli M, Silove D. Measuring trauma, measuring torture: Instructions and guidance on the utilization of the Harvard Program in Refugee Trauma’s Versions of the Hopkins Symptom checklist-25 (HSCL-25) and the Harvard Trauma questionnaire (HTQ). Cambridge: Harvard Program in Refugee Trauma; 2004.Google Scholar
  22. 22.
    Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J. The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992;180:111–6.CrossRefGoogle Scholar
  23. 23.
    Hesbacher PT, Rickels K, Morris RJ, Newman H, Rosenfeld H. Psychiatric Illness in family practice. J Clin Psychiatr. 1980;41:6–10.Google Scholar
  24. 24.
    Schweitzer RD, Melville FA, Steel Z, Lacherez P. Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006;40:79–187.CrossRefGoogle Scholar
  25. 25.
    Schweitzer RD, Brough MK, Vromans LP, Asic-Kobe M. Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience. Aust N Z J Psychiatry. 2011;45:299–307.CrossRefGoogle Scholar
  26. 26.
    Kaiser HF. The application of electronic computers to factor analysis. Educ Psychol Meas. 1960;20:141–51.CrossRefGoogle Scholar
  27. 27.
    Cattell RB. The scree test for the number of factors. Multivar Behav Res. 1966;1:245–76.CrossRefGoogle Scholar
  28. 28.
    Stevens JP. Applied multivariate statistics for the social sciences. 2 Hillsdale, NJ: Erlbaum; 1992.Google Scholar
  29. 29.
  30. 30.
    Rosbrook B, Schweitzer RD. The meaning of home for Karen and Chin refugees from Burma: an interpretative phenomenological approach. Eur J Psychother Counsel. 2010;12:159–72.CrossRefGoogle Scholar
  31. 31.
    Lenette C. ‘I am a widow, mother and refugee’: narratives of widowhood: lived experiences of two refugee women in Brisbane. J Refugee Stud. 2014;27:403–21.CrossRefGoogle Scholar
  32. 32.
    Lenette C. Mistrust and refugee women who are lone parents in resettlement contexts. Qualit Social Work. 2015;14:119–34.CrossRefGoogle Scholar
  33. 33.
    Triandis H. Collectivism and individualism as cultural syndromes. Cross Cult Res. 1993;27:155–80.CrossRefGoogle Scholar
  34. 34.
    Bruce EJ, Schultz CL. Nonfinite loss and grief: a psychoeducational approach. Baltimore: Paul H. Brookes; 2001.Google Scholar
  35. 35.
    Shear KM, Smith-Caroff K. Traumatic loss and the syndrome of complicated grief. PTSD Res Quart. 2002;13(1):1–8.Google Scholar
  36. 36.
    Boss P. Ambiguous loss: learning to live with unresolved grief. Cambridge: Harvard University Press; 1999.Google Scholar
  37. 37.
    Doran G, Hansen D. Constructions of Mexican American family grief after the death of a child: an exploratory study. Cult Divers Ethnic Minor Psychol 2006; 12:199 – 21.Google Scholar
  38. 38.
    Herman J. Recovery from psychological trauma. Psychiatr Clin Neurosci. 1998;52:S98-S103.CrossRefGoogle Scholar
  39. 39.
    Rando T. Treatment of complicated mourning. Champaign, IL: Research Press; 1993.Google Scholar
  40. 40.
    Krause N, Shaw BA, Carney J. A descriptive epidemiology of lifetime trauma and the physical health status of older adults. Psychol Aging. 2004;19:637–48.CrossRefGoogle Scholar
  41. 41.
    Doka K. Challenging the paradigm: new understandings of grief. Grief Matters. 2001;4:31–3.Google Scholar
  42. 42.
    Worden W. Grief counselling and grief therapy. A handbook for the mental health practitioner. 4. London: Routledge; 2009.Google Scholar
  43. 43.
    Rosenblatt P, Jackson D, Walsh P. Grief and mourning in cross-cultural perspective. Med Anthropol. 1978;9:18–9.Google Scholar
  44. 44.
    Fava GA, Sonino N. Psychosomatic assessment. Psychother Psychosom. 2009;78:333–41.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Psychology and CounsellingQueensland University of TechnologyBrisbaneAustralia
  2. 2.School of Public Health and Social WorkQueensland University of TechnologyBrisbaneAustralia
  3. 3.School of Social Sciences, Forced Migration Research NetworkUniversity of New South WalesSydneyAustralia

Personalised recommendations