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Validation of the Extreme Experiences Scale (EX2) for Armed Conflict Contexts

Psychiatric Quarterly volume 91, pages 495–520 (2020)Cite this article

Abstract

Psychological approaches to the study of armed conflict have focused on analyzing post-traumatic stress outcomes, and on evaluating the intensity of exposure to violent confrontation. Nevertheless, psychometrically valid tools required for measuring these traumatic experiences are scarce To validate the Extreme Experiences scale (EX2) for armed conflict contexts for its use in Colombia, and to provide a framework for validation in conflict contexts around the world This Cross-sectional aims to validate the scale with 187 participants, study of validate with 187 participants, comprising population with high exposure to conflict (former combatants and a set of armed conflict victims) and low conflict-exposed individuals (control group). Structures of two domains and 18 items were confirmed: Direct Extreme Experiences (dEX2) and Indirect Extreme Experiences (iEX2); these dimensions were also validated by expert judgment, producing 14-item version. Good levels of internal consistency were found, with a KR-20 of 0.80 for the 18-item version, and 0.77 for the 14-item. The scale differentiates between population with ‘high exposure to conflict’ from population with ‘low exposure’ (dnp > 0.5 and area under the ROC >0.90). The scale scores have significant correlation with some mental health constructs. The EX2 scale has good internal consistency, as well as structural validity with regard to exposed groups. This scale can be potentially validated for its use in countries with armed confrontation history. In future versions, the scale may include additional items in order to improve content validity.

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Notes

  1. The ECAE scale has not been validated, its original authors have used it as a screening test to identify extreme experiences and subsequently with the VIVO instrument (Ontological Vital Impact Assessment) identify strategies and the ability of people to cope to difficult experiences in order to deepen the vital impact of extreme. The instrument can be found on the following page: http://www.psicosocial.info/cuestionario/cuestionario.php

  2. CERAC - Conflict Analysis Resource Center. Data on the armed conflict in Colombia, 2017: http://www.cerac.org.co/es/recursos/datosconflictoscolombia/

  3. Updated figures are available at https://cifras.unidadvictimas.gov.co/.

  4. The National Historical Memory Commission, for instance, suggests the systematic measure of the following categories: 1) displacement of population; 2) land eviction; 3) kidnapping; 4) extortion; 5) illicit recruitment of children; 6) torture; 7) homicide of protected persons, selective assassination, and massacre; 8) threats; 9) crimes against freedom and sexual integrity; 10) forced disappearance; 11) antipersonnel mines, unexploded munitions, and improvised explosive devices; 12) attacks on and losses of civil property; and 13) attacks on public property.

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Acknowledgments

We express gratitude to the participants who shared their experiences. To governmental administrations of two municipalities of Antioquia, Colombia. To the support of the Mental Health and Epidemiology research groups at National School of Public Health at Universidad de Antioquia, and the project “Evaluating the effectiveness of individual training in social cognition in the behavioral improvement of observed deficiencies and modulations of brain connectivity patterns in a sample of former armed group combatants’. To the Agency for the Reincorporation and Normalization (ARN), and to the Justice and Peace Program at Medellín. To Dr. Pau Pérez and his work team allowed us to study the psychometric properties of their original questionnaire. To Dr. Sandra Alvarán, from the Mental Health Group, for her fieldwork contribution. Finally, to the experts who participated in the content validity process: Jenny García, Difariney González, Nora Londoño, Dora Hernández, Eneida Puerta, Claudia Osorio, Diana María Castro, and José David López.

Funding

Research funded by the Mental Health Group, Epidemiology Group (Universidad de Antioquia), and Colciencias project 777–111577757638.

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Affiliations

  1. School of Public Health, Universidad de Antioquia, Calle 70 No. 52-21, Medellín, Colombia

    L. S. Giraldo, S. Trujillo & N. Trujillo

  2. Institute of Medical Research, Facultad de Medicina, Universidad de Antioquia, Carrera 51 D No. 62-29, Medellín, Colombia

    D. C. Aguirre-Acevedo

  3. Faculty of Law, Universidad del Rosario, Carrera 6 # 15-18, Bogotá, Colombia

    S. Trujillo, J. E. Ugarriza & N. Trujillo

Authors
  1. L. S. Giraldo
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  2. D. C. Aguirre-Acevedo
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  4. J. E. Ugarriza
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Correspondence to N. Trujillo.

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The research ethics committee of the National School of Public Health at the University of Antioquia, with certificate CI 00236–2018 given in Medellín. gave ethical approval for the study.

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Both, participants and experts were informed about the aims of the study and gave their informed consent, guaranteed the appropriate conditions of archiving, confidentiality, storage, and manipulation of information.

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Giraldo, L.S., Aguirre-Acevedo, D.C., Trujillo, S. et al. Validation of the Extreme Experiences Scale (EX2) for Armed Conflict Contexts. Psychiatr Q 91, 495–520 (2020). https://doi.org/10.1007/s11126-020-09710-z

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Keywords

  • Extreme experiences scale
  • Validation
  • War exposure
  • Armed conflict
  • Mental health
  • Victims
  • Ex-combatants
  • Colombia