The Traumatic Event Checklist for North Korean Defectors.

Abstract

Objective: This study aimed to develop and validate a trauma checklist specifically designed to capture the complex and culturally unique potentially traumatic events (PTEs) experienced by North Korean defectors (NKDs), in alignment with International Classification of Diseases, 11th Revision criteria that distinguish posttraumatic stress disorder (PTSD) from complex PTSD (cPTSD).

Methods: A cross-sectional secondary data analysis was conducted using online survey data from 520 NKDs. Participants were randomly divided into two groups (n=260 each) for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A preliminary 22-item PTE checklist was refined through factor analysis and reliability testing. Criterion validity was assessed using the Depression and Somatic Symptom Scale and World Health Organization of Life Assessment Instrument Bref. Statistical analyses were performed using SPSS 28.0 and AMOS 28.0.

Results: EFA identified a four-factor model: "death and life-threatening events," "interpersonal violence and discrimination," "violence by public authorities," and "family dissolution"-comprising 17 refined items. CFA confirmed a good model fit (RMSEA=0.059, GFI=0.930, CFI=0.930). Internal consistency for the total scale was high (Cronbach's α=0.830), with acceptable reliability across most subscales. The checklist demonstrated strong criterion validity with depression, somatic symptoms, and quality of life indices.

Conclusion: The revised PTEs checklist is a valid and reliable screening tool that reflects NKDs' unique trauma experiences across the pre-, peri-, and post-migration phases. Its combined use with the International Trauma Questionnaire is recommended for comprehensive trauma assessment and tailored intervention planning.