The Italian Toolkit was developed by the Harvard Italian Team after the earthquake in L’Aquila (2009) and was revised after the earthquake Central Italy in 2016. The Toolkit includes the Harvard Trauma Questionnaire-R (HTQ-R), the Hopkins Symptom Checklist-25 (HSCL-25), a psychopharmacological booklet developed by Giovanni Muscettola, a systemic review of the psychiatric consequences of disaster in Italy, and a pocket card with 11 points about how to approach a person with traumatic experiences. The toolkit can be used as a guideline in projects focused on Health and Mental Health after natural disaster.
Hopkins Symptom Checklist-25 (HSCL-25) - Italian Version
The Hopkins Symptoms Checklist (HSCL) is a well-known and widely used screening instrument whose history dates from the 1950s. It was originally designed by Parloff, Kelman, and Frank at Johns Hopkins University. Professor Karl Rickels, one of the original developers of the HSCL, demonstrated with his colleagues the usefulness of a 25- item version of the HSCL in a family practice or a family planning service.
The HSCL-25 is a symptom inventory which measures symptoms of anxiety and depression. It consists of 2 parts and 25 items: Part I of the HSCL-25 has 10 items for anxiety symptoms; Part II has 15 items for depression symptoms. The scale for each question includes four categories of response (“Not at all,” “A little,” “Quite a bit,” “Extremely,” rated 1 to 4, respectively). Two scores are calculated: the total score is the average of all 25 items, while the depression score is the average of the 15 depression items. It has been consistently shown in several populations that the total score is highly correlated with severe emotional distress of unspecified diagnosis, and the depression score is correlated with major depression as defined by the Diagnostic and Statistical Manual of the American Psychiatric Association, IV Version (DSM-IV).
The Italian version was translated after the earthquake in L’Aquila (2009) by Sonia Graziano, Cristina Zaetta and Franco Paparo under the supervision of Richard Mollica.
Screening instruments should be administered by health care workers under the supervision and support of a psychiatrist, medical doctor, and/or psychiatric nurse. They were not designed to be used as a self-reporting measure; no checklist can replace the role of a mental health professional.
Harvard Trauma Questionnaire Revised (HTQ-R) - Italian Version developed after the earthquake in L’Aquila
The Harvard Trauma Questionnaire (HTQ) is a checklist written by HPRT. It inquires about a variety of trauma events, as well as the emotional symptoms considered to be uniquely associated with trauma.
Currently there are many versions of this questionnaire. The Vietnamese, Cambodian, and Laotian versions of the HTQ were written for use with Southeast Asian refugees. The Japanese version was written for survivors of the 1995 Kobe earthquake. The Croatian Veterans’ version was written for soldiers who survived the wars in the Balkans, while the Bosnian version was written for civilian survivors. The Italian version was developed after the earthquake in L’Aquila (2009) by Sonia Graziano, Cristina Zaetta and Franco Paparo under the supervision of Richard Mollica. It consists of an adolescent and adult version.
The Italian version consist of three sections. Part I asks about traumatic life events linked with the earthquake. Part II includes open-ended questions that ask respondents for a subjective description of the most traumatic event(s) they have experienced. Part III includes 40 trauma symptoms. The first 16 items were derived from the DSM-IV (Diagnostic and Statistical Manual of the American Psychiatric Association, IV Version) criteria for posttraumatic stress disorder (PTSD). The other items were developed by HPRT to describe symptoms related to earthquake experiences that focus on the impact of trauma on an individual’s perception of his/her ability to function in everyday life. The scale for each question in Part III includes four categories of response: “Not at all”, “A little”, “Quite a bit”, “Extremely”, rated 1 to 4, respectively.
Screening instruments should be administered by health care workers under the supervision and support of a psychiatrist, psychologist and/or medical doctor. They were not designed to be used as a self-reporting measure; no checklist can replace the role of a mental health professional.