Validation of the Long-term Difficulties Questionnaire-Youth version as a measure of chronic stress in adolescents in Sri Lanka.

Introduction: As a validated stress questionnaire to assess ongoing adversities of adolescents in developing countries is not available, we developed a brief general checklist, the "Long-term Difficulties Questionnaire-Youth" version (LTD-Y) to measure daily stressors of adolescents and examine the psychometric properties of the instrument.

Methods: In 2008, 755 schoolchildren in Sri Lanka (54% girls), age 12-16 years, completed a self-reported questionnaire with four sections. (1) demographic information (2) daily stressors and social support (3) trauma exposures measures; different trauma exposures and tsunami impact, (4) current psychological problem measures; posttraumatic stress symptoms, emotional and behavioral problems, functional impact, happiness at home, and happiness at school. In July 2009, a subsample of 90 adolescents repeated these measures. Internal consistency factor structure, concurrent validity, construct validity, and temporal stability were assessed in the scale.

Results: LTD-Y adequately identified the ongoing adversities of adolescents. The scale showed an excellent internal consistency with Cronbach's alpha = 0.79. The principal component analysis showed two-factor solutions which concern "external" and "internal" stressors. The concurrent validity was indicated by its positive association with all measures of current psychological problems. The discriminant ability of the adversity measure was evident in cumulative trauma exposure and all variables with current psychological problems. The stability of reporting was satisfactory.

Conclusion: This school-based screening showed that the LTD-Y has sufficient validity, competency, and stability in measuring ongoing adversities of adolescents.