Baksbat (broken courage): the development and validation of the inventory to measure baksbat, a Cambodian trauma-based cultural syndrome of distress.Cult Med Psychiatry. 2012 Dec; 36(4):640-59.CM
This article outlines the development and validation of an inventory measuring a Cambodian cultural syndrome of distress called 'baksbat' (broken courage). The inventory development phase involved ethnographic interviews with a preliminary group of 53 experts having knowledge or experience of baksbat. The initial ethnographically derived inventory with 32 items was developed and administered to a second group of 390 consecutive patients to assess factor loadings. The validation phase used confirmatory factor analysis (CFA) to test goodness-of-fit of four hypothesized factor models of the newly developed inventory in a third group of 159 participants. CFA confirms three-factor models that have the best goodness-of-fit, thus a 24-item baksbat inventory clustering of three-symptom categories was developed. Multiple regression, which assesses the relationship between the dependent variable (PTSD) and a subcluster of baksbat inventory (predictors), shows baksbat inventory accounts for 47 % of the total variance of symptoms in PTSD (R (2) = .47). Of the three-symptom clusters, 'psychological distress' shows significant contribution to the total variance of symptoms in PTSD (β = .63, p < .001). Of significance, some symptoms of baksbat were independent from symptoms of PTSD with isolated symptoms that are culturally specific. These preliminary findings suggest that baksbat could be a potential Cambodian trauma-based syndrome with its own culturally validated inventory.