International Society for Traumatic Stress Studies

The Benefits of Focus Groups in Stress and Trauma Research

Posted 1 January 2000 in StressPoints by Dawne Vogt, Ph.D., National Center for PTSD, Boston University School of Medicine

Researchers face a significant challenge when deciding how they will measure the constructs they are interested in studying. Psychometricians have long recommended the use of consultations with persons from a target population in the process of item development (Haynes, Richard, & Kubany, 1995). Consultation can improve the representativeness and relevance of items. This practice can also suggest additional facets and the need for construct refinement.

Developers of psychological instruments, however, have rarely used this strategy (Haynes et al., 1995), and those who have typically relied on interviews with individual members of the population. An alternative to individual interviews is the use of focus groups. This brief article will highlight the benefits of a focus group strategy as an aid to instrument construction and describe how this strategy was used in research on Gulf War veterans.

The focus group is a technique that involves a moderator-facilitated discussion among multiple participants. The moderator initiates conversation and then becomes an observer as the conversation flows under the direction of group members. While primarily used by marketing researchers, this technique has recently been recognized as potentially useful for the behavioral and social sciences and it may be of particular benefit to stress and trauma research.

Because participants respond to each other's comments as well as to questions posed by the moderator, a richer discussion of traumatic events and their effects may be elicited than in a one-on-one interview. Furthermore, participants may feel more comfortable discussing traumatic experiences with others that have had similar experiences and a more honest discussion tends to result.

The discussion among group members may also reveal information about the rules, norms and system of functioning of the population under study that is less likely to emerge when the researcher sets the agenda. Traumatized populations often come from very different backgrounds than the researchers who study them. Applying assumptions that underlie measures developed for non-traumatized populations may be problematic. Furthermore, different language may be appropriate for describing the experiences of traumatized populations than for other populations.

In a study being done by the National Center for PTSD, researchers are examining risk and resilience factors that may be related to health outcomes in Gulf War veterans. They put together a series of focus groups to assist in developing a survey to assess Gulf War-related experiences. Through this strategy, they learned a great deal about the terminology that Gulf War veterans use to describe their experiences.

For example, researchers found that Gulf War veterans refer to the threat of nuclear, biological and chemical warfare as NBCs, and researchers incorporated this colloquialism into their items. They also learned about specific events and circumstances that contributed to the veterans' experiences. For instance, they revealed details of life in the Gulf region that were crucial to researchers' measurement of difficult living conditions.

Finally, they were able to refine existing hypotheses regarding the relative importance of the risk and resilience factors. For example, researchers found that the perceived threat of NBC warfare may have been as detrimental to veterans as their actual exposure to combat.

In summary, researchers found the use of focus groups to be extremely helpful in their efforts to construct a survey instrument for Gulf War veterans. They believe that this method holds promise for enriching research on the experiences of other traumatized populations or subcultures with different ways of interacting with their environments.

ISTSS Research Methodology Special Interest Group sponsored this brief report. If you are interested in becoming a member of the group, please contact chairs Daniel and Lynda King, National Center for PTSD (116B-2), VA Boston Healthcare System, 150 S. Huntington Ave., Boston, MA 02130, e-mail: king.daniel@boston.va.gov or lking@world.std.com.

References
Haynes, S. N., Richard, D. C. S., & Kubany, E. S. (1995). Content validity in psychological assessment: A functional approach to concepts and methods. Psychological Assessment, 7, 238-247.

Contributing Editor Resigns
Bessel van der Kolk resigned as a contributing editor of StressPoints in order to pursue other ISTSS efforts. The editors would like to thank Bessel van der Kolk for his years of service as a contributing editor for StressPoints.