Publications of Interest

Publications of Interest Refugees, Trauma and Dissociation

Introducing our new Assistant Editor of Publications of Interest

I am really delighted to introduce our new Assistant Editor of Publications of Interest, our quarterly feature where we draw attention to a small selection of recently published articles around a certain theme. Michael Serpico has kindly volunteered for this role and will be taking over POI from next quarter. Michael is a fourth year doctoral student at Nova Southeastern University, located in Fort Lauderdale, Florida. He is the Clinical Coordinator of the Intensive Psychodynamic Psychotherapy Clinic at Nova Southeastern University’s Psychology Services Center. His interests include psychodynamic psychotherapy: theory and practice, projective techniques, and personality theories. Other interests include human sexuality, evolutionary psychology, and trauma and dissociation. He earned his Bachelors in Psychology in 2011 from Long Island University Post in Brookville, New York, and his Masters in Clinical Psychology from Barry University in Miami Shores, Florida in 2015.

Recent Publication: Refugees, Trauma and Dissociation

To commemorate World Refugee Day on 20 June, the June POI is focusing on refugee trauma. Although the abstracts can only tell part of the picture each of these articles in full touches on issues very relevant to complex trauma and dissociation. Eunyoung Kim, Minwoo Yun, Jin Yong Jun & Woong‑Sub Park (2019) Pre-migration Trauma, Repatriation Experiences, and PTSD Among North Korean Refugees Journal of Immigrant and Minority Health, 21:466–472. Abstract

Many studies on refugees suggested that refugees’ traumatic events associated with post-traumatic stress disorder (PTSD). However, it is unknown whether refugees’ PTSD was caused by their negative experience before or after the entry of their destination country. Thus, a separation of refugees’ pre-migration from their post-migration experience is particularly important in understanding the causal impact of trauma. Using a sample from North Korean refugees, this study investigates the prevalence of PTSD symptoms, the impact of tortured trauma, repatriation experiences, on PTSD among North Korean refugees (n = 698). We found that North Korean refugees in our sample (a) demonstrated a high rate of current probable PTSD; (b) were demonstrated a higher frequency of repatriation experiences with a greater risk for PTSD symptoms. The findings suggest that particular types of trauma for populations with particular socio-demographic characteristics may be at a greater risk of PTSD.

Sumithra S. Raghavan (2019) Cultural Considerations in the Assessment of Survivors of Torture. Journal of Immigrant and Minority Health, 21:586–595.

Abstract The cultural and ethnic landscape of North America is becoming increasingly diverse, with many refugees fleeing torture and persecution and seeking safety in the United States and Canada. In working with this population, clinicians must implement culturally appropriate methods of assessing and treating individuals from diverse backgrounds. Culture can exert a powerful and often misunderstood influence on psychological assessment, and the critical challenge is to account for both subjective experience of the client and the objective symptoms or behaviors present. The present review explores the literature on cross-cultural issues in the assessment of survivors of torture. I summarize best practices and review the theoretical and statistical bases for establishing the equivalence of constructs across cultures. Discussion centers around the utility of a cross-culturally valid measure of distress, and it is hoped that this review will encourage collaboration between clinicians and psychometricians to develop assessments for use with this vulnerable population.

Nina Thorup Dalgaard, Safwat Y. Diab, Edith Montgomery, Samir R. Qouta, Raija-Leena Punamaki, (2019). Is silence about trauma harmful for children? Transgenerational communication in Palestinian families. Transcultural Psychiatry, Vol. 56(2) 398–427 DOI: 10.1177/1363461518824430

Abstract Style of family communication is considered important in the transgenerational transmission of trauma. This study had three aims: first, to identify the contents of family communication about past national trauma; second, to examine how parents’ current war trauma is associated with transgenerational communication; and third, to analyze the associations between transgenerational communication and children’s mental health, measured as posttraumatic stress disorder (PTSD), depression and psychological distress. The study sample consisted of 170 Palestinian families in Gaza Strip, in which both mothers (n¼170) and fathers (n¼170) participated, each with their 11–13-yearold child. Mothers and fathers responded separately to three questions: 1) what did their own parents tell them about the War of 1948, Nakba?; 2) what did they tell their own children about the Nakba?; and 3) What did they tell their own children about the 1967 Arab–Israeli War and military occupation? Current war trauma, as reported separately by mothers, fathers and their children, refers to the Gaza War 2008/09. Children reported their symptoms of PTSD, depression, and psychological distress.

Tobias Hecker, Stephanie Huber, Thomas Maier & Andreas Maercker (2018) Differential Associations Among PTSD and Complex PTSD Symptoms and Traumatic Experiences and Postmigration Difficulties in a Culturally Diverse Refugee Sample. Journal of Traumatic Stress, 31, 795–804. DOI: 10.1002/jts.22342

Abstract Forced migration is one of the major challenges currently facing the international community. Many refugees have been affected by traumatic experiences at home and during their flight, putting them at a heightened risk of developing trauma-related disorders. The new version of the International Classification of Diseases (ICD-11) introduced two sibling disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). So far, little is known about risk and protective factors in refugees that are specifically associated with the disturbances in self-organization (DSO) characteristic of CPTSD. In this study, we aimed to investigate the association between PTSD and DSO symptoms and traumatic experiences, postmigration difficulties, and social support in a culturally diverse sample of refugees who resettled in Switzerland. A total of 94 refugees (85.1% male; M age = 31.60 years, SD = 10.14, range: 18–61 years) participated in this study. Trained assessors performed either guided questionnaire assessments or structured interviews. In our advice- and help-seeking sample, 32.9% of individuals suffered from PTSD and 21.3% from CPTSD. After controlling for potential gender differences, we found positive associations between PTSD symptoms and trauma exposure, β = .22, as well as between DSO symptoms and postmigration living difficulties, β = .42, and lack of social support, β = .22. Our findings support the notion that it is highly important to consider differential associations among PTSD and DSO symptoms and risk and protective factors to gain a deeper understanding of the trauma-related problems refugees face.

Nadia Vossoughi, Yo Jackson, Stephanie Gusler, and Katie Stone (2018) Mental Health Outcomes for Youth Living in Refugee Camps: A Review. Trauma, Violence, & Abuse, Vol. 19(5) 528-542 DOI: 10.1177/1524838016673602

Abstract Currently, there are approximately 10.8 million child refugees worldwide. Youth living in refugee camps face a wide range of difficulties placing them at risk for trauma exposure and negative mental health outcomes. However, little is known about the mental health functioning of these youth. The present review provides a systematic review of mental health outcomes for refugee/ displaced youth residing in refugee camps. Twenty studies were included in the present review. Among these studies, the prevalence of mental health disorders varied greatly with some studies reporting null effects for disorders like posttraumatic stress disorder and others reporting prevalence as high as 87%. Levels of anxiety, somatic symptoms, depression, and aggression also varied across studies. The results point to the significant need for more research on the mental health of youth residing in refugee camps. Despite the wide range of measurement approaches, the evidence points to a fairly consistent finding of a range of maladjustment problems for youth living in refugee camps. Implications for improving the methodology for investigating mental health are discussed.