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Psychological sequelae of torture and organised violence suffered by refugees from Iraq

Trauma-related factors compared with social factors in exile

Published online by Cambridge University Press:  03 January 2018

Caroline Gorst-Unsworth  and
Eva Goldenberg
Caroline Gorst-Unsworth*
Affiliation:
Department of Psychiatry, Greenwich District Hospital, Vanbrugh Hill, London
Eva Goldenberg
Affiliation:
Medical Foundation for the Care of Victims of Torture, London
*
Dr C. Gorst-Unsworth, GB2 ward, Greenwich District Hospital, Vanbrugh Hill, London SE10 9HE
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Abstract

Background

Refugees who have suffered traumatic events present complex therapeutic challenges to health professionals. There is little research into post-exile factors that may be amenable to change, and therefore reduce morbidity. We examined the importance of social factors in exile and of trauma factors in producing the different elements of psychological sequelae of severe trauma.

Method

Eighty-four male Iraqi refugees were interviewed. Adverse events and level of social support were measured. Various measures of psychological morbidity were applied, all of which have been used in previous trauma research.

Results

Social factors in exile, particularly the level of ‘affective’ social support, proved important in determining the severity of both post-traumatic stress disorder and depressive reactions, particularly when combined with a severe level of trauma/torture. Poor social support is a stronger predictor of depressive morbidity than trauma factors.

Conclusions

Some of the most important factors in producing psychological morbidity in refugees may be alleviated by planned, integrated rehabilitation programmes and attention to social support and family reunion.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 1 , January 1998 , pp. 90 - 94
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM – III – R). Washington, DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical manual of Mental Disorders (4th edn) (DSM – IV). Washington, DC: APA.Google Scholar
Basoglu, M., Paker, M., Ozmen, E., et al (1994) Psychological effects of torture: comparison of tortured and non-tortured political activists in Turkey. American Journal of Psychiatry, 151, 76–81.Google Scholar
Boscarino, J. A. (1995) Post traumatic stress and associated disorders among Vietnam veterans: the significance of combat exposure and social support. Journal of Traumatic Stress, 8, 317–336.Google Scholar
Broadhead, W. E., Gehlbach, S. H., DeGruy, F. V., et al (1988) The Duke–UNC Functional Social Support Questionnaire. Medical Care, 26, 709–723.Google Scholar
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression: A Study of Psychiatric Disorders in Women. London: Tavistock.Google Scholar
Dalgard, O. S., Bjork, S. & Tambs, K. (1995) Social support, negative life events and mental health. British Journal of Psychiatry, 166, 29–34.Google Scholar
Donald, C. A., Ware, J. E., Brook, R. H., et al (1978) Conceptualisation and Measurement of Health for Adults in the Health Insurance Study. Vol. IV: Social Health. Santa Monica, CA: Rand.Google Scholar
Easton, J. A. & Turner, S. W. (1991) Detention of British citizens as hostages in the Gulf – health, psychological and family consequences. British Medical Journal, 303, 1231–1234.CrossRefGoogle ScholarPubMed
Gorst-Unsworth, C., Van Valsen, C. & Turner, S. W. (1993) Prospective pilot study of survivors of torture and organised violence: Examining the existential dilemma. Journal of Nervous and Mental Disease, 181, 263–264.CrossRefGoogle ScholarPubMed
Green, B. L. (1994) Psychosocial research in traumatic stress: An update. Journal of Traumatic Stress, 7, 341–363.CrossRefGoogle ScholarPubMed
Hauff, E. & Vaglum, P. (1995) Organised violence and the stress of exile. Predictors of mental health in a community cohort of Vietnamese refugees three years after resettlement. British Journal of Psychiatry, 166, 360–367.CrossRefGoogle Scholar
Hume, F. & Summerfield, D. (1994) After the war in Nicaragua: A psychological study of war wounded and ex-combatants. Medicine and War, 10, 4–24.CrossRefGoogle ScholarPubMed
Kulka, R. A., Schlenger, W. E., Fairbank, J. A., et al (1990) Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel.Google Scholar
Mollica, R. F., Wyshak, G. & Lavelle, J. (1987) The psychosocial impact of war trauma and torture on South East Asian refugees. American Journal of Psychiatry, 144, 1567–1572.Google Scholar
Mollica, R. F., Capsi-Yavin, Y., Bollini, P., et al (1992) The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma and PTSD in Indochinese refugees. Journal of Nervous and Mental Diseases, 180, 111–116.Google Scholar
Paykel, E. S., Rao, B. M. & Taylor, C. N. (1984) Life stress and symptom pattern in out-patient depression. Psychological Medicine, 14, 559–568.Google Scholar
Ramsay, R., Gorst-Unsworth, C. & Turner, S. (1993) Psychiatric morbidity in survivors of organised state violence, including torture. A retrospective series. British Journal of Psychiatry, 162, 55–59.CrossRefGoogle ScholarPubMed
Rosser, R., Dewar, S. & Thompson, J. (1991) Psychiatric aspects of disaster. Journal of the Royal Society of Medicine, 84, 4–8.CrossRefGoogle Scholar
SPSS Inc. (1988) Statistical Package for the Social Sciences. SPSS/PC + V2.0. Chicago, IL: SPSS Inc.Google Scholar
Turner, S. & Gorst-Unsworth, C. (1990) Psychological sequelae of torture. A descriptive model. British Journal of Psychiatry, 157, 475–480.Google Scholar
Van Velsen, C., Gorst-Unsworth, C. & Turner, S. W. (1996) Survivors of torture and organised violence: Demography and diagnosis. Journal of Traumatic Stress, 9, 181–193.CrossRefGoogle ScholarPubMed
Weisaeth, L. (1989) The stressors and the post-traumatic stress syndrome after an industrial disaster. Acta Psychiatrica Scandinavica, 80, 25–37.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Categor Program. Cambridge: Cambridge University Press.Google Scholar
Yehuda, R. & McFarlane, A. C. (1995) Conflict between current knowledge about post-traumatic stress disorder and its original conceptual basis. American Journal of Psychiatry, 152, 1705–1713.Google ScholarPubMed
World Health Organization (1975) Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
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