Asunto(s)
Refugiados/psicología , Rehabilitación/historia , Rehabilitación/métodos , Trastornos por Estrés Postraumático/historia , Trastornos por Estrés Postraumático/rehabilitación , Tortura/psicología , Adaptación Psicológica , Historia del Siglo XX , Humanos , Refugiados/historia , Rehabilitación/psicología , Rehabilitación/normas , Tortura/historiaRESUMEN
OBJECTIVE: This study assessed whether a simple, readily implemented four-symptom somatic screen would be able to effectively identify current posttraumatic stress symptoms in victimized populations. METHODS: The sample consisted of 622 Somali community-dwelling refugees who fled widespread violence and trauma occurring in East Africa during 1990-1992. Data were collected during 2000-2003 and included demographic characteristics, number of types of torture and nontorture trauma experienced earlier in Africa, and current self-rated posttraumatic stress symptoms, as measured by the Posttraumatic Stress Disorder Checklist (PCL). The sample was also assessed with the HADStress screen, which was developed for this study, to determine whether the screen was effective in detecting current posttraumatic stress symptoms. The HADStress screen assessed for the presence of four somatic symptoms: Headaches, Appetite change, Dizziness, and Sleep problems. All items were given equal weight. Possible scores on the screen range from 0 to 4, with higher scores indicating more somatic symptoms. RESULTS: Univariate analysis showed that persons who experienced more types of trauma (both torture and nontorture trauma) and persons who had higher PCL scores (indicating more current posttraumatic stress symptoms) had significantly higher HADStress scores. Negative binomial regression analysis showed that PCL scores were the most effective variable in predicting HADStress scores. On the Tukey-B post hoc analysis, a HADStress score of 0 or 1 was associated with a mean PCL score of less than 30, a score of 2 was associated with a mean PCL score of 40.28, and a score of 4 was associated with a mean PCL score of 51.07 (suggesting that over 50% of this group would have active posttraumatic stress disorder). CONCLUSIONS: A score of 2 or higher on the HADStress scale among refugees warrants additional evaluation for posttraumatic stress symptoms in clinical settings. For communitywide efforts at early recognition and treatment, a cutoff score of 4 may be more practical and cost-effective.
Asunto(s)
Refugiados/psicología , Trastornos Somatomorfos/psicología , Trastornos por Estrés Postraumático/diagnóstico , Adulto , Análisis de Varianza , Distribución de Chi-Cuadrado , Femenino , Indicadores de Salud , Humanos , Masculino , Minnesota/epidemiología , Distribución de Poisson , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Somalia/etnología , Trastornos Somatomorfos/diagnóstico , Trastornos Somatomorfos/epidemiología , Trastornos por Estrés Postraumático/psicología , Tortura/psicologíaRESUMEN
PURPOSE: To describe war-related trauma history, immigration factors, problems, and coping of Somali and Oromo refugee youth. METHODS: Analysis of a subset of participants (N = 338) aged 18-25 years from a population-based survey of Somali and Oromo refugees conducted in 2000-2002. Data included trauma history, life situation, and scales for physical (Cronbach alpha =.69), psychological (alpha =.56), and social problems (alpha =.69). Data were analyzed using Chi-square and Mann-Whitney U tests. RESULTS: Average emigration age was 14.8 years, with 4.2 years in transit and 2.0 years in the United States; 60% reported plans to return home to live. Two-thirds (66%) had less than a high school education, 49% had English language problems, 49% were employed (38% female vs. 57% male); 70% were single, with Somali females more likely than Oromo to be partnered and mothers (39% vs. 19%). There were significant ethnicity/gender differences for all problem scales. More females reported feeling alone (24% vs. 61%, p <.001). Youth with symptoms of posttraumatic stress syndrome reported more traumatic events (mean number of events: 28 vs.16). Trauma history was strongly associated with physical, psychological, and social problems. Most frequent strategies to combat sadness were praying (55.3%), sleeping (39.9%), reading (32.3%), and talking to friends (27.8%). CONCLUSIONS: Many young Somali and Oromo immigrants to the United States experience life problems associated with war trauma and torture, but many others are coping well. The findings suggest a need to develop age-appropriate strategies to promote the health of refugee youth to facilitate their successful adaptation to adult life in the United States.
Asunto(s)
Adaptación Psicológica , Emigración e Inmigración , Acontecimientos que Cambian la Vida , Refugiados/psicología , Trastornos por Estrés Postraumático/etnología , Adolescente , Adulto , Análisis de Varianza , Comparación Transcultural , Estudios Transversales , Emigración e Inmigración/estadística & datos numéricos , Etiopía/etnología , Femenino , Humanos , Masculino , Minnesota/epidemiología , Refugiados/estadística & datos numéricos , Factores de Riesgo , Distribución por Sexo , Factores Socioeconómicos , Somalia/etnología , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/psicología , Tortura/psicología , GuerraRESUMEN
OBJECTIVES: This cross-sectional, community-based, epidemiological study characterized Somali and Ethiopian (Oromo) refugees in Minnesota to determine torture prevalence and associated problems. METHODS: A comprehensive questionnaire was developed, then administered by trained ethnic interviewers to a nonprobability sample of 1134. Measures assessed torture techniques; traumatic events; and social, physical, and psychological problems, including posttraumatic stress symptoms. RESULTS: Torture prevalence ranged from 25% to 69% by ethnicity and gender, higher than usually reported. Unexpectedly, women were tortured as often as men. Torture survivors had more health problems, including posttraumatic stress. CONCLUSIONS: This study highlights the need to recognize torture in African refugees, especially women, identify indicators of posttraumatic stress in torture survivors, and provide additional resources to care for tortured refugees.