Advertisement

Journal of Immigrant and Minority Health

, Volume 16, Issue 6, pp 1247–1261 | Cite as

Psychological Distress in Afghan Refugees: A Mixed-Method Systematic Review

  • Qais Alemi
  • Sigrid James
  • Romalene Cruz
  • Veronica Zepeda
  • Michael Racadio
Original Paper

Abstract

Mental health problems disproportionately affect Afghan refugees and asylum seekers who continue to seek international protection with prolonged exposure to war. We performed a systematic review aimed at synthesizing peer-reviewed literature pertaining to mental health problems among Afghans resettled in industrialized nations. We used five databases to identify studies published between 1979 and 2013 that provided data on distress levels, and subjective experiences with distress. Seventeen studies met our inclusion criteria consisting of 1 mixed-method, 7 qualitative, and 9 quantitative studies. Themes from our qualitative synthesis described antecedents for distress being rooted in cultural conflicts and loss, and also described unique coping mechanisms. Quantitative findings indicated moderate to high prevalence of depressive and posttraumatic symptomatology. These findings support the need for continued mental health research with Afghans that accounts for: distress among newly resettled groups, professional help-seeking utilization patterns, and also culturally relevant strategies for mitigating distress and engaging Afghans in research.

Keywords

Afghan Depression Post-traumatic stress disorder (PTSD) Qualitative Refugee Trauma 

Notes

Acknowledgments

This manuscript was supported in part by the Sigma Xi dissertation scholarship, Loma Linda University (recipient Q. Alemi) and by NIMH K01 MH077732-01A1 (PI: S. James).

Conflict of interest

None.

References

  1. 1.
    Nyrop RF, Seekins DF. Afghanistan: a country study. Washington, DC: Foreign area studies. The American University; 1986.Google Scholar
  2. 2.
    UNHCR. Refugees, asylum seekers, returnees, internally displaced and stateless persons 2009 global trends. 2010. http://www.unhcr.org/4c11f0be9.html. Date last Accessed 12 May 2011.
  3. 3.
    Lipson JG. Afghan refugees in California: mental health issues. Issues Mental Health Nurs. 1993;14(4):411–23.CrossRefGoogle Scholar
  4. 4.
    US Census Bureau. Selected population profile in the United States. 2011. http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_11_1YR_S0201&prodType=table. Date last Accessed 3 Apr 2013.
  5. 5.
    US Census Bureau. Place of birth for the foreign-born population in the United States. 2011. http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_11_1YR_B05006&prodType=table. Date last Accessed 3 Apr 2013.
  6. 6.
    US Department of Health and Human Services (USDHHS). Office of Refugee Resettlement. Refugee arrival data. 2012. http://www.acf.hhs.gov/programs/orr/resource/refugee-arrival-data. Date last Accessed 3 Apr 2013.
  7. 7.
    UNHCR. Asylum-Seekers. 2011. http://www.unhcr.org/pages/49c3646c137.html. Date last Accessed 12 May 2011.
  8. 8.
    UNHCR. Asylum levels and trends in industrialized countries, first half. 2011. http://www.unhcr.org/4e9beaa19.html. Date last Accessed 11 Apr 2013.
  9. 9.
    Carney R, Freedland K. Psychological distress as a risk factor for stroke-related mortality. Stroke. 2002;33(1):5–6.PubMedGoogle Scholar
  10. 10.
    Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7,000 refugees resettled in western countries: a systematic review. Lancet. 2005;365(9467):1309–14.PubMedCrossRefGoogle Scholar
  11. 11.
    Lindert J, Ehrenstein OS, Priebe S, Mielck A, Brähler E. Depression and anxiety in labor migrants and refugees—a systematic review and meta-analysis. Soc Sci Med. 2009;69(2):246–57.PubMedCrossRefGoogle Scholar
  12. 12.
    Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons. JAMA. 2005;294(5):602–12.PubMedCrossRefGoogle Scholar
  13. 13.
    Keyes EF. Mental health status in refugees: an integrative review of current research. Issues Mental Health Nurs. 2000;21(4):397–410.CrossRefGoogle Scholar
  14. 14.
    World Health Organization. Section II. Mental health atlas. 2005. http://www.who.int/mental_health/evidence/atlas/profiles_countries_a_b.pdf. Date last Accessed 25 Oct 2011.
  15. 15.
    Chung R, Lin K. Help-seeking behavior among Southeast Asian refugees. J Commun Psychol. 1994;22(2):109–20.CrossRefGoogle Scholar
  16. 16.
    Furnham A, Malik RR. Cross-cultural beliefs about ‘depression’. Int J Soc Psychiatr. 1994;40(2):106–23.CrossRefGoogle Scholar
  17. 17.
    Luu TD, Leung PP, Nash SG. Help-seeking attitudes among Vietnamese Americans: the impact of acculturation, cultural barriers, and spiritual beliefs. Soc Work Ment Health. 2009;7(5):476–93.CrossRefGoogle Scholar
  18. 18.
    Organization for Economic Co-operation and Development (OECD). 2012. http://www.oecd.org/about/membersandpartners/. Date last Accessed 10 Oct 2012.
  19. 19.
    Silove D, Sinnerbrink I, Field A, Manicavasagar V, Steel Z. Anxiety, depression and PTSD in asylum-seekers: associations with pre-migration trauma and post-migration stressors. Br J Psychiatr. 1997;170:351–7.CrossRefGoogle Scholar
  20. 20.
    Wright RW, Brand RA, Dunn W, Spindler KP. How to write a systematic review. Clin Orthop Relat Res. 2007;455(1):23–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Pluye P, Gagnon M, Griffiths F, Johnson-Lafleur J. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed studies reviews. Int J Nurs Stud. 2009;46(4):529–46.PubMedCrossRefGoogle Scholar
  22. 22.
    Teddlie C, Tashakkori A. Foundations of mixed methods research: integrating quantitative and qualitative approaches in the social and behavioral sciences. Thousand Oaks: Sage Publications; 2009.Google Scholar
  23. 23.
    Critical Appraisal Skills Programme (CASP). 2010. http://www.casp-uk.net/. Date last Accessed 10 Oct 2012.
  24. 24.
    Fowkes FGR, Fulton PM. Critical appraisal of published research: introductory guidelines. Br Med J. 1991;302(6785):1136–40.CrossRefGoogle Scholar
  25. 25.
    Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Plos Clin Trials. 2009;6(7):1–6.Google Scholar
  26. 26.
    Bowles R, Mehraby N. Lost in limbo: cultural dimensions in psychotherapy and supervision with a temporary protection visa holder from Afghanistan. In: Drozbek B, Wilson JP, editors. Voices of trauma. Treating survivors across cultures. New York: Springer Science and Business Media; 2007. p. 295–320.Google Scholar
  27. 27.
    Feldmann CT, Bensing JM, Boeije HR. Afghan refugees in the Netherlands and their general practitioners; to trust or not to trust? In: Feldmann CT, editor. Refugees and general practitioners. Partners in care?. Amsterdam: Dutch University Press; 2006. p. 47–65.Google Scholar
  28. 28.
    Hafshejani A. Relationship between meaning in life and post-traumatic stress disorder among Iranians and Afghans. In: Barnes D, editor. Asylum seekers and refugees in Australia: issues of mental health and wellbeing. Sydney: Transcultural Mental Health Centre; 2003.Google Scholar
  29. 29.
    Lipson J, Omidian P. Health and the transnational connection: Afghan refugees in the United States. In: Rynearson A, Phillips J, editors. Selected Papers on Refugee Issues. Washington, DC: American Anthropological Association; 1996. p. 2–17.Google Scholar
  30. 30.
    Miller KE, Rasco LM. An ecological framework for addressing the mental health needs of refugee communities. In: Miller KE, Rasco LM, editors. The mental health of refugees: Ecological Approaches to Healing and Adaptation. Mah Wah, NJ: Lawrence Erlbaum Associates; 2004. p. 1–64.Google Scholar
  31. 31.
    Omidian PA. Qualitative measures in refugee research. The case of Afghan refugees. In: Ahearn FL, editor. Psychosocial wellness of refugees: issues in qualitative and quantitative research, studies in forced migration. Oxford: Bergahn Books; 2000. pp 41–66.Google Scholar
  32. 32.
    Omidian P. Aging and family in an Afghan refugee community. New York: Garland; 1996.Google Scholar
  33. 33.
    Omidian P, Lipson J. Elderly Afghan refugees: tradition and transition in Northern California. In: Selected papers on refugee issues. Washington, DC: American Anthropology Association; 1992. pp 27–39.Google Scholar
  34. 34.
    Renner W, Salem I, Ottomeyer K. Posttraumatic stress in asylum seekers from Chechnya, Afghanistan, and West Africa: differential findings obtained by quantitative and qualitative methods in three Austrian samples. In: Wilson J, Tang C, editors. Cross-cultural assessment of psychological trauma and PTSD. New York: Springer; 2007. p. 239–75.CrossRefGoogle Scholar
  35. 35.
    Zulfacar M. Afghan immigrants in the USA and Germany: a comparative analysis of the use of ethnic social capital. Portland: International Specialized Book Service Inc; 1999.Google Scholar
  36. 36.
    Edwards DB. Marginality and migration: cultural dimensions of the Afghan refugee problem. Int Migr Rev. 1986;20(2):313–25.PubMedCrossRefGoogle Scholar
  37. 37.
    Firling K. The Afghan refugee client. J Couns Dev. 1988;67(1):31–4.CrossRefGoogle Scholar
  38. 38.
    Gerritsen AM, Bramsen I, Devillé W, van Willigen LM, Hovens JE, Van der Ploeg HM. Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study. BMC Public Health. 2004;4(7):1–10.Google Scholar
  39. 39.
    Mehraby N. Counselling Afghanistan torture and trauma survivors. Psychother Aust. 2002;8(3):12.Google Scholar
  40. 40.
    Mehraby N. Unaccompanied child refugees: a group experience. Psychother Aust. 2002;4:30–6.Google Scholar
  41. 41.
    Lipson JG, Omidian PA. Health issues of Afghan refugees in California. West J Med. 1992;157(3):271–5.PubMedPubMedCentralGoogle Scholar
  42. 42.
    Sulaiman-Hill CR, Thompson SC. Sampling challenges in a study examining refugee resettlement. BMC Int Health Human Rights. 2011;11(2):1–10.Google Scholar
  43. 43.
    Aziz N. Cultural sensitization and clinical guidelines for mental health professionals working with Afghan immigrant/refugee women in the United States. United States International University. USA: Dissertation Abstracts International; 1999.Google Scholar
  44. 44.
    Iqbal RA. Somatization underlying depression as related to acculturation among Afghan women in the San Francisco Bay Area. San Francisco Bay: Alliant International University; 2006.Google Scholar
  45. 45.
    Omidian P. Aging and intergenerational conflict: Afghan refugee families in transition. San Francisco: University of California; 1993.Google Scholar
  46. 46.
    Smith V. The information needs of female Afghan refugees: recommendations for service providers. Hayward, CA: Department of Communication, California State University, East Bay; 2009.Google Scholar
  47. 47.
    Welsh EA. After every darkness is light: the experiences of Afghan women coping with violence and immigration. Baltimore County: University of Maryland; 2010.Google Scholar
  48. 48.
    Yusuf M. The potential for transformation in second generation Afghan women through graduate education. USA: Dissertation Abstracts International; 2008.Google Scholar
  49. 49.
    Cherry L, Redmond S. A social marketing approach to involving Afghans in community-level alcohol problem prevention. J Prim Prev. 1994;14(4):289–310.PubMedCrossRefGoogle Scholar
  50. 50.
    Dossa P. Creating politicized spaces: Afghan immigrant women’s stories of migration and displacement. Affilia. 2008;23(1):10–21.CrossRefGoogle Scholar
  51. 51.
    Kanji Z, Drummond J, Cameron B. Resilience in Afghan children and their families: a review. Paediatr Nurs. 2007;19(2):30–3.PubMedGoogle Scholar
  52. 52.
    Khanlou N, Koh JG, Mill C. Cultural identity and experiences of prejudice and discrimination of Afghan and Iranian immigrant youth. Int J Ment Health Addict. 2008;6(4):494–513.CrossRefGoogle Scholar
  53. 53.
    Perry CM, Shams M, DeLeon CC. Voices from the Afghan community. J Cult Divers. 1998;5(4):127–31.PubMedGoogle Scholar
  54. 54.
    Sadat M. Hyphenating Afghaniyat (Afghan-ness) in the Afghan diaspora. J Muslim Minor Aff. 2008;28(3):329–42.CrossRefGoogle Scholar
  55. 55.
    Smith VJ. Ethical and effective ethnographic research methods: a case study with Afghan refugees in California. J Empir Res Human Res Ethics. 2009;4(3):59–72.CrossRefGoogle Scholar
  56. 56.
    Stack JC, Iwasaki Y. The role of leisure pursuits in adaptation processes among Afghan refugees who have immigrated to Winnipeg, Canada. Leis Stud. 2009;28(3):239–59.CrossRefGoogle Scholar
  57. 57.
    Taherpoor F, Zamani R, Mohseni N. Comparative study of individual, cognitive, and motivational bases of prejudice towards Afghan immigrants. Psychol Res. 2006;8(3–4):9–29.Google Scholar
  58. 58.
    Gerritsen AM, Bramsen II, Devillé WW, van Willigen L, Hovens JE, Ploeg H. Use of health care services by Afghan, Iranian, and Somali refugees and asylum seekers living in The Netherlands. Eur J Public Health. 2006;16(4):394–9.PubMedCrossRefGoogle Scholar
  59. 59.
    Ichikawa M, Nakahara S, Wakai S. Cross-cultural use of the predetermined scale cutoff points in refugee mental health research. Soc Psychiatry Psychiatr Epidemiol. 2006;41(3):248–50.PubMedCrossRefGoogle Scholar
  60. 60.
    Manneschmidt S, Griese K. Evaluating psychosocial group counseling with Afghan women: is this a useful intervention? Torture. 2009;19(1):41–50.PubMedGoogle Scholar
  61. 61.
    Miles M. Afghan children and mental retardation: information, advocacy and prospects. Disabil Rehabil. 1997;19(11):496–500.PubMedCrossRefGoogle Scholar
  62. 62.
    Osman M, Hornblow A, Macleod S, Coope P. Christchurch earthquakes: how did former refugees cope? N Z Med J. 2012;125(1357):113–21.PubMedGoogle Scholar
  63. 63.
    Bhatia R, Wallace P. Experiences of refugees and asylum seekers in general practice: a qualitative study. BMC Fam Pract. 2007;8(48):81–9.Google Scholar
  64. 64.
    Casimiro S, Hancock P, Northcote J. Isolation and insecurity: resettlement issues among Muslim refugee women in Perth, Western Australia. Aust J Soc Issues. 2007;42(1):55–69.Google Scholar
  65. 65.
    Feldmann CT, Bensing JM, de Ruijter A, Boeije HR. Afghan refugees and their general practitioners in the Netherlands: to trust or not to trust? Sociol Health Illn. 2007;29(4):515–35.PubMedCrossRefGoogle Scholar
  66. 66.
    Kanji Z, Cameron BL. Exploring the experiences of resilience in Muslim Afghan refugee children. J Muslim Ment Health. 2010;5:22–40.CrossRefGoogle Scholar
  67. 67.
    Lindgren T, Lipson JG. Finding a way: Afghan women’s experience in community participation. J Transcult Nurs. 2004;15(2):122–30.PubMedCrossRefGoogle Scholar
  68. 68.
    Lipson JG, Miller S. Changing roles of Afghan refugee women in the United States. Health Care Women Int. 1994;15(3):171–80.PubMedCrossRefGoogle Scholar
  69. 69.
    Lipson JG, Hosseini T, Kabir S, Omidian PA, Edmonston F. Health issues among Afghan women in California. Health Care Women Int. 1995;6(4):279–86.CrossRefGoogle Scholar
  70. 70.
    Neale A, Abu-Duhou J, Black J, Biggs B. Health services: knowledge, use and satisfaction of Afghan, Iranian and Iraqi settlers in Australia. Divers Health Soc Care. 2007;4(4):267–76.Google Scholar
  71. 71.
    Sulaiman-Hill CR, Thompson SC. Learning to fit in: an exploratory study of general perceived self efficacy in selected refugee groups. J Immigr Minor Health. 2013;15(1):125–31.Google Scholar
  72. 72.
    Masmas TN, Møller E, Buhmann C, Bunch V, Jensen JH, Hansen TN, Jørgensen LM, Kjær C, Mannstaedt M, Oxholm A, Skau J, Theilade L, Worm L, Ekstrøm M. Asylum seekers in Denmark—a study of health status and grade of traumatization of newly arrived asylum seekers. Torture. 2008;18(2):77–86.PubMedGoogle Scholar
  73. 73.
    McCaw BR, DeLay P. Demographics and disease prevalence of two new refugee groups in San Francisco. The Ethiopian and Afghan refugees. West J Med. 1985;143(2):271–5.PubMedPubMedCentralGoogle Scholar
  74. 74.
    Miremadi S, Ganesan S, McKenna M. Pilot study of the prevalence of alcohol, substance use and mental disorders in a cohort of Iraqi, Afghani, and Iranian refugees in Vancouver. Asia-Pac Psychiatr. 2011;3(3):137–44.CrossRefGoogle Scholar
  75. 75.
    Renner W. The effectiveness of psychotherapy with refugees and asylum seekers: preliminary results from an Austrian study. J Immigr Minor Health. 2009;11(1):41–5.PubMedCrossRefGoogle Scholar
  76. 76.
    Renner W, Salem I. Post-traumatic stress in asylum seekers and refugees from Chechnya, Afghanistan, and West Africa: gender differences in symptomatology and coping. Int J Soc Psychiatr. 2009;55(2):99–108.CrossRefGoogle Scholar
  77. 77.
    Renner W, Laireiter AR, Maier MJ. Social support from sponsorships as a moderator of acculturative stress: predictors of effects on refugees and asylum seekers. Soc Behav Pers. 2012;40(1):129–46.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Renner W, Salem I, Ottomeyer K. Cross-cultural validation of measures of traumatic symptoms in groups of asylum seekers from Chechnya, Afghanistan, and West Africa. Soc Behav Pers. 2006;34(9):1101–14.CrossRefGoogle Scholar
  79. 79.
    Steel Z, Momartin S, Silove D, Coello M, Aroche J, Tay K. Two year psychosocial and mental health outcomes for refugees subjected to restrictive or supportive immigration policies. Soc Sci Med. 2011;72(7):1149–56.PubMedCrossRefGoogle Scholar
  80. 80.
    Sulaiman-Hill CR, Thompson SC. Afghan and Kurdish refugees, 8–20 years after resettlement, still experience psychological distress and challenges to well being. Aust NZ J Public Health. 2012;36(2):126–34.CrossRefGoogle Scholar
  81. 81.
    Sulaiman-Hill CR, Thompson SC. Thinking too much—psychological distress, sources of stress and coping strategies of resettled Afghan and Kurdish refugees. J Muslim Ment Health. 2011;6(2):63–86.Google Scholar
  82. 82.
    de Anstiss H, Ziaian T. Mental health help-seeking and refugee adolescents: qualitative findings from a mixed-methods investigation. Aust Psychol. 2010;45(1):29–37.CrossRefGoogle Scholar
  83. 83.
    Feldmann CT, Bensing J, Ruijter A. Worries are the mother of many diseases: general practitioners and refugees in the Netherlands on stress, being ill and prejudice. Patient Educ Couns. 2007;65(3):369–80.PubMedCrossRefGoogle Scholar
  84. 84.
    Lipson JG. Afghan refugee health: some findings and suggestions. Qual Health Res. 1991;1(3):349–69.CrossRefGoogle Scholar
  85. 85.
    Lipson J, Omidian PA. Afghan refugee issues in the US social environment. West J Nurs Res. 1997;19(1):110–9.PubMedCrossRefGoogle Scholar
  86. 86.
    Morioka-Douglas N, Sacks T, Yeo G. Issues in caring for Afghan American elders: insights from literature and a focus group. J Cross-Cult Gerontol. 2004;2004(19):27–40.CrossRefGoogle Scholar
  87. 87.
    Omeri A, Lennings C, Raymond L. Beyond asylum: implications for nursing and health care delivery for Afghan refugees in Australia. J Transcult Nurs. 2006;17(1):30–9.PubMedCrossRefGoogle Scholar
  88. 88.
    Omeri A, Lennings C, Raymond L. Hardiness and transformational coping in asylum seekers: the Afghan experience. Divers Health Soc Care. 2004;1:21–30.Google Scholar
  89. 89.
    Welsh EA, Brodsky AE. After every darkness is light: resilient Afghan women coping with violence and immigration. Asian Am J Psychol. 2010;1(3):163–74.CrossRefGoogle Scholar
  90. 90.
    Bronstein I, Montgomery P. Sleeping patterns of Afghan unaccompanied asylum-seeking adolescents: a large observational study. PLoS ONE. 2013;8(2):e56156.PubMedPubMedCentralCrossRefGoogle Scholar
  91. 91.
    Bronstein I, Montgomery P, Dobrowolski S. PTSD in asylum-seeking male adolescents from Afghanistan. J Trauma Stress. 2012;25(5):551–7.PubMedCrossRefGoogle Scholar
  92. 92.
    Gernaat HB, Malwand AD, Laban CJ, Komproe I, de Jong JT. Many psychiatric disorders in Afghan refugees with residential status in Drenthe, especially depressive disorder and post-traumatic disorder. Nederlands Tijdschr Geneeskd. 2002;146(24):127–31.Google Scholar
  93. 93.
    Gerritsen A, Bramsen I, Devillé W, van Willigen L, Hovens J, Ploeg H. Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2006;41(1):18–26.PubMedCrossRefGoogle Scholar
  94. 94.
    Haasen C, Sinaa M, Reimer J. Alcohol use disorders among Afghan migrants in Germany. Subst Abus. 2008;29(3):65–70.PubMedCrossRefGoogle Scholar
  95. 95.
    Ichikawa M, Nakahara S, Wakai S. Effect of post-migration detention on mental health among Afghan asylum seekers in Japan. Aust NZ J Psychiatr. 2006;40(4):341–6.CrossRefGoogle Scholar
  96. 96.
    Lipson J, Omidian P, Paul S. Afghan health education project: a community survey. Public Health Nurs. 1995;12(3):143–50.PubMedCrossRefGoogle Scholar
  97. 97.
    Malekzai A, Niazi JM, Paige SR, Hendricks SE, Fitzpatrick D, Leuschen M, Millimet C. Modification of CAPS-1 for diagnosis of PTSD in Afghan refugees. J Trauma Stress. 1996;9(4):891–8.PubMedCrossRefGoogle Scholar
  98. 98.
    Mghir R, Raskin A. The psychological effects of the war in Afghanistan on young Afghan refugees from different ethnic backgrounds. Int J Soc Psychiatr. 1999;45(1):29–40.CrossRefGoogle Scholar
  99. 99.
    Mghir R, Freed W, Raskin A, Katon W. Depression and posttraumatic stress disorder among a community sample of adolescent and young adult Afghan refugees. J Nerv Ment Dis. 1995;183:24–30.PubMedCrossRefGoogle Scholar
  100. 100.
    Seglem KB, Oppedal B, Raeder S. Predictors of depressive symptoms among resettled unaccompanied minors. Scand J Psychol. 2011;52:457–64.PubMedCrossRefGoogle Scholar
  101. 101.
    Sulaiman-Hill CR, Thompson SC. Selecting instruments for assessing psychological wellbeing in Afghan and Kurdish refugee groups. BMC Res Notes. 2010;3(237):1–9.Google Scholar
  102. 102.
    Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J. The Harvard Trauma Questionnaire: validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992;180:111–6.PubMedCrossRefGoogle Scholar
  103. 103.
    Mollica RF, Wyshak G, de-Marnaffe D, Khuon F, Lavelle J. Indochinese versions Hopkins Symptom Checklist-25: a screening instrument for the psychiatric care of refugees. Am J Psychiatr. 1987;144:497–500.PubMedGoogle Scholar
  104. 104.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–71.PubMedCrossRefGoogle Scholar
  105. 105.
    Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.CrossRefGoogle Scholar
  106. 106.
    Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-I disorders in the National Comorbidity Survey Replication (NCS-R). Arch Gen Psychiatry. 2005;62(6):617–27.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.
    Marsden J, Gossop M, Stewart D, Best D, Farrell M, Lehmann P, Edwards C, Strang J. The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome. Addiction. 1998;93:1857–67.PubMedCrossRefGoogle Scholar
  108. 108.
    Bean T, Eurelings-Bontekoe E, Derluyn I, Spinhoven P. Stressful life events (SLE): user’s manual. Oegstgeest, The Netherlands: Centrum’45.Google Scholar
  109. 109.
    Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P. Validation of the multiple language versions of the reactions of adolescents to traumatic stress questionnaire (RATS). J Trauma Stress. 2006;19:241–55.PubMedCrossRefGoogle Scholar
  110. 110.
    Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Klauminzer G, Charney DS, Keane TM. A clinician rating scale for assessing current and lifetime PTSD: the CAPS-1. Behav Ther. 1990;13:187–8.Google Scholar
  111. 111.
    Composite International Diagnostic Interview (CIDI) (Version 2.1). Geneva: World Health Organization; 1997.Google Scholar
  112. 112.
    Spitzer RL, Williams JBW, Gibbons M, First MB. Structure clinical interview for DSM-III-R (SCID). New York: New York State Psychiatric Institute, Biometrics Research; 1998.Google Scholar
  113. 113.
    Oberg K. Culture shock: adjustment to new cultural environments. Pract Anthropol. 1960;7(4):177–82.Google Scholar
  114. 114.
    Bhugra D, Ayonrinde O. Depression in immigrants and ethnic minorities. In: Bhattacharya R, Cross S, Bhugra D, editors. Clinical topics in cultural psychiatry. London: Royal College of Psychiatrists; 2010. p. 119–27.Google Scholar
  115. 115.
    Uba LL. Cultural barriers to health care for Southeast Asian refugees. Public Health Rep. 1992;107(5):544–8.PubMedPubMedCentralGoogle Scholar
  116. 116.
    Kleinman A. Culture and depression. NEJM. 2004;351(10):951–3.PubMedCrossRefGoogle Scholar
  117. 117.
    Miller KE. Rethinking a familiar model: psychotherapy and the mental health of refugees. J Contemp Psychother. 1999;29(4):283–306.CrossRefGoogle Scholar
  118. 118.
    Heller K. Prevention activities for older adults: social structures and personal competencies that maintain useful social roles. J Couns Dev. 1993;72(2):124–30.CrossRefGoogle Scholar
  119. 119.
    Bhugra D, Becker MA. Migration, cultural bereavement and cultural identity. World Psychiatr. 2005;5(1):18–24.Google Scholar
  120. 120.
    Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kesler J, Westermeyer J. Measuring trauma and health status in refugees: a critical review. J Am Med Assoc. 2002;288(5):611–21.Google Scholar
  121. 121.
    Deyo RA, Diehl AK, Hazuda H, Stern MP. A simple language-based acculturation scale for Mexican Americans: validation and application to health care research. Am J Public Health. 1985;75(1):51–5.PubMedPubMedCentralCrossRefGoogle Scholar
  122. 122.
    Fix M, Passel J. The scope and impact of welfare reform’s immigrant provisions. Discussion papers. Assessing the new federalism. Washington, DC: The Urban Institute; 2002.Google Scholar
  123. 123.
    Sawhill IV. Welfare reform: an analysis of the issues. 2009. The Urban Institute. http://www.urban.org/publications/306620.html. Accessed 16 Oct 2012.
  124. 124.
    Keigher SM. America’s most cruel xenophobia. Health Soc Work. 1997;22(3):232–7.PubMedCrossRefGoogle Scholar
  125. 125.
    Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Q. 2005;83(4):1–28.CrossRefGoogle Scholar
  126. 126.
    Birman DD, Tran NN. Psychological distress and adjustment of Vietnamese refugees in the United States: association with pre- and post-migration factors. Am J Orthopsychiatr. 2008;78(1):109–20.CrossRefGoogle Scholar
  127. 127.
    Miller KE. Beyond the frontstage: trust, access, and the relational context in research with refugee communities. Am J Commun Psychol. 2004;33(3/4):217–28.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Qais Alemi
    • 1
    • 2
  • Sigrid James
    • 1
  • Romalene Cruz
    • 1
  • Veronica Zepeda
    • 1
  • Michael Racadio
    • 1
  1. 1.Department of Social Work and Social Ecology, School of Behavioral HealthLoma Linda UniversityLoma LindaUSA
  2. 2.San BernardinoUSA

Personalised recommendations