Uncertainty persists about the impact of trauma on the long-term mental health of resettled refugees. The present study aimed to assess the contributions of trauma and PTSD to overall mental disorder and related need for services amongst Vietnamese refugees resettled for over a decade in Australia. The data were compared with a survey of the host population.
The study involved a probabilistic sample of Vietnamese refugees (n = 1,161) resettled in Australia for 11 years. The Australian-born sample (n = 7,961) was drawn from a national survey using the same diagnostic measure, the Composite International Diagnostic Interview (CIDI).
The PTSD prevalence for both groups was 3.5% and the diagnosis was present in 50% of Vietnamese and 19% of Australians with any mental disorder(s). Trauma made the largest contribution to mental disorder in the Vietnamese (odds ratio >8), whereas amongst Australians, younger age (odds ratio >3) and trauma (odds ratio >4) each played a role. PTSD was equally disabling in both populations but Vietnamese with the disorder reported more physical, and Australians more mental disability. Approximately one in three Australians and one in 10 Vietnamese with PTSD sought help from mental health professionals.
Trauma and PTSD continue to affect the mental health of Vietnamese refugees even after a decade of resettlement in Australia. The tendency of Vietnamese with PTSD to report symptoms of physical disability may create obstacles to their obtaining appropriate mental health care.
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Andrews G, Peters L (1998) The psychometric properties of the Composite International Diagnostic Interview. Soc Psychiatry Psychiatr Epidemiol 33:80–88
Beiser M, Hou F (2001) Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10-year study. Soc Sci Med 53:1321–1334
Bracken BA, Barona A (1991) State of the art procedures for translating, validating and using psychoeducational tests in cross-cultural assessment. School Psychol Int 12:119–132
Carlson E, Rosser-Hogan R (1991) Trauma experiences, posttraumatic stress, dissociation, and depression in Cambodian refugees. Am J Psychiatry 148:1548–1551
Creamer M, Burgess P, McFarlane AC (2001) Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-being. Psychol Med 31:1237–1247
Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365:1309–1314
Fenta H, Hyman I, Noh S (2006) Mental health service utilization by Ethiopian immigrants and refugees in Toronto. J Nerv Ment Dis 194:925–934
Gandek B, Ware JE, Aaronson NK, Giovanni A, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M (1998) Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. J Clin Epidemiol 51:1171–1178
Gong-Guy E (1987) California Southeast Asian mental health needs assessment study. California State Department of Mental Health, Oakland, California
Hauff E, Vaglum P (1994) Chronic posttraumatic stress disorder in Vietnamese refugees. A prospective community study of prevalence, course, psychopathology, and stressors. J Nerv Ment Dis 182:85–90
Henderson S, Andrews G, Hall W (2000) Australia’s mental health: an overview of the general population survey. Aust N Z J Psychiatry 34:197–205
Henningsen P, Jakobsen T, Schiltenwolf M, Weiss MG (2005) Somatization revisited: diagnosis and perceived causes of common mental disorders. J Nerv Ment Dis 193:85–92
Hinton WL, Chen YC, Du N, Tran CG, Lu FG, Miranda J, Faust S (1993) DSM-III-R disorders in Vietnamese refugees. Prevalence and correlates. J Nerv Ment Dis 181:113–122
Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kesler J, Stevenson J, Westermeyer J (2002) Measuring trauma and health status in refugees: a critical review. JAMA 288:611–621
Horowitz MJ (1993) Stress-response syndromes a review of posttraumatic stress and adjustment disorders. In: Wilson JP, Raphael B (eds) International handbook of traumatic stress syndromes. Plenum Press, New York, pp 49–60
Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley & Sons, New York
Kessler RC, Chiu WT, Demler O, Walters EE (2005) Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:617–627
Kroll J (2003) Posttraumatic symptoms and the complexity of responses to trauma. JAMA 290:667–670
Kroll J, Habenicht M, Mackenzie T, Yang M, Chan S, Vang T, Nguyen T, Ly M, Phommasouvanh B, Nguyen H, et al. (1989) Depression and posttraumatic stress disorder in Southeast Asian refugees. Am J Psychiatry 146:1592–1597
Levy PS, Lemeshow S (2003) Sampling of populations: methods and applications. John Wiley & Sons Inc., New York
Marshall GN, Schell TL, Elliott MN, Berthold SM, Chun CA (2005) Mental Health of Cambodian refugees 2 decades after resettlement in the United States. JAMA 294:571–579
Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J (1992) The Harvard Trauma Questionnaire: validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis 180:111–116
Mollica RF, Donelan K, Tor S, Lavelle J, Elias C, Frankel M, Blendon RJ (1993) The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps. JAMA 270:581–586
Mollica RF, McInnes K, Pham T, Smith Fawzi MC, Murphy E, Lin L (1998) The dose-effect relationships between torture and psychiatric symptoms in Vietnamese ex-political detainees and a comparison group. J Nerv Ment Dis 186:543–553
Mollica RF, McInnes K, Poole C, Tor S (1998) Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. Brit J Psychiatry 173:482–488
Mollica RF, McInnes K, Sarajlic N, Lavelle J, Sarajlic I, Massagli MP (1999) Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. JAMA 282:433–439
Mollica RF, Wyshak G, Lavelle J (1987) The psychosocial impact of war trauma and torture on Southeast Asian refugees. Am J Psychiatry 144:1567–1572
Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294:602–612
Robinson WC (1998) Terms of refuge: the Indochinese Exodus and the International response. Zed Books, London
Sanderson K, Andrews G (2003) Prevalence and severity of mental health-related disability and relationship to diagnosis. Psychiatr Serv 53:80–86
Schweitzer R, Melville F, Steel Z, Lacherez P (2006) Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry 40:179–187
Silove D (1999) The psychosocial effects of torture, mass human rights violations, and refugee trauma: toward an integrated conceptual framework. J Nerv Ment Dis 187:200–207
Silove D, Ekblad S (2002) How well do refugees adapt after resettlement in Western countries? Acta Psychiatr Scand 106:401–402
Silove D, Manicavasagar V, Coello M, Aroche J (2005) PTSD, depression and acculturation. Intervention 3:46–50
Silove D, Sinnerbrink I, Field A, Manicavasagar V, Steel Z (1997) Anxiety, depression and PTSD in asylum seekers: associations with pre-migration trauma and post-migration stressors. Brit J Psychiatry 170:351–357
Steel Z, Silove D, Chey T, Bauman A, Phan T, Phan T (2005) Mental disorders, disability and health service use amongst Vietnamese refugees and the host Australian population. Acta Psychiatr Scand 111:300–309
Steel Z, Silove D, Phan T, Bauman A (2002) Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet 360:1056–1062
Summerfield D (2002) Effects of war: moral knowledge, revenge, reconciliation, and medicalised concepts of “recovery”. Brit Med J 325:1105–1107
Turner SW, Bowie C, Dunn G, Shapo L, Yule W (2003) Mental health of Kosovan Albanian refugees in the UK. Brit J Psychiatry 182:444–448
Van Ommeren M, Sharma B., Sharma GK, Komproe I, Cardena E, de Jong JT (2002) The relationship between somatic and PTSD symptoms among Bhutanese refugee torture survivors: examination of comorbidity with anxiety and depression. J Trauma Stress 15:415–421
Wagner R, Manicavasagar V, Silove D, Marnane C, Tran VT (2006) Characteristics of Vietnamese patients attending an anxiety clinic in Australia and perceptions of the wider Vietnamese community about anxiety. Transcult Psychiatry 43:259–274
Westermeyer J, Neider J, Callies A (1989) Psychosocial adjustment of Hmong refugees during their first decade in the United States: a longitudinal study. J Nerv Ment Dis 177:132–139
This study was supported by the National Health and Medical Research Council of Australia, grant numbers 980067 and 300403.
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Silove, D., Steel, Z., Bauman, A. et al. Trauma, PTSD and the longer-term mental health burden amongst Vietnamese refugees. Soc Psychiat Epidemiol 42, 467–476 (2007). https://doi.org/10.1007/s00127-007-0194-z
- mental disorders