Journal of Immigrant and Minority Health

, Volume 15, Issue 5, pp 890–897 | Cite as

Effects of Post-migration Factors on PTSD Outcomes Among Immigrant Survivors of Political Violence

Original Paper

Abstract

This study examined the predictors of posttraumatic stress disorder (PTSD) in a clinical sample of 875 immigrant survivors of political violence resettled in the United States, with a specific aim of comparing the relative predictive power of pre-migration and post-migration experiences. Results from a hierarchical OLS regression indicated that pre-migration experiences such as rape/sexual assault were significantly associated with worse PTSD outcomes, as were post-migration factors such as measures of financial and legal insecurity. Post-migration variables, which included immigration status in the US, explained significantly more variance in PTSD outcomes than premigration variables alone. Discussion focused on the importance of looking at postmigration living conditions when treating trauma in this population.

Keywords

PTSD Immigrants Mental health Political violence 

References

  1. 1.
    Keyes EF. Mental health status in refugees: an integrative review of current research. Issues Ment Health Nurs. 2000;21:397–410.PubMedCrossRefGoogle Scholar
  2. 2.
    Nicholl C, Thompson A. The psychological treatment of post traumatic stress disorder (PTSD) in adult refugees: a review of the current state of psychological therapies. J Ment Health. 2004;13(4):351–62.CrossRefGoogle Scholar
  3. 3.
    Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA. 2005;294(5):602–12.PubMedCrossRefGoogle Scholar
  4. 4.
    de Jong JP, et al. Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA. 2001;286:555–62.PubMedCrossRefGoogle Scholar
  5. 5.
    Crescenzi A, et al. Effect of political imprisonment and trauma history on recent Tibetan refugees in India. J Trauma Stress. 2002;15(5):369375.CrossRefGoogle Scholar
  6. 6.
    Holtz TH. Refugee trauma versus torture trauma: a retrospective controlled cohort study of Tibetan refugees. J Nerv Ment Dis. 1998;186(1):24–34.PubMedCrossRefGoogle Scholar
  7. 7.
    Shrestha NM, et al. Impact of torture on refugees displaced within the developing world: symptomatology among Bhutanese refugees in Nepal. JAMA. 1998;280:443–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Tang SS, Fox SH. Traumatic experiences and the mental health of Senegalese refugees. J Nerv Ment Dis. 2001;189(8):507–12.PubMedCrossRefGoogle Scholar
  9. 9.
    Eisenman DP, et al. Mental health and health-related quality of life among adult Latino primary care patients living in the United States with previous exposure to political violence. JAMA. 2003;290(5):627–34.PubMedCrossRefGoogle Scholar
  10. 10.
    Fox PG, et al. Depression among immigrant Mexican women and Southeast Asian refugee women in the US. Int J Psychiatr Nurs Res. 2001;7(1):778–92.PubMedGoogle Scholar
  11. 11.
    Gerritsen AAM, et al. 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
  12. 12.
    Keller A, et al. From persecution to prison: the health consequences of detention for asylum seekers. Boston and New York City: Physicians for Human Rights and the Bellevue/NYU Program for Survivors of Torture; 2003.Google Scholar
  13. 13.
    Nicholson BL. The influence of pre-emigration and post-emigration stressors on mental health: a study of Southeast Asian refugees. Social Work Res. 1997;21(1):19–31.CrossRefGoogle Scholar
  14. 14.
    Robertson CL, et al. Somali and Oromo refugee women: trauma and associated factors. J Adv Nurs. 2006;56(6):577–87.PubMedCrossRefGoogle Scholar
  15. 15.
    Keller A, et al. Traumatic experiences and psychological distress in an urban refugee population seeking treatment services. J Nerv Ment Dis. 2006;194(3):188–94.PubMedCrossRefGoogle Scholar
  16. 16.
    Summerfield D. A critique of seven assumptions behind psychological trauma programmes in war-affected areas. Soc Sci Med. 1999;48:1449–62.PubMedCrossRefGoogle Scholar
  17. 17.
    Knipscheer JW, Kleber RJ. The relative contribution of posttraumatic and acculturative stress to subjective mental health among Bosnian refugees. J Clin Psychol. 2006;62(3):339–53.PubMedCrossRefGoogle Scholar
  18. 18.
    Hondius AJK, et al. Health problems among Latin-American and Middle-Eastern refugees in the Netherlands: relations with violence exposure and ongoing sociopsychological strain. J Trauma Stress. 2000;13(4):619–34.PubMedCrossRefGoogle Scholar
  19. 19.
    Eisenbruch M. From post-traumatic stress disorder to cultural bereavement: diagnosis of Southeast Asian refugees. Soc Sci Med. 1991;33(6):673–80.PubMedCrossRefGoogle Scholar
  20. 20.
    Knipscheer JW, Kleber RJ. Help-seeking behavior of West African migrants. J Community Psychol. 2008;36:915–28.CrossRefGoogle Scholar
  21. 21.
    Mollica RF, et al. Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in croatia. JAMA. 1999;282(5):433–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Kinzie DJ, Fleck J. Psychotherapy with severely traumatized refugees. Am J Psychother. 1987;41(1):82–95.PubMedGoogle Scholar
  23. 23.
    Mollica RF, et al. 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(2):111–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Kira IA, et al. The effects of torture: two community studies. Peace Confl. 2006;12(3):205–28.CrossRefGoogle Scholar
  25. 25.
    Jamil H, Nassar-McMillan SC, Lambert RG. Immigration and attendant psychological sequelae: a comparison of three waves of Iraqi immigrants. Am J Orthopsychiatry. 2007;77(2):199–205.PubMedCrossRefGoogle Scholar
  26. 26.
    Mollica RF, Caridad KR, Massagli MP. Longitudinal study of posttraumatic stress disorder, depression, and changes in traumatic memories over time in Bosnian refugees. J Nerv Ment Dis. 2007;195(7):572–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Amon E. The Asylum wars. The American lawyer. 2006.Google Scholar
  28. 28.
    Dueck J, Aida M. HURIDOCS standard formats: a tool for documenting human rights violations. Oslo: Human Rights Information and Documentation Systems International (HURIDOCS); 1993.Google Scholar
  29. 29.
    Hollifield M, et al. Measuring trauma and health status in refugees: a critical review. JAMA. 2002;288(5):611–21.PubMedCrossRefGoogle Scholar
  30. 30.
    Hooberman JB, et al. Classifying the torture experiences of refugees living in the United States. J Interpers Violence. 2007;22(1):108–23.PubMedCrossRefGoogle Scholar
  31. 31.
    Keller AS. Torture in Abu Ghraib. Perspect Biol Med. 2006;49(4):553–69.PubMedCrossRefGoogle Scholar
  32. 32.
    Terheggen MA, Stroebe MS, Kleber RJ. Western conceptualizations and Eastern experience: a cross-cultural study of traumatic stress reactions among Tibetan refugees in India. J Trauma Stress. 2001;14(2):391–403.PubMedCrossRefGoogle Scholar
  33. 33.
    Swiss S, Giller JE. Rape as a crime of war: a medical perspective. JAMA. 1993;270(5):612–5.PubMedCrossRefGoogle Scholar
  34. 34.
    Oosterhoff P, Zwanikken P, Ketting E. Sexual torture of men in Croatia and other conflict situations: an open secret. Reprod Health Matters. 2004;12(23):68–78.PubMedCrossRefGoogle Scholar
  35. 35.
    Carlsson J, Mortensen E, Kastrup M. Predictors of mental health and quality of life in male tortured refugees. Nord J Psychiatry. 2006;60:51–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Gagnon AJ, Tuck J, Barkun L. A systematic review of questionnaires measuring the health of resettling refugee women. Health Care Women Int. 2004;25:111–49.PubMedCrossRefGoogle Scholar
  37. 37.
    Ai AL, Peterson C, Ubelhor D. War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees. J Trauma Stress. 2002;15(2):157–60.PubMedCrossRefGoogle Scholar
  38. 38.
    Kivling-Boden G, Sundbom E. The relationship between post-traumatic symptoms and life in exile in a clinical group of refugees from the former Yugoslavia. Acta Psychiatr Scand. 2002;105:461–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Health and Nutrition Sciences, Brooklyn CollegeCity University of New YorkBrooklynUSA
  2. 2.New York University School of MedicineBellevue/NYU Program for Survivors of TortureNew YorkUSA
  3. 3.Fordham UniversityNew YorkUSA

Personalised recommendations