Journal of Traumatic Stress

, Volume 15, Issue 5, pp 389–395 | Cite as

Mental Health Status of Human Rights Workers, Kosovo, June 2000

  • Timothy H. Holtz
  • Peter Salama
  • Barbara Lopes Cardozo
  • Carol A. Gotway


Human rights workers in humanitarian relief settings may be exposed to traumatic events that put them at risk for psychiatric morbidity. We conducted a cross-sectional survey in June 2000 to study the prevalence of psychiatric morbidity among 70 expatriate and Kosovar Albanian staff collecting human rights data in Kosovo. Among those surveyed, elevated levels of anxiety, depression, and posttraumatic stress disorder symptoms were found in 17.1, 8.6, and 7.1% respectively. Multiple regression analysis revealed that human rights workers at risk for elevated anxiety symptoms were those who had worked with their organization longer than 6 months, those who had experienced an armed attack, and those who experienced local hostility. Our study indicates that human rights organizations should consider mental health assessment, care, and prevention programs for their staff.

human rights mental health trauma anxiety 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.Google Scholar
  2. Amnesty International. (2000). Medical and psychosocial services for victims of human rights violations. London: Amnesty International.Google Scholar
  3. Dean, A. G., Dean, J. A., Coulombier, D., Brendel, K. A., Smith, D. C., Burton, A. H., et al. (1997). Epi Info (Version 6.04). Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  4. Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science, 19, 1–15.Google Scholar
  5. Eisenman, D. P., Bergner, S., & Cohen, I. (2000). An ideal victim: Idealizing trauma victims causes traumatic stress in human rights workers. Human Rights Review, 1, 106–114.Google Scholar
  6. Eriksson, C. B., Vande Kemp, H., Gorsuch, R., Hoke, S., & Foy, D. W. (2001). Trauma exposure and PTSD symptoms in international relief and development personnel. Journal of Traumatic Stress, 14, 205–212.Google Scholar
  7. Fawzi, M. C., Pham, T., Lin, L., Nguyen, T. V., Ngo, D., Murphy, E., et al. (1997). The validity of posttraumatic stress disorder among Vietnamese refugees. Journal of Traumatic Stress, 10, 101–108.Google Scholar
  8. Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O., et al. (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27, 191–197.Google Scholar
  9. Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.Google Scholar
  10. Kleijn, W. C., Hovens, J. E., & Rodenburg, J. J. (2001). Posttraumatic stress symptoms in refugees: Assessments with the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25 in different languages. Psychological Reports, 88, 527–532.Google Scholar
  11. Lopes Cardozo, B., Vergara, A., Agani, F., & Gotway, C. A. (2000). Mental health, social functioning, and attitudes of Kosovar Albanians following the war in Kosovo. Journal of the American Medical Association, 284, 569–577.Google Scholar
  12. McCall, M., & Salama, P. (1999). Selection, training, and support of relief workers: An occupational health issue. B M J, 318, 113–116.Google Scholar
  13. McCarroll, J. E., Ursano, R. J., & Fullerton, C. S. (1993). Symptoms of posttraumatic stress disorder following recovery of war dead. American Journal of Psychiatry, 150, 1875–1877.Google Scholar
  14. Mollica, R. F., 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. Journal of Nervous and Mental Disease, 180, 111–116.Google Scholar
  15. Mollica, R. F., McInnes, K., Sarajlic, N., Lavelle, J., Sarajlic, I., & Massagli, M. P. (1999). Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. Journal of the American Medical Association, 282, 433–439.Google Scholar
  16. Mollica, R. F., Wyshak, G., de Marneffe, D., Khuon, F., & Lavelle, J. (1987). Indochinese versions of the Hopkins Symptom Checklist-25: A screening instrument for the psychiatric care of refugees. American Journal of Psychiatry, 144, 497–500.Google Scholar
  17. Roberts, H. (2001). Kosovo: Rebuilding the mental health system. Lancet, 358, 1705.Google Scholar
  18. Salama, P., Lopes Cardozo, B., Holtz, T. H., Gotway, C., Kaiser, R., Ghitis, F., et al. (2002). The mental health of Kosovar Albanian and expatriate relief workers, Kosovo, June 2000. Manuscript submitted for publication.Google Scholar
  19. SAS Institute. (1999–2000). Statistical Analysis System (SAS) Version 8.01. Cary, NC: Author.Google Scholar
  20. Sheik, M., Gutierrez, M. I., Bolton, P., Spiegel, P., Thieren, M., & Burnham, G. (2000). Deaths among humanitarian workers. British Medical Journal, 321, 166–168.Google Scholar
  21. Shrestha, N. M., Sharma, B., Van Ommeren, M., Regmi, S., Makaju, R., Komproe, I., et al. (1998). Impact of torture on refugees displaced within the developing world: Symptomatology among Bhutanese refugees in Nepal. Journal of the American Medical Association, 280, 443–448.Google Scholar
  22. Smith Fawzi, M. C., Murphy, E., Pham, T., Lin, L., Poole, C., & Mollica, R. F. (1997). The validity of screening for posttraumatic stress disorder and major depression among Vietnamese former political prisoners. Acta Psychiatrica Scandinavica, 95, 87–93.Google Scholar
  23. Stamm, B. H. (1997). Work-related secondary traumatic stress. PTSD Research Quarterly, 8(2), 1–6.Google Scholar
  24. Ursano, R. J., Fullerton, C. S., Vance, K., & Kao, T. C. (1999). Posttraumatic stress disorder and identification in disaster workers. American Journal of Psychiatry, 156, 353–359.Google Scholar
  25. Ursano, R. J., & McCarroll, J. E. (1990). The nature of a traumatic stressor: Handling dead bodies. Journal of Nervous and Mental Disease, 178, 396–398.Google Scholar
  26. Weisaeth, L. (1989). Importance of high response rates in traumatic stress research. Acta Psychiatrica Scandinavica Supplementum, 355, 131–137.Google Scholar

Copyright information

© International Society for Traumatic Stress Studies 2002

Authors and Affiliations

  • Timothy H. Holtz
    • 1
    • 2
    • 3
  • Peter Salama
    • 2
    • 4
  • Barbara Lopes Cardozo
    • 4
  • Carol A. Gotway
    • 5
  1. 1.Division of Parasitic DiseasesNational Center for Infectious Diseases, Centers for Disease Control and PreventionAtlanta
  2. 2.Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and PreventionAtlanta
  3. 3.New York City Department of Health and Mental HygieneNew York
  4. 4.International Emergency and Refugee Health Branch, National Center for Environmental Health, Centers for Disease Control and PreventionAtlanta
  5. 5.Environmental Hazards and Health EffectsNational Center for Environmental Health, Centers for Disease Control and PreventionAtlanta

Personalised recommendations