Neuropsychological issues in the assessment of refugees and victims of mass violence.

Department of Psychiatry, Beth Israel-Deaconess Hospital-East Boston, Massachusetts 02115, USA.
Neuropsychology Review (Impact Factor: 5.4). 10/2001; 11(3):131-41. DOI: 10.1023/A:1016650623996
Source: PubMed

ABSTRACT Brain injury, stressor severity, depression, premorbid vulnerabilities, and PTSD are frequently intertwined in trauma populations. This interaction is further complicated when the neuropsychologist evaluates refugees from other cultures. In addition, the observed psychiatric symptoms reported in refugees and victims of mass violence may in fact not be the primary features of PTSD and depression but psychiatric symptoms secondary to the effects of traumatic brain injury. This paper reviews the occurrence of starvation, torture, beatings, imprisonment, and other head injury experiences in refugee and POW populations to alert treators to the presence of chronic and persistent neuropsychiatric morbidity, with implications for psychosocial adjustment. The concept of fixed neural loss may also interact with environmental and emotional stresses, and a model of neuropsychological abnormalities triggered by traumatic events and influenced by subsequent stress will also be considered. Neuropsychologists working with refugees play an important role in assessing the possibility of traumatic brain injury with tools that are relatively culture-fair.

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    ABSTRACT: Abstract S√łndergaard, Hans Peter (2002): Post-traumatic stress disorder and life events among recently resettled refugees. Stockholm, Sweden. Karolinska Institutet, Department of Public Health Sciences, Division of Psychosocial Factors and Health. ISBN 91-7349-318-X. Background In refugee health, one topic is the importance of posttraumaticstress disorder (PTSD) from a public health point of view. The present study was initiated in order to study the prevalence of PTSD through structured assessment in a group of recently resettled refugees, and to study important classes of present life events and their interaction with health by means of qualitative and quantitative methods as well as hormonal markers. Further, associations between traumatisation, PTSD and alexithymia were of interest. Subjects and methods Participants eligible for the study were every fourth 18-48 years old recently resettled
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    ABSTRACT: Little is known about the relationship between traumatic head injury (THI) and psychiatric morbidity in torture survivors. We examine the relationship between THI and depression, PTSD, post-concussive syndrome (PCS), disability and poor health status in Vietnamese ex-political detainees who survived incarceration in Vietnamese re-education camps. A community sample of ex-political detainees (n=337) and a non-THI, non-ex-detainee comparison group (n=82) were surveyed. Seventy-eight percent of the ex-political detainees had experienced THI; 90.6% of the ex-political detainees and 3.6% of the comparison group had experienced 7 or more trauma events. Depression and PTSD were greater in ex-detainees than in the comparison group (40.9% vs 23.2% and 13.4% vs 0%). Dose-effect relationships for THI and trauma/torture in the ex-political detainee group were significant. Logistic regression in the pooled sample of ex-detainees and the comparison group confirmed the independent impact of THI from trauma/torture on psychiatric morbidity (OR for PTSD=22.4; 95% CI: 3.0-165.8). These results demonstrate important effects of THI on depression and PTSD in Vietnamese ex-detainees who have survived torture.
    Comprehensive Psychiatry 04/2014; · 2.26 Impact Factor