Neuropsychological Issues in the Assessment of Refugees and Victims of Mass Violence

Harvard University, Cambridge, Massachusetts, United States
Neuropsychology Review (Impact Factor: 4.59). 10/2001; 11(3):131-41. DOI: 10.1023/A:1016650623996
Source: PubMed


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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Available from: Robert Fucetola, Dec 01, 2015
    • "A developmental history is particularly important in view of a child's refugee experiences (CDCP, 2012). This should include timing of major milestones; the history of availability of food, shelter, and health services; and particularly any history of major organ or system disorders or diseases such as epilepsy, cerebral malaria, and injuries, especially head injuries (John et al., 2008;Weinstein, Fucetola, & Mollica, 2001). A refugee child may well have missed out on auditory and visual function screening due to their age at arrival (CDCP, 2012;NSW Refugee Health Service, 2009). "
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    ABSTRACT: Each year, approximately 60,000 children of refugee background are resettled in Western countries. This paper reviews the effects of the refugee experience on cognitive functioning. The distinctive influences for these children include exposure to traumatic events and the need to acquire a new language, factors that need to be considered to avoid overdiagnosis of learning disorders and inappropriate educational placements. Prearrival trauma, psychological sequelae of traumatic events, developmental impact of trauma, and the quality of family functioning have been found to influence cognitive functioning, learning, and academic performance. In addition, the refugee child may be semiproficient in several languages, but proficient in none, whilst also trying to learn a new language. The influence that the child's limited English proficiency, literacy, and school experience may have on academic and test performance is demonstrated by drawing on the research on refugees' English language acquisition, as well as the more extensive literature on bilingual English language learners. Implications for interventions are drawn at the level of government policy, schools, and the individual. The paper concludes with the observation that there is a major need for longitudinal research on refugee children's learning and academic performance and on interventions that will close the academic gap, thereby enabling refugee children to reach their educational potential.
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    ABSTRACT: Abstract Søndergaard, 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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