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This article focuses on the conditions for the development of organised violence to women and children with the ensuing traumatic effects, and details the situation of the affected persons. The claim is that present situations of social unrest, wars, and persecution produce conditions where archaic images of male dominance and entitlement are likely to emerge. When these are justified by some religious–political ideology, atrocities are particularly likely to follow. In the same way that ethnic groups may be targeted, women and girls may be the chosen objects of repression and aggression.

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There are several million war-refugees worldwide, majority of whom stay in the recipient countries for years. However, little is known about their long-term mental health. This review aimed to assess prevalence of mental disorders and to identify their correlates among long-settled war-refugees. We conducted a systematic review of studies that assessed current prevalence and/or factors associated with depression and anxiety disorders in adult war-refugees 5 years or longer after displacement. We searched Medline, Embase, CINAHL, PsycINFO, and PILOTS from their inception to October 2014, searched reference lists, and contacted experts. Because of a high heterogeneity between studies, overall estimates of mental disorders were not discussed. Instead, prevalence rates were reviewed narratively and possible sources of heterogeneity between studies were investigated both by subgroup analysis and narratively. A descriptive analysis examined pre-migration and post-migration factors associated with mental disorders in this population. The review identified 29 studies on long-term mental health with a total of 16,010 war-affected refugees. There was significant between-study heterogeneity in prevalence rates of depression (range 2.3–80 %), PTSD (4.4–86 %), and unspecified anxiety disorder (20.3–88 %), although prevalence estimates were typically in the range of 20 % and above. Both clinical and methodological factors contributed substantially to the observed heterogeneity. Studies of higher methodological quality generally reported lower prevalence rates. Prevalence rates were also related to both which country the refugees came from and in which country they resettled. Refugees from former Yugoslavia and Cambodia tended to report the highest rates of mental disorders, as well as refugees residing in the USA. Descriptive synthesis suggested that greater exposure to pre-migration traumatic experiences and post-migration stress were the most consistent factors associated with all three disorders, whilst a poor post-migration socio-economic status was particularly associated with depression. There is a need for more methodologically consistent and rigorous research on the mental health of long-settled war refugees. Existing evidence suggests that mental disorders tend to be highly prevalent in war refugees many years after resettlement. This increased risk may not only be a consequence of exposure to wartime trauma but may also be influenced by post-migration socio-economic factors.
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In this paper, the numbers of refugees travelling to the European Union are set in a global context. It is argued that the increasing restrictions placed on asylum seekers from the 1980s onwards in the UK and the associated culture of deterrence and prohibition have had the perverse effect of supporting the economic market for people smuggling. It appears that these restrictions were initially designed to deter people, most of whom would have been granted humanitarian assistance had they managed to arrive in the UK, so as to prevent them from accessing the decision-making process on asylum. Policy changes concerning travel, benefits, and other pressures on asylum seekers are also considered in the context of deterrence. The problems facing asylum seekers do not end with their arrival in a safe country. The current methods of determining refugee status are alarmingly weak. Indeed there is evidence suggesting that those who are most traumatised before arrival face systematic disadvantage. The focus of this paper is on the United Kingdom but its conclusions apply to most Western European countries. The paper concludes with some tentative suggestions for change.
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Adverse and potentially traumatic experiences (PTEs) in childhood were examined among 54 adult refugee patients with pre-flight PTEs of war and human rights violations (HRVs) and related to mental health and quality of life at treatment start. Extent of childhood PTEs was more strongly related to mental health and quality of life than the extent of war and HRV experiences. Childhood PTEs were significantly related to arousal and avoidance symptoms of posttraumatic stress disorder (PTSD) and to quality of life, whereas pre-flight war and HRV experiences were significantly related to reexperiencing symptoms of PTSD only. Within childhood adversities, experiences of family violence and external violence, but not of loss and illness, were significantly related to increased mental health symptoms and reduced quality of life. These results point to the importance of taking childhood adverse experiences into account in research and treatment planning for adult refugees with war and HRVs trauma.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
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Refugee families often encounter a number of acculturative and resettlement stressors as they make lives for themselves in host countries. These difficulties may be compounded by past trauma and violence exposure, posing increased risk for mental health problems. Greater knowledge is needed about protective processes contributing to positive development and adjustment in refugee families despite risk (e.g., resilience). The aims of this research were to identify and examine strengths and resources utilized by Somali refugee children and families in the Boston area to overcome resettlement and acculturative stressors. We used maximum variation sampling to conduct a total of 9 focus groups: 5 focus groups (total participants N = 30) among Somali refugee adolescents and youth, capturing gender and a range of ages (15 to 25 years), as well as 4 focus groups of Somali refugee mothers and fathers in groups (total participants N = 32) stratified by gender. Drawing from conservation of resources theory (COR), we identified 5 forms of resources comprising individual, family, and collective/community strengths: religious faith, healthy family communication, support networks, and peer support. "Community talk" was identified as a community dynamic having both negative and positive implications for family functioning. Protective resources among Somali refugee children and families can help to offset acculturative and resettlement stressors. Many of these locally occurring protective resources have the potential to be leveraged by family and community-based interventions. These findings are being used to design preventative interventions that build on local strengths among Somali refugees in the Boston area. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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In the 1990s there was more focus on war-time sexual violence than ever before. Within academia, among policy-makers and in the media emerged a consensus that sexual violence can be used as a weapon of war. This article attempts to understand the complex relationship between sexual violence and war by presenting three different conceptualizations based on a literature study of 140 scholarly texts published mainly during the 1990s. The crux of this article is the argument that the relationship between sexual violence and war is best conceptualized within a social constructionist paradigm. My analysis shows that it is the social constructionist conceptualization which is best equipped to explain the complex empirical reality at hand.
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War experiences are associated with substantially increased rates of mental disorders, particularly Post-Traumatic Stress Disorder (PTSD) and Major Depression (MD). There is limited evidence on what type of war experiences have particularly strong associations with subsequent mental disorders. Our objective was to investigate the association of violations of human rights, as indicated in the 4th Geneva Convention, and other stressful war experiences with rates of PTSD and MD and symptom levels of intrusion, avoidance and hyperarousal. In 2005/6, human rights violations and other war experiences, PTSD, post-traumatic stress symptoms and MD were assessed in war affected community samples in five Balkan countries (Bosnia-Herzegovina, Croatia, Kosovo, Macedonia, and Serbia) and refugees in three Western European countries (Germany, Italy, United Kingdom). The main outcome measures were the MINI International Neuropsychiatric Interview and the Impact of Event Scale-Revised. In total 3313 participants in the Balkans and 854 refugees were assessed. Participants reported on average 2.3 rights violations and 2.3 other stressful war experiences. 22.8% of the participants were diagnosed with current PTSD and also 22.8% had MD. Most war experiences significantly increased the risk for both PTSD and MD. When the number of rights violations and other stressful experiences were considered in one model, both were significantly associated with higher risks for PTSD and were significantly associated with higher levels of intrusion, avoidance and hyperarousal. However, only the number of violations, and not of other stressful experiences, significantly increased the risk for MD. We conclude that different types of war experiences are associated with increased prevalence rates of PTSD and MD more than 5 years later. As compared to other stressful experiences, the experience of human rights violations similarly increases the risk of PTSD, but appears more important for MD.
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Uncertainties continue about the roles that methodological factors and key risk factors, particularly torture and other potentially traumatic events (PTEs), play in the variation of reported prevalence rates of posttraumatic stress disorder (PTSD) and depression across epidemiologic surveys among postconflict populations worldwide. To undertake a systematic review and meta-regression of the prevalence rates of PTSD and depression in the refugee and postconflict mental health field. An initial pool of 5904 articles, identified through MEDLINE, PsycINFO and PILOTS, of surveys involving refugee, conflict-affected populations, or both, published in English-language journals between 1980 and May 2009. Surveys were limited to those of adult populations (n > or = 50) reporting PTSD prevalence, depression prevalence, or both. Excluded surveys comprised patients, war veterans, and civilian populations (nonrefugees/asylum seekers) from high-income countries exposed to terrorist attacks or involved in distal conflicts (> or = 25 years). Methodological factors (response rate, sample size and design, diagnostic method) and substantive factors (sociodemographics, place of survey, torture and other PTEs, Political Terror Scale score, residency status, time since conflict). A total of 161 articles reporting results of 181 surveys comprising 81,866 refugees and other conflict-affected persons from 40 countries were identified. Rates of reported PTSD and depression showed large intersurvey variability (0%-99% and 3%-85.5%, respectively). The unadjusted weighted prevalence rate reported across all surveys for PTSD was 30.6% (95% CI, 26.3%-35.2%) and for depression was 30.8% (95% CI, 26.3%-35.6%). Methodological factors accounted for 12.9% and 27.7% PTSD and depression, respectively. Nonrandom sampling, small sample sizes, and self-report questionnaires were associated with higher rates of mental disorder. Adjusting for methodological factors, reported torture (Delta total R(2) between base methodological model and base model + substantive factor [DeltaR(2)] = 23.6%; OR, 2.01; 95% CI, 1.52-2.65) emerged as the strongest factor associated with PTSD, followed by cumulative exposure to PTEs (DeltaR(2) = 10.8%; OR, 1.52; 95% CI, 1.21-1.91), time since conflict (DeltaR(2) = 10%; OR, 0.77; 95% CI, 0.66-0.91), and assessed level of political terror (DeltaR(2) = 3.5%; OR, 1.60; 95% CI, 1.03-2.50). For depression, significant factors were number of PTEs (DeltaR(2) = 22.0%; OR, 1.64; 95% CI, 1.39-1.93), time since conflict (DeltaR(2) = 21.9%; OR, 0.80; 95% CI, 0.69-0.93), reported torture (DeltaR(2) = 11.4%; OR, 1.48; 95% CI, 1.07-2.04), and residency status (DeltaR(2) = 5.0%; OR, 1.30; 95% CI, 1.07-1.57). Methodological factors and substantive population risk factors, such as exposure to torture and other PTEs, after adjusting for methodological factors account for higher rates of reported prevalence of PTSD and depression.
This book chronicles the occupation of Nanking, China by the Jananeese, known as "the rape of nanking". Between 260,000 and 350,000 were killed in a few months from late 1937 to early 1938. The rape is virtually unknown and undocumented in the West. The Japaneese covered up the massacre, and still mostly denies it happened.
After the so-called refugee crisis of 2015–2016 European reactions to foreigners had come to the fore and we are seeing xenophobic political and populist movements become increasingly mainstream. The massive rejection of refugees/asylum seekers taking place has made their conditions before, during and after flight, increasingly difficult and dangerous. This paper relates current xenophobia to historical attitudinal trends in Europe regarding Islam, and claims that a much more basic conflict is at work: the one between anti-modernism/traditionalism and modernism/globalization. Narratives on refugees often relate them to both the foreign (Islam) and to “trauma”. In an environment of insecurity and collective anxiety, refugees may represent something alien and frightening but also fascinating. I will argue that current concepts and theories about “trauma” or “the person with trauma” are insufficient to understand the complexity of the refugee predicament. Due to individual and collective countertransference reactions, the word “trauma” tends to lose its theoretical anchoring and becomes an object of projection for un-nameable anxieties. This disturbs relations to refugees at both societal and clinical levels and lays the groundwork for the poor conditions that they are currently experiencing. Historically, attitudes towards refugees fall somewhere along a continuum between compassion and rejection/dehumanization. At the moment, they seem much closer to the latter. I would argue that today’s xenophobia and/or xeno-racism reflect the fact that, both for individuals and for society, refugees have come to represent the Freudian Uncanny/das Unheimliche.
More than two decades after Michael Rutter (1987) published his summary of protective processes associated with resilience, researchers continue to report definitional ambiguity in how to define and operationalize positive development under adversity. The problem has been partially the result of a dominant view of resilience as something individuals have, rather than as a process that families, schools,communities and governments facilitate. Because resilience is related to the presence of social risk factors, there is a need for an ecological interpretation of the construct that acknowledges the importance of people's interactions with their environments. The Social Ecology of Resilience provides evidence for this ecological understanding of resilience in ways that help to resolve both definition and measurement problems. © Springer Science+Business Media, LLC 2012. All rights reserved.
In this sweeping, definitive work, historian David Crowe offers an unflinching account of the long and troubled history of genocide and war crimes. From ancient atrocities to more recent horrors, he traces their disturbing consistency but also the heroic efforts made to break seemingly intractable patterns of violence and retribution.
Background: Adolescent refugees face many challenges but also have the potential to become resilient. The purpose of this study was to identify and characterize the protective agents, resources, and mechanisms that promote their psychosocial well-being. Methods: Participants included a purposively sampled group of 73 Burundian and Liberian refugee adolescents and their families who had recently resettled in Boston and Chicago. The adolescents, families, and their service providers participated in a two-year longitudinal study using ethnographic methods and grounded theory analysis with Atlas/ti software. A grounded theory model was developed which describes those persons or entities who act to protect adolescents (Protective Agents), their capacities for doing so (Protective Resources), and how they do it (Protective Mechanisms). Protective agents are the individuals, groups, organizations, and systems that can contribute either directly or indirectly to promoting adolescent refugees' psychosocial well-being. Protective resources are the family and community capacities that can promote psychosocial well-being in adolescent refugees. Protective mechanisms are the processes fostering adolescent refugees' competencies and behaviors that can promote their psychosocial well-being. Results: Eight family and community capacities were identified that appeared to promote psychosocial well-being in the adolescent refugees. These included 1) finances for necessities; 2) English proficiency; 3) social support networks; 4) engaged parenting; 5) family cohesion; 6) cultural adherence and guidance; 7) educational support; and 8) faith and religious involvement. Nine protective mechanisms identified were identified and grouped into three categories: 1) Relational (supporting, connecting, belonging); 2) Informational (informing, preparing), and; 3) Developmental (defending, promoting, adapting). Conclusions: To further promote the psychosocial well-being of adolescent refugees, targeted prevention focused policies and programs are needed to enhance the identified protective agents, resources, and mechanisms. Because resilience works through protective mechanisms, greater attention should be paid to understanding how to enhance them through new programs and practices, especially informational and developmental protective mechanisms.
The just war tradition is based on two principles: jus ad bellum – just war-making, and jus in bello – just war-fighting. jus in bello contains the non-combatant immunity principle. This ‘protects’ civilians during war, giving them ‘immunity’ from the violence of war-fighting. Women are, for the most part, non-combatants. Still, their experiences during war are far from ‘protected’. Following the widespread use of rape in the conflicts in Rwanda and the former Yugoslavia, the raping of women in combat and occupation zones is now considered a human rights violation and treated as a crime against humanity. Yet, despite developments in international law and policy-making on sexual violence in armed conflict, the systematic rape of girls and women during armed conflict continues. In the Democratic Republic of Congo (DRC), this type of gender-based violence is being perpetrated and facilitated at a macro, meso, and micro level. This article will explore these levels through a feminist lens and will consider what is necessary to achieve just post bellum (just peace) in the DRC.
This paper offers a multicultural understanding of trauma and resilience as experienced in the lives of individuals from diverse cultural and racial backgrounds. The research and clinical literature on resilience has focused largely if not exclusively on individual personality traits and coping styles, and has neglected to explore all possible sources and expressions of resilience in individuals and groups. For many ethnic minorities, traditional notions of resilience, shaped largely by middle class European and North American values, may not capture culturally more familiar modes of positive adaptation to adverse and traumatic experience. This paper explores the concept of resilience as a multidetermined phenomenon, and considers the implications of this perspective for clinical research and intervention with ethnic minorities.
To examine sustainability of symptom outcomes of a 1-year phase-based trauma-focused, multimodal, and multicomponent group therapy in a day treatment program for posttraumatic stress disorder (PTSD) over an average period of 7 years. Iranian and Afghan patients (N = 69) were assessed with self-rated symptom checklists for PTSD, anxiety, and depression symptoms before (T1), after (T2), and up to 11 years upon completion of the treatment (T3). A series of mixed model regression analyses was applied to determine the course of the measured symptoms over time. At T2, all symptoms were reduced, but PTSD symptoms showed the strongest reduction. The trend of symptom reduction continued up to 5 years posttreatment and was similar for all the examined symptoms. After 5 years, all symptoms started to worsen, but remained under baseline levels at T3. The applied treatment appears to improve mental health of the studied sample on both the short and longer term.
Any thorough understanding of the modern epidemics of AIDS and tuberculosis in Haiti or elsewhere in the postcolonial world requires a thorough knowledge of history and political economy. This essay, based on over a decade of research in rural Haiti, draws on the work of Sidney Mintz and others who have linked the interpretive project of modern anthropology to a historical understanding of the large-scale social and economic structures in which affliction is embedded. The emergence and persistence of these epidemics in Haiti, where they are the leading causes of young-adult death, is rooted in the enduring effects of European expansion in the New World and in the slavery and racism with which it was associated. A syncretic and properly biosocial anthropology of these and other plagues moves us beyond noting, for example, their strong association with poverty and social inequalities to an understanding of how such inequalities are embodied as differential risk for infection and, among those already infected, for adverse outcomes including death. Since these two diseases have different modes of transmission, different pathophysiologies, and different treatments, part of the interpretive task is to link such an anthropology to epidemiology and to an understanding of differential access to new diagnostic and therapeutic tools now available to the fortunate few. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A retrospective investigation was carried out into the mortality and morbidity up to the end of 1966 among Norwegian concentration camp survivors. The aim was to study the effects of imprisonment on the health of an unselected total prisoner population and in so doing throw light on the effects of excessive stress on the organism. Compared with the mortality of the Norwegian population that of the ex prisoners was much higher. The morbidity study was carried out on a random sample of 498 people selected from the register of ex prisoners still alive at the end of 1966. A matched control material was selected from the health insurance files by choosing the card nearest that of each selected ex prisoner belonging to a person of the same age, sex and occupational group. The ex prisoners had less stable working lives than the controls, with more frequent changes of job, occupation and domicile. They had more sick periods, longer sick leaves, and more frequent and long lasting hospitalization periods than the controls. Some deaths and implications of the findings are discussed.
Longitudinal studies of traumatized refugees are needed to study changes in mental health over time and to improve health-related and social interventions. The aim of this study was to examine changes in symptoms of PTSD, depression, and anxiety, and in health-related quality of life during treatment in traumatized refugees. The study group comprises 55 persons admitted to the Rehabilitation and Research Centre for Torture Victims in 2001 and 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and health-related quality of life (WHO Quality of Life-Bref) were collected before treatment and after 9 months. No change in mental symptoms or health-related quality of life was observed. In spite of the treatment, emotional distress seems to be chronic for the majority of this population. Future studies are needed to explore which health-related and social interventions are most useful to traumatized refugees.
Extreme traumatization affects the individual's relation to others in several social and psychological ways. The post-traumatic experiences are characterized by helplessness, insecurity, anxiety, loss of basic trust, and fragmentation of perspectives on one's own life. Special considerations should be given to the destruction of the ability to regulate negative emotions (extreme fear, distress, anguish, anger, rage, shame) in relation to others and activate internal good and empathic object relations. Destruction of the capacity for symbolization of traumatic experience may threaten the mind with chaotic states against which the 'I' tries to defend itself and find a balanced psychic mise-en-scene. The authors emphasize three dimensions that the analyst should observe in his understanding of the traumatized mind and its conflicts. The proposed dimensions are called the body-other dimension, the subject-group dimension, and the subject-discourse dimension. All three dimensions have specific structural characteristics that are expressed in the analytic relation. Extreme trauma causes disturbances in each of these dimensions. The authors present clinical material from a traumatized refugee to illustrate the analytic work.
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