Effects of Traumatic Stress after Mass Violence, Terror, or Disaster

2007 ◽

Vol 36 (1) ◽

pp. 3-19 ◽

Cited By ~ 13

Author(s):

Nick Grey ◽

Kerry Young

Keyword(s):

Traumatic Stress ◽

Clinical Pathway ◽

Asylum Seekers ◽

Behaviour Therapy ◽

Mass Violence ◽

Multicultural Issues ◽

Stress Symptoms ◽

Cognitive Behaviour ◽

Prolonged Duration ◽

Refugees And Asylum Seekers

AbstractThis paper describes the nature of the difficulties faced by asylum seekers and refugees who present with traumatic stress symptoms and uses existing cognitive models to better understand theoretical issues in these cases. The focus is on those people for whom traumatic stress symptoms are their main problem/pre-occupation. It is acknowledged that these people may only form a small proportion of those who have experienced such events. This paper does not focus on the important multicultural issues integral to this work. A possible clinical pathway is presented, including the role of exposure/reliving, and how it may be adapted where necessary for people who have experienced multiple traumatic events, often of prolonged duration. Discussion of possible psychosocial understandings of torture and mass violence may be important in this work. A case example is presented that demonstrates how this clinical pathway might unfold in practice.

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Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence

The British Journal of Psychiatry ◽

10.1192/bjp.173.6.482 ◽

1998 ◽

Vol 173 (6) ◽

pp. 482-488 ◽

Cited By ~ 241

Author(s):

Richard F. Mollica ◽

Keith McInnes ◽

Charles Pool ◽

Svang Tor

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Cultural Sensitivity ◽

Stress Disorder ◽

Psychiatric Symptoms ◽

Dose Effect ◽

Cumulative Trauma ◽

Post Traumatic Stress ◽

Mass Violence ◽

Post Traumatic

BackgroundThe dose – effect relationships of cumulative trauma to the psychiatric symptoms of major depression and post-traumatic stress disorder (PTSD) in a community study of Cambodian survivors of mass violence were evaluated.MethodIn 1990, a survey of 1000 households was conducted in aThai refugee camp (Site 2) using a multi-stage random sampling design. Trauma history and psychiatric symptoms were assessed for two time periods. Analysis used linear dose – response regression modelling.Results993 Cambodian adults reported a mean of 14 Pol Pot era trauma events and 1.3 trauma events during the past year. Symptom categories of depression, PTSD, dissociative and culturally dependent symptoms exhibited strong dose – effect responses with the exception of avoidance. All symptom categories, except avoidant symptoms, were highly correlated.ConclusionsCumulative trauma continued to affect psychiatric symptom levels a decade after the original trauma events. The diagnostic validity of PTSD criteria, with the notable exception of avoidance, was supported. Inclusion of dissociative and culturally dependent symptoms increased the cultural sensitivity of PTSD.

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Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: Meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.115.180265 ◽

2017 ◽

Vol 210 (4) ◽

pp. 247-254 ◽

Cited By ~ 35

Author(s):

Nexhmedin Morina ◽

Mina Malek ◽

Angela Nickerson ◽

Richard A. Bryant

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Effect Sizes ◽

Psychological Interventions ◽

Post Traumatic Stress ◽

Mass Violence ◽

Middle Income ◽

Middle Income Countries ◽

Post Traumatic

BackgroundThe majority of survivors of mass violence live in low- and middle-income countries (LMICs).AimsTo synthesise empirical findings for psychological interventions for children and adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.MethodRandomised controlled trials with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21812 records were found through July 2016 in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended guidelines.ResultsTwenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes (g = 1.15) and a medium controlled effect size (g = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and small respectively.ConclusionsPsychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted approaches are needed for depressive responses.

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