scholarly journals Complex post-traumatic stress disorder and post-migration living difficulties in traumatised refugees and asylum seekers: the role of language acquisition and barriers

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Jennifer Schiess-Jokanovic ◽  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Dina Weindl ◽  
Ingo Schäfer ◽  
...  
Keyword(s):  
Language Acquisition ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Asylum Seekers ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Refugees And Asylum Seekers

scholarly journals Long-distance migration was associated with increased prevalence of post-traumatic stress disorder in Syrian refugees

2021 ◽  
Author(s):  
Andreas Halgreen Eiset ◽  
Michaelangelo P Aoun ◽  
Monica Stougaard ◽  
Annemarie Graa Gottlieb ◽  
Ramzi S Haddad ◽  
...  
Keyword(s):  
Health Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Asylum Seekers ◽  
Stress Disorder ◽  
Syrian Refugees ◽  
Post Traumatic Stress ◽  
Long Distance ◽  
Post Traumatic ◽  
Refugees And Asylum Seekers

Background: Refugees are forced migrants but there is a large variation in the distance that refugees cover and there is a knowledge gap on how this may affect refugee' health and health care needs. We investigated the association between long-distance migration and post-traumatic stress disorder (PTSD), a serious psychiatric disorder associated with deteriorating mental and somatic health. Methods: Included from 2016-2019 were 712 adult Syrian refugees and asylum seekers in Lebanon and Denmark arrived up to 12 months prior. PTSD was assessed using the Harvard Trauma Questionnaire and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience and WHO-5-score, reporting the bootstrap 95-percentile confidence interval (95% CI). Additionally, a number of sensitivity analyses were performed. Results: After multiply imputing missing data and propensity score-weighted adjustment for confounding, migration to Denmark instead of Lebanon was associated with an increase in PTSD prevalence of 9 percentage point (95% CI [-1; 19] percentage point). Discussion: We found that long-distance migration was associated with an increase in the prevalence of PTSD suggesting that long-distance migration may be a factor to consider when assessing refugees' and asylum seekers' health. To secure timely and appropriate health care for this vulnerable group we need to remedy the current knowledge gap regarding the health effects of migration. This study is the first step in doing so.

scholarly journals The narrative matrix: a narrative-hermeneutic approach in refugee care

2021 ◽  
Vol 14 (1) ◽  
pp. 47-62
Author(s):  
Martyna Chrzescijanska
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Asylum Seekers ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Therapeutic Setting ◽  
Post Traumatic Growth ◽  
Hermeneutic Approach ◽  
Post Traumatic ◽  
Refugees And Asylum Seekers

This article presents an approach to refugee care that is based on a hermeneutic understanding of the meanings constituted by narratives in therapy. It proposes distinguishing psychotherapeutic models commonly used in therapy with refugees, such as post-traumatic stress disorder or post-traumatic growth theories, from an approach that involves many different narratives in the form of multi-voiced conversation within the therapeutic setting. Such a concept, called here the narrative matrix, is discussed and presented as an alternative and efficient way of providing therapeutic support for refugees and asylum seekers. It discusses family therapy with refugees as an example of the narrative-hermeneutic approach that involves not only different voices from members of a family but different psychotherapeutic models.

scholarly journals Prevalence of complex post-traumatic stress disorder in refugees and asylum seekers: systematic review

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Umanga de Silva ◽  
Naomi Glover ◽  
Cornelius Katona
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Asylum Seekers ◽  
Stress Disorder ◽  
Treatment Seeking ◽  
Post Traumatic Stress ◽  
Extreme Stress ◽  
Post Traumatic ◽  
Refugees And Asylum Seekers

Background Refugees and asylum seekers often report having experienced numerous complex traumas. It is important to understand the prevalence of complex post-traumatic stress disorder (CPTSD), which can follow complex traumas. Aims This systematic review aims to summarise the available literature reporting the prevalence in refugees and asylum seekers of three operationalised definitions of CPTSD: the ICD-11 diagnostic criteria, the ICD-10 criteria (for enduring personality change after catastrophic experience) and the DSM-IV criteria (for disorders of extreme stress not otherwise specified). Method Six electronic databases were searched for studies reporting the prevalence of CPTSD in adult refugee and/or asylum-seeking samples. Owing to heterogeneity between the studies, a narrative synthesis approach was used to summarise studies. Methodological quality was assessed using the Joanna Briggs Critical Appraisal Checklist for Prevalence Studies. This systematic review has been registered with PROSPERO (registration number CRD42020188422, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188422). Results Systematic searches identified 15 eligible studies, with 10 examining treatment-seeking samples and five using population samples. CPTSD prevalence in treatment-seeking samples was between 16 and 38%. Prevalence in population samples ranged from 2.2 to 9.3% in four studies, with the fifth reporting a much higher estimate (50.9%). Conclusions This review highlights both the high prevalence of CPTSD in treatment samples and the lack of research aiming to establish prevalence of CPTSD in refugee and asylum-seeking populations. Understanding the prevalence of these disabling disorders has implications for policy and healthcare services for the appropriate promotion, planning and provision of suitable treatment and interventions for this highly traumatised population.

The management of post-traumatic stress disorder and associated pain and sleep disturbance in refugees

2019 ◽  
Vol 25 (3) ◽  
pp. 196-206
Author(s):  
July Lies ◽  
Lester Jones ◽  
Roger Ho
Keyword(s):  
Sleep Disturbance ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Asylum Seekers ◽  
Stress Disorder ◽  
Psychological Trauma ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Refugees And Asylum Seekers ◽  
The Relationship

SUMMARYMore than 68 million people worldwide have been forcibly displaced and one-third of these are refugees. This article offers an overview of the current literature and reviews the epidemiology and evidence-based psychological and pharmacological management of post-traumatic stress disorder (PTSD), sleep disturbance and pain in refugees and asylum seekers. It also considers the relationship between sleep disturbance and PTSD and explores concepts of pain in relation to physical and psychological trauma and distress. During diagnosis, clinicians must be aware of ethnic variation in the somatic expression of distress. Treatments for PTSD, pain and sleep disturbance among refugees and asylum seekers are essentially the same as those used in the general population, but treatment strategies must allow for cultural and contextual factors, including language barriers, loss of freedom and threat of repatriation.LEARNING OBJECTIVESAfter reading this article you will be able to: •recognise the challenges faced by the large number of refugees worldwide•understand the relationship between PTSD, sleep disturbance and pain in refugees•broadly understand the evidence for psychological and pharmacological therapy for treating PTSD, sleep disturbance and pain in refugees.DECLARATION OF INTERESTNone.

scholarly journals Genes and hormones of the hypothalamic–pituitary–adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response?

2021 ◽  
Author(s):  
Susanne Fischer ◽  
Tabea Schumacher ◽  
Christine Knaevelsrud ◽  
Ulrike Ehlert ◽  
Sarah Schumacher
Keyword(s):  
Hpa Axis ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Alternative Treatments ◽  
Hypothalamic Pituitary Adrenal ◽  
Post Traumatic

Abstract Background Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic–pituitary–adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). Methods This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. Results Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. Conclusions Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.

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