The Impact of Death Anxiety, Meaning and Coping on Posttraumatic Stress Disorder and Psychiatric Co-Morbidity Among Iraqi Civilians Exposed to a Car Bomb Attack A Latent Class Analysis

2021 ◽  
pp. 088626052110551
Author(s):  
Man Cheung Chung ◽  
Fuaad Mohammed Freh

Much has been documented that the experience of a bombing is associated with posttraumatic stress disorder and psychiatric co-morbidity. Whether the co-existing relationship between death anxiety, meaning in life and coping styles would influence the aforementioned association is unknown. The present study aimed to identify latent classes of victims with different levels of death anxiety, meaning in life and coping styles, and to examine whether the severity of PTSD and co-morbid psychiatric symptoms differed between classes. One hundred and eighty-five victims who had experienced the first car bombing completed a demographic page, the Posttraumatic Stress Diagnosis Scale, General Health Questionnaire-28, Multidimensional Fear of Death Scale, Meaning in Life Questionnaire and Coping Responses Inventory. The results showed that 82% and 18% of the victims met the criteria for PTSD and no-PTSD, respectively. Four classes of victims were identified: Class 1 victims were approach copers with low levels of death anxiety and meaning. Class 2 victims were minimal copers with high levels of death anxiety and meaning. Class 3 victims were approach copers with a high level of death anxiety and meaning. Class 4 victims were avoidance copers with high levels of death anxiety. Individuals in Class 1 reported significantly lower levels of PTSD and psychiatric co-morbidity than the other three classes. Class 3 victims also reported significantly lower levels of psychiatric co-morbidity than Class 2 victims. To conclude, victims exposed to a car bombing were likely to exhibit posttraumatic stress symptoms in addition to other psychological symptoms. The severity of these symptoms tended to be lower among those who had little fear of death, did not search for meaning in life and approached their distress proactively.

Refuge ◽  
1999 ◽  
pp. 30-40 ◽  
Author(s):  
David P. Lumsden

This article provides a rethinking of the concept of' exile and promotes its utility regarding both the externally and the internally displaced. It does so from the perspective of Medical Anthropology. A number of variables affecting and shaping the morality, performance, nature and outcomes of exile are identified. Edward Said's views are discussed; but, must exiles always and forever be viewed or be felt as 'broken lives'? The article argues against a naive presumption of 'universalism' to exile's embodied experience and response; instead, the specificities of cultural meaning systems must be taken into account. Further, it argues against analysts' common presumption of pathology and 'posttraumatic stress disorder' among exiles; instead, evidence for 'agency' and 'resilience' in exile populations' health and coping through time must also, and explicitly, be recognized. Finally, where lives are 'broken', the potential of Truth Commissions and 'forgiveness' to be practices of collective repair is noted. Examples are drawn from Africa, Bosnia, Cambodia, Chile, China, Holocaust survivors, and Tibet.


Author(s):  
Ali Zbidat ◽  
Ekaterini Georgiadou ◽  
Andrea Borho ◽  
Yesim Erim ◽  
Eva Morawa

Background: A high prevalence of mental distress, especially posttraumatic stress disorder, has been widely confirmed among refugees. In order to establish adequate interventions in psychotherapy, however, it must first be examined whether refugees have similar ideas and concepts of stress, trauma, and healing. This study, therefore, aimed to analyze the representations of trauma, self-reported complaints, indications of somatization, and coping strategies among a refugee population. Methods: Semi-structured interviews based on the Cultural Formulation Interview (CFI) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were conducted with Syrian refugees who have residence permission in Germany. The interviews were audio-recorded, transcribed, and analyzed according to the qualitative content analysis of Mayring. The foci of interest were determined on the basis of the predefined interview guideline, and inductive subcategories were extracted from the transcripts. Results: Sixteen refugees participated (50% women; mean age: 35.5 years, SD = 11.2; the mean duration of stay in Germany: 23.3 months, SD = 6.6). War experiences were the most frequently reported subjective perceptions of trauma. Frequently reported complaints included sleeping disturbance, cardiovascular symptoms, rumination, and pain. Among half of the participants, we found indications of somatization. We identified the following coping strategies: Activity, cognitive coping, social coping, religious coping, avoidance, and emotional coping. Conclusions: War-related traumatic events are the most common trauma perceptions among Syrian refugees. The self-reported complaints demonstrate somatoform, depressive, and posttraumatic symptoms. Syrian refugees should be screened for somatization, depression, and posttraumatic stress disorder and should receive targeted interventions that consider and support individual coping resources.


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