Psychological distress in torture survivors: pre- and post-migration risk factors in a US sample

Suzan J. Song, Charles Kaplan, Wietse A. Tol, Andrew Subica, Joop de Jong

Research output: Contribution to journalArticlepeer-review


Purpose: To investigate the relationships between sociodemographic, pre- and post-migration variables with prevalence of psychological distress and global functioning in a heterogeneous sample of torture survivors.

Methods: Clients referred from resettlement agencies via the Office of Refugee Resettlement (ORR) to a community clinic in the United States (N = 278) were interviewed with structured, translated questionnaires. Univariate and multivariate logistic regression analyses determined the associations of sociodemographic, pre-, and post-migration risk factors with posttraumatic stress disorder (PTSD), depression, anxiety, and global functioning.

Results: Regression data indicate that length of time between arrival in US and clinical services was significantly associated with PTSD and depression; participants receiving services after 1 year of resettlement were more likely to experience PTSD (adjusted OR = 3.29) and depression (adjusted OR = 4.50) than participants receiving services within 1 year. Anxiety was predicted by female gender (adjusted OR = 3.43), age over 40 years (adjusted OR = 3.12), Muslim religion (adjusted OR = 2.64), and receiving medical services (AOR 3.1). Severely impaired global functioning was associated with female gender (adjusted OR = 2.75) and unstable housing status (adjusted OR = 2.21).

Conclusion: Findings highlight the importance of examining post-migration variables such as length of time in country prior to receiving services in addition to pre-migration torture history upon relocated torture survivors. Clinicians and policy-makers should be aware of the importance of early mental health screening and intervention on reducing the psychiatric burden associated with torture and forced relocation.

Original languageEnglish (US)
Pages (from-to)549-560
Number of pages12
JournalSocial psychiatry and psychiatric epidemiology
Issue number4
StatePublished - Apr 2015


  • Asylum
  • Health services
  • Mental health
  • Refugee
  • Trauma

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health


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