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

doi:10.1007/s00127-014-0982-1

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

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

35 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	549-560
Number of pages	12
Journal	Social psychiatry and psychiatric epidemiology
Volume	50
Issue number	4
DOIs	https://doi.org/10.1007/s00127-014-0982-1
State	Published - Apr 2015

Keywords

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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10.1007/s00127-014-0982-1

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@article{08eaba467f734fd285d3baee733b3073,

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

abstract = "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.",

keywords = "Asylum, Health services, Mental health, Refugee, Trauma",

author = "Song, {Suzan J.} and Charles Kaplan and Tol, {Wietse A.} and Andrew Subica and {de Jong}, Joop",

note = "Funding Information: This project was supported by a grant from the Stanford Office of Community Health. We also wish to express our appreciation to James Livingston, PhD, Sarita Kohli, LMFT and Armina Husic for their support, and to the clinicians of the Center for Survivors of Torture who are dedicated to serving this community. We also thank all of the participants who made this research possible. Publisher Copyright: {\textcopyright} 2014, Springer-Verlag Berlin Heidelberg.",

year = "2015",

month = apr,

doi = "10.1007/s00127-014-0982-1",

language = "English (US)",

volume = "50",

pages = "549--560",

journal = "Social psychiatry and psychiatric epidemiology",

issn = "0933-7954",

publisher = "D. Steinkopff-Verlag",

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TY - JOUR

T1 - Psychological distress in torture survivors

T2 - pre- and post-migration risk factors in a US sample

AU - Song, Suzan J.

AU - Kaplan, Charles

AU - Tol, Wietse A.

AU - Subica, Andrew

AU - de Jong, Joop

N1 - Funding Information: This project was supported by a grant from the Stanford Office of Community Health. We also wish to express our appreciation to James Livingston, PhD, Sarita Kohli, LMFT and Armina Husic for their support, and to the clinicians of the Center for Survivors of Torture who are dedicated to serving this community. We also thank all of the participants who made this research possible. Publisher Copyright: © 2014, Springer-Verlag Berlin Heidelberg.

PY - 2015/4

Y1 - 2015/4

N2 - 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.

AB - 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.

KW - Asylum

KW - Health services

KW - Mental health

KW - Refugee

KW - Trauma

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SN - 0933-7954

VL - 50

SP - 549

EP - 560

JO - Social psychiatry and psychiatric epidemiology

JF - Social psychiatry and psychiatric epidemiology

IS - 4

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

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