Social Science and Medicine
Volume 57, Issue 5, 2003, Pages 775-781

Dimensions of trauma associated with posttraumatic stress disorder (PTSD) caseness, severity and functional impairment: A study of Bosnian refugees resettled in Australia (Article)

Momartin S.* , Silove D. , Manicavasagar V. , Steel Z.
  • a School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
  • b School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
  • c School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
  • d School of Psychiatry, University of New South Wales, Sydney, NSW, Australia

Abstract

Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma experiences. Discerning which experiences are most salient to generating and perpetuating disorders such as posttraumatic stress disorder (PTSD) is critical to the mounting rational strategies for targeted psychosocial interventions. In a sample of Bosnian Muslim refugees (n=126) drawn from a community centre and supplemented by a snowball sampling method, PTSD status and associated disability were measured using the clinician-administered PTSD Scale (CAPS) for DSM-IV. A principal components analysis (PCA) based on a pool of trauma items yielded four coherent trauma dimensions: Human Rights Violations, Threat to Life, Traumatic Loss and Dispossession and Eviction. A cluster analysis identified three subgroupings according to extent of trauma exposure. There were no differences in PTSD risk for the group most exposed to human rights violations (internment in concentration camps, torture) compared to the general war-exposed group. Logistic regression analysis using the dimensions derived from the PCA indicated that Threat to Life alone of the four trauma factors predicted PTSD status, a finding that supports the DSM-IV definition of a trauma. Both Threat to Life and Traumatic Loss contributed to symptom severity and disability associated with PTSD. It may be that human rights violations pose a more general threat to the survivor's future psychosocial adaptation in areas of functioning that extend beyond the confines of PTSD. © 2003 Elsevier Science Ltd. All rights reserved.

Author Keywords

Australia Bosnian refugees resettlement trauma

Index Keywords

rating scale social psychology refugee Australia logistic regression analysis sampling mental health human risk assessment Refugees community middle aged war Survivors controlled study moslem health status Bosnia and Herzegovina Aged human rights Bosnia-Herzegovina cluster analysis Humans ethnic conflict Adolescent Severity of Illness Index male female Aged, 80 and over prediction Multivariate Analysis symptom Article social adaptation functional disease life major clinical study adult posttraumatic stress disorder Stress Disorders, Post-Traumatic disability disease severity principal component analysis threat Torture immigrant population

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0038501064&doi=10.1016%2fS0277-9536%2802%2900452-5&partnerID=40&md5=5331b75101480e7009cee698af66ccb7

DOI: 10.1016/S0277-9536(02)00452-5
ISSN: 02779536
Cited by: 56
Original Language: English