Psychological medicine
Volume 49, Issue 9, 2019, Pages 1481-1489

Defining a combined constellation of complicated bereavement and PTSD and the psychosocial correlates associated with the pattern amongst refugees from West Papua (Article) (Open Access)

Tay A.K. , Rees S. , Tam N. , Kareth M. , Silove D.
  • a Centre for Population Mental Health Research, Liverpool Hospital, Psychiatry, Research and Teaching Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool NSW 2170, Sydney, Australia
  • b Centre for Population Mental Health Research, Liverpool Hospital, Psychiatry, Research and Teaching Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool NSW 2170, Sydney, Australia
  • c Centre for Population Mental Health Research, Liverpool Hospital, Psychiatry, Research and Teaching Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool NSW 2170, Sydney, Australia
  • d Centre for Population Mental Health Research, Liverpool Hospital, Psychiatry, Research and Teaching Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool NSW 2170, Sydney, Australia
  • e Centre for Population Mental Health Research, Liverpool Hospital, Psychiatry, Research and Teaching Unit, School of Psychiatry, University of New South Wales, Cnr Forbes and Campbell Streets, Liverpool NSW 2170, Sydney, Australia

Abstract

BACKGROUND: Refugees are at risk of experiencing a combined constellation of complicated bereavement and posttraumatic stress disorder (PTSD) symptoms following exposure to complex traumas associated with personal threat and loss. Features of identity confusion are central to both complicated bereavement and PTSD and these characteristics may be particularly prominent amongst refugees from traditional cultures displaced from their homelands, families, and kinship groups. We investigate whether a combined pattern of complicated bereavement and PTSD can be identified amongst West Papuan refugees participating in an epidemiological survey (n = 486, response rate: 85.8%) in a remote town in Papua New Guinea. METHODS: Latent class analysis was applied to derive subpopulations of refugees based on symptoms of complicated bereavement and PTSD. Associations were examined between classes and traumatic loss events, post-migration living difficulties (PMLDs), and psychosocial support systems. RESULTS: The four classes identified comprised a complicated bereavement class (11%), a combined posttraumatic bereavement class (10%), a PTSD class (11%), and a low symptom class (67%). Symptoms of identity confusion were prominent in the posttraumatic bereavement class. Compared with the low symptom class, the combined posttraumatic bereavement class reported greater exposure to traumatic loss events (OR 2.43, 95% CI 1.11-5.34), PMLDs (OR 2.24, 95% CI 1.01-4.6), disruptions to interpersonal bonds and networks (OR 3.3, 95% CI 1.47-7.38), and erosion of roles and identities (OR 2.18, 95% CI 1.11-4.27). CONCLUSIONS: Refugees appear to manifest a combined pattern of complicated bereavement and PTSD symptoms in which identity confusion is a prominent feature. This response appears to reflect the combined impact of high levels of exposure to traumatic losses, PMLDs, and disruption of relevant psychosocial systems.

Author Keywords

Psychosocial Refugee Post-migration living difficulties PTSD Complicated bereavement prolonged grief

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85052852925&doi=10.1017%2fS0033291718002027&partnerID=40&md5=acf6e7494abb96bcd4ca88afa017ccda
DOI: 10.1017/S0033291718002027
ISSN: 14698978
Cited by: 1
Original Language: English