We explored the mental health effects of war trauma and torture as described by 111 refugees newly arrived in the United States. We used ethnocultural methodologies to inform 13 culture-specific focus groups with refugees from Bhutan (34), Burma (23), Ethiopia (27), and Somalia (27). Contrary to the belief that stigma prevents refugees from discussing mental health distress, participants readily described complex conceptualizations of degrees of mental health distress informed by political context, observation of symptoms, cultural idioms, and functional impairment. Recommendations for health care providers include assessment processes that inquire about symptoms in their political context, the degree of distress as it is culturally conceptualized, and its effect on functioning. Findings confirm the cross-cultural recognition of symptoms associated with posttraumatic stress disorder; however, refugees described significant cultural variation in expressions of distress, indicating the need for more research on culture-bound disorders and idioms of distress. © The Author(s) 2014.

posttraumatic stress disorder (PTSD) refugees, research, cross-cultural war, victims of focus groups mental health and illness trauma

information processing cultural anthropology refugee war exposure Emotions mental health human Refugees middle aged comparative study Aged Bhutan United States Young Adult Humans psychology Cross-Cultural Comparison Adolescent male female cognition Myanmar cultural factor emotion Ethiopia adult Somalia Stress Disorders, Post-Traumatic Anthropology, Cultural adverse effects Focus Groups Torture