Social Science and Medicine
Volume 69, Issue 9, 2009, Pages 1387-1394

Anger, PTSD, and the nuclear family: A study of Cambodian refugees (Article)

Hinton D.E.* , Rasmussen A. , Nou L. , Pollack M.H. , Good M.-J.
  • a Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, 15 Parkman Street, WACC 812, Boston, United States, Southeast Asian Clinic, Arbour Counseling, Lowell, MA, United States
  • b Division of General Internal Medicine, New York University School of Medicine, United States
  • c Department of Sociology, California State University, Long Beach, United States
  • d Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, 15 Parkman Street, WACC 812, Boston, United States
  • e Harvard University, Cambridge, MA, United States

Abstract

This study profiles the family-directed anger of traumatized Cambodian refugees, all survivors of the Pol Pot genocide (1975-1979), who were patients at a psychiatric clinic in Lowell, MA, USA. We focus on the nuclear family (NF) unit, the NF unit defined as the patient's "significant other" (i.e. spouse or boyfriend/girlfriend) and children. Survey data were collected from a convenience sample of 143 Cambodian refugee patients from October 2006 to August 2007. The study revealed that 48% (68/143) of the patients had anger directed toward a NF member in the last month, with anger directed toward children being particularly common (64 of the 143 patients, or 49% [64/131] of the patients with children). NF-type anger was severe, for example, almost always resulting in somatic arousal (e.g., causing palpitations in 91% [62/68] of the anger episodes) and often in trauma recall and fears of bodily dysfunction. Responses to open-ended questions revealed the causes of anger toward a significant other and children, the content of anger-associated trauma recall, and what patients did to gain relief from anger. A type of cultural gap, namely, a linguistic gap (i.e., the parent's lack of English language skills and the child's lack of Khmer language skills), seemingly played a role in generating conflict and anger. NF-type anger was associated with PTSD presence. The effect of anger on PTSD severity resulted in part from anger-associated trauma recall and fears of bodily dysfunction, with 54% of the variance in PTSD severity explained by that regression model. The study: 1) suggests that among traumatized refugees, family-related anger is a major clinical concern; 2) illustrates how family-related anger may be profiled and investigated in trauma-exposed populations; and 3) gives insights into how family-related anger is generated in such populations. © 2009 Elsevier Ltd. All rights reserved.

Author Keywords

Catastrophic cognitions Anger Acculturation PTSD USA Cambodian refugees Family

Index Keywords

refugee regression analysis demography Cambodia Massachusetts human Refugees survivor language ability middle aged Stress, Psychological Aged Adaptation, Psychological anger language checklist United States North America Humans Severity of Illness Index Lowell Interviews as Topic male Acculturation cognition female psychological rating scale Psychiatric Status Rating Scales qualitative analysis population research Parent-Child Relations Article Family Relations major clinical study adult posttraumatic stress disorder Stress Disorders, Post-Traumatic Nuclear Family disease severity heart palpitation psychotrauma quantitative analysis Mental Recall Genocide

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-72049089323&doi=10.1016%2fj.socscimed.2009.08.018&partnerID=40&md5=533735aba5322b25ba5b0a2f522827ac

DOI: 10.1016/j.socscimed.2009.08.018
ISSN: 02779536
Cited by: 70
Original Language: English