Trauma, exile and mental health in young refugees

A review about the connection between trauma, exile and mental health in young refugees from the Middle East.

The Forgotten Children. National Inquiry into Children in Immigration Detention 2014

This report gives a voice to these children. It provides compelling first-hand evidence of the impact that prolonged immigration detention is having on their mental and physical health. The evidence given by the children and their families is fully supported by psychiatrists, pediatricians and academic research.

Frequent relocations between asylum-seeker centres are associated with mental distress in asylum-seeking children

This study concludes that the risk of mental distress is greater in asylum-seeking children who have undergone a high annual relocation rate.

Sexual Violence and Migration The hidden reality of Sub-Saharan women trapped in Morocco en route to Europe

The exact proportions of sexual violence are impossible to measure, yet MSF’s medical data reveals that it is a problem of alarming proportions. Information provided by our patients reveals the high risk of sexual violence throughout the migration process, with survivors experiencing rape and other forms of sexual violence by numerous different perpetrators in their countries of origin, in route and in Morocco itself.

80% of Central American women and girls are raped crossing to the US

According to a stunning Fusion investigation, 80 percent of women and girls crossing into the U.S. by way of Mexico are raped during their journey. That’s up from a previous estimate of 60 percent, according to an Amnesty International report. Through May, the number of unaccompanied girls younger than 18 caught at the US-Mexico border increased by 77 percent.

I didn’t Have Anywhere to Run: Migrant Women Are Facing a Rape Epidemic

An estimated 60 to 80 percent of female migrants from Central America are sexually assaulted on their journey—and perpetrators often act with total impunity. As thousands of Central American women weigh the risks of migrating to the US each year, they must take into account an extra peril: An estimated 80 percent of female migrants from Central America are victims of sexual abuse at the hands of criminal groups, human smugglers, or corrupt officials during the journey.

Female Asylum-Seekers and Refugees in France

The aim of this study is to provide a comprehensive review of the situation of female asylum-seekers and refugees in France, in order to furnish a base of information which might guide future UNHCR policies and actions in this area, and which may serve to make recommendations to French government and institutions.

Women’s Refugee Commission

This Commission advocates for laws, policies, and programs to improve the lives and protect the rights of refugee and internally displaced women, including those seeking asylum.

Reception Conditions for Torture Victims in the European Union

Torture victims are not receiving the specialised support they need to get better and to engage effectively with the asylum process. One reason for this is that most EU Member States, including the eight countries featured in this report, do not have a procedure for systematic identification of torture victims in the asylum procedure. This key issue has a range of negative consequences on the individual, such as deteriorating physical and mental health and flawed consideration of their asylum claim.

Resilience as a Protective Factor against the Development of Psychopathology among Refugees

Refugee research to date has predominantly focused on factors that make refugees more vulnerable for developing posttraumatic stress disorder (PTSD) and /or psychological distress. Few papers have studied potential protective factors such as resilience.

15 TED Talks on refugee resilience

Feel like getting inspired today? Then look no further than these TED and TEDx Talks that highlight the resilience of refugees from all around the world. These are just a handful of voices representing the ingenuity of tens of millions of displaced persons and the daily struggles they face.

Common mental health problems in immigrants and refugees: general approach in primary care

Systematic inquiry into patients’ migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way

A paradigm shift: relationships in trauma-informed mental health services

Trauma-informed approaches emerged partly in response to research demonstrating that trauma is widespread across society, that it is highly correlated with mental health and that this is a costly public health issue. The fundamental shift in providing support using a trauma-informed approach is to move from thinking ‘What is wrong with you?’ to considering ‘What happened to you?

The impact of detention on the health of asylum seekers: a protocol for a systematic review

This Campbell systematic review assessed whether detaining asylum seekers has an impact on their mental health. The review also assessed whether detaining asylum seekers has a negative impact on their physical health and social functioning.

The impact of immigration detention on mental health

The article outlines the effects of detention of asylum-seekers in their country of refuge. Anxiety, depression and post-traumatic stress disorder were most commonly reported.

Public health aspects of mental health among migrants and refugees

This paper reviews current literature regarding the mental health of asylum seekers and refugees. Good practice measures for mental health care is also discussed.

Predictors of acculturative hassles among Vietnamese refugees in Norway: Results from a long-term longitudinal study

The article suggests that addressing psychological distress during the early phase in a resettlement country may promote long-term refugee adjustment and reduce exposure to acculturative hassles.

The physical and mental health problems of refugee and migrant fathers: findings from an Australian population-based study of children and their families

Fathers of refugee background experience poorer mental health and poorer general health than Australian-born fathers. Fathers who have migrated from non-English-speaking countries also report greater psychological distress than Australian-born fathers. This underscores the need for primary healthcare services to tailor efforts to reduce disparities in health outcomes for refugee populations that may be vulnerable due to circumstances and sequelae of forced migration and to recognise the additional psychological stresses that may accompany fatherhood following migration from non-English-speaking countries.

Mental health promotion and mental health care in refugees and migrants

This technical guidance reviews the prevalence of some disorders such as post-traumatic stress disorder and depressive and anxiety disorders. Based on best-available evidence regarding risk factors and areas for intervention, eight key priority action areas are identified for consideration by policymakers regarding the mental health of refugees and migrants.

Guidelines on the Treatment of Iraqi Asylum Seekers and Refugees in Europe

This paper (30 p.) is in response to the treatment of Iraqi asylum seekers and refugees in Europe, it discusses the background of decisions in whether asylum is granted (or not), and criticises some principles in handling this problem.

The Exclusion of Asylum Seekers in Europe

The article discusses mechanisms of exclusion, practiced by a number of European states, and the associated costs.

Refugees and Internally Displaced Persons

Comprehensive information on this topic. The website also provides with the basic legal framework, agencies, as well as education and training materials by lots of quite useful links.

Refugees, Asylum Seekers & Migrants: A Crucial Difference

What is the difference between a refugee, an asylum seeker and a migrant? Does it really matter to understand their definition? Yes, absolutely. It’s crucial today to understand what an asylum seeker or a refugee is because of all the misconceptions and misunderstandings around those terms.

Refugees, Asylum Seekers & Migrants: A Crucial Difference

What is the difference between a refugee, an asylum seeker and a migrant? Does it really matter to understand their definition? Yes, absolutely. It’s crucial today to understand what an asylum seeker or a refugee is because of all the misconceptions and misunderstandings around those terms.

Convention relating to the Status of Refugees

In this convention the UN frames the important topics how refugees are to be treated, referring to juridical status, employment, welfare and other subjects.

The National Child Traumatic Stress Network (NCTSN)

Created in 2000 as part of the Children’s Health Act to raise the standard of care and increase access to services for children and families who experience or witness traumatic events.

A Guide to Post Traumatic Stress Disorder

A site for military personnel and others, with a list of facts and resources for patients and their family members who are coping with PTSD, as well as medical professionals assisting with the care and treatment of PTSD patients.

David Baldwin’s Trauma Information Pages

These Trauma Pages focus primarily on emotional trauma, traumatic stress and PTSD – following both individual traumatic experience and a large-scale disaster. It provides information for clinicians and researches. It`s represents a huge collection of very useful articles and links to these topics.

PTSD Online Resource Center

A good collection of useful links related to PTSD.

Understanding Post-Traumatic Stress Disorder (PTSD)

Dr. Bruce G. Fagel have collected useful links on how to understand PTSD.

Online PTSD Helpline

It can be difficult to pick up the phone and ask for help, but calling a PTSD hotline number is a free and easy way to speak with someone who is knowledgeable about PTSD and the treatment options available.

Post-traumatic stress disorder – the management of PTSD in adults and children in primary and secondary care

Here you will find “Presenter slides”, a slide-show which presents an overview about PTSD, symptoms, and some considerations according treatment.

Wounded Spirits, Ailing Hearts Training Manual

A manual about PTSD, its symptoms and treatment, with lots of general thoughts, but all over with the very interesting focus on the impact of PTSD on American Indians and Alaska Native (American Veterans). Maybe in some aspects outdated, but quite interesting.

Shell Shock during World War One

This represents an overview by the BBC on “Shell Shock”, here in World War I, the historical development of the term, symptoms, treatment at that time. – BBC World Wars in-depth,

Usefulness and validity of post-traumatic stress disorder as a psychiatric category

Good overview (although some years old and may be therefore in some aspects outdated) on some aspects of the diagnosis of PTSD as a psychiatric diagnosis. Highlights social aspects, the validity of the diagnosis, causes, effects as well as biochemical and anatomical findings.

Conflict Transformation. Civil Conflict Management

On this website we find an overview of recent developments in the field of conflict transformation from various perspectives: from academic analysts and practitioners as well as from experts representing different areas of work inside and outside of conflict zones. The site intends to provide continually updated cutting-edge knowledge, experience and lessons learned for those working in the field of transforming violent ethnopolitical conflict.

What Dreams May Come: Treating the Nightmares of PTSD

A standard part of any psychiatric evaluation involves inquiring about a patient’s sleep. Hidden in the answers that follow the basic question of, “How are you sleeping?” are the clues that are needed to diagnose what is ailing the patient seeking help.

Correlates and Treatments of Nightmares in Adults

Nightmares, distressing dreams that primarily arise from REM sleep, are prevalent among the general population and even more so among clinical populations. The frequency of nightmares and related nightmare distress are linked to both sleep disturbance and waking psychopathology. Based on the extant evidence, nightmares appear to be particularly relevant to posttraumatic stress disorder, and may even be implicated in its pathophysiology.

PTSD and Nightmares

The scientific community has made major strides in recent years to untangle PTSD, a mental health condition that can trigger flashbacks to a traumatic event or cause one to feel distant and angry. Advancements have been made to understand the reasons behind PTSD, where the condition takes hold in the brain, and which therapies work best.

The relationship between nightmares and PTSD: The possible role of Image Rescripting in the treatment of PTSD

One of the most common and distressing symptoms of PTSD are nightmares, which occur in 50 – 70% of PTSD patients. It is suggested that sleep problems are a core feature of PTSD, and that they form a risk factor in PTSD development. Despite the high prevalence of nightmares and the distress they cause, first-line treatment in PTSD does not focus on sleep. However, evidence suggests that sleep problems usually remain as residual symptoms after PTSD is treated.

The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category

This article represents a debate on PTSD with several aspects not often to be seen in a clinical daily routine, with also ethical aspects. Is PTSD always to be seen as a disease? Which impact do sociopolitical and medical aspects have on setting a diagnosis?

Pharmacotherapy for PTSD

We searched the Cochrane Depression, Anxiety and Neurosis Group specialised register (CCDANCTR‐Studies) on 18 August 2005, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 4, 2004), MEDLINE (January 1966 to December 2004), PsycINFO (1966 to 2004), and the National PTSD Center Pilots database. Reference lists of retrieved articles were searched for additional studies.

Expert Consensus Guideline Series: Treatment of Posttraumatic Stress Disorder

This is a supplement to the Journal of Clinical Psychiatry, where information about PTSD, recommended approaches and therapy suggestions are collected. Target group: clinicians/professionals. It gives an good overview, which is unfortunately kind of limited because it`s edited in 1999, and some of the newer therapies (as EMDR) are`nt mentioned yet, as well as recommendation concerning medication can be partially outdated.

Practice guidelines for the treatment of patients with ASD and PTSD

A great overview of current approach and treatment, kind of clinical standard. This represents a so called “guideline-watch”, a supplement to get the original guideline (from 2004) up-to-date. Target group: clinicians

Post-traumatic Stress Disorder: National Clinical Practice Guideline

This is the complete PTSD-guideline of the “National Institute for Clinical Excellence” / NICE. Great overview, considering all of the importend topics from symptoms, treatment (also regarding children), intervention, recommendations.

Psychological therapies for chronic post‐traumatic stress disorder (PTSD) in adults

This is an article in “The Cochrane Library”, where the author reviews lots of trials of all psychological treatments considered useful by The Cochrane Collaboration. Target group: clinicians/professionals. 

Eye Movement Desensitization and Reprocessing (EMDR) Therapy

A structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories.

Efficacy of exposure based cognitive behaviour therapy for posttraumatic stress disorder in emergency service personnel: a randomised clinical trial

Although emergency service personnel experience markedly elevated the rates of post-traumatic stress disorder (PTSD), there are no rigorously conducted trials for PTSD in this population. This study assessed the efficacy of cognitive behaviour therapy (CBT) for PTSD in emergency service personnel, and examined if brief exposure (CBT-B) to trauma memories is no less efficacious as prolonged exposure (CBT-L).

Trauma Symptom Check-list 40

TSC is limited to professionals (should not be used as self-test). “The TSC-40 is a research measure that evaluates symptomatology in adults associated with childhood or adult traumatic experiences. It measures aspects of posttraumatic stress and other symptom clusters found in some traumatized individuals. It does not measure all 17 criteria of PTSD, and should not be used as a complete measure of that construct.” – John Briere, Marsha Runt.

Psychological Testing: Minnesota Multiphasic Personality Inventory

The original MMPI was developed in 1939 (Groth Marnat, Handbook of Psychological Assessment, 2009) using an empirical keying approach, which means that the clinical scales were derived by selecting items that were endorsed by patients known to have been diagnosed with certain pathologies

Mississippi Scale for Combat-Related PTSD (M-PTSD) for DSM-III

The M-PTSD is a 35-item self-report measure that assesses combat-related PTSD in Veteran populations. Items sample DSM-III symptoms of PTSD and frequently observed associated features (substance abuse, suicidality, and depression).

Modified PTSD Symptom Scale (MPSS-SR) for DSM-III-R

The MPSS-SR is a 17-item self-report measure that assesses the 17 DSM-III-R symptoms of PTSD. This scale is a modification of the PTSD Symptom Scale (PSS; Foa, Riggs, Dancu, & Rothbaum, 1993), which was a precursor of the Posttraumatic Stress Diagnostic Scale (PDS; Foa, et al.).

Structured Clinical Interview for the DSM-5 (SCID PTSD Module)

The Structured Clinical Interview for DSM-5 (SCID-5) is a semi-structured interview for making the major DSM-5 diagnoses. The instrument is designed to be administered by a clinician or trained mental health professional.

Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)

The CAPS is the gold standard in PTSD assessment. The CAPS-5 is a 30-item structured interview that can be used to: Make current (past month) diagnosis of PTSD. Make lifetime diagnosis of PTSD. Assess PTSD symptoms over the past week

Psychiatric Rating Scales for PTSD

A catalogue of the most used assessments, some as direct links, most of the assessments has to be purchased. Neurotransmitter.net There are lots of assessments available, which should help to diagnose and measure PTSD-symptoms. Only some of these assessments are available for free, most of them have to be purchased. Specially the structured clinical interviews are thought to be used only by clinicians. Therefore we present here a list of the most common assessments just with names.

FAQs about PTSD Assessment: For Professionals

A fact sheet that provides professionals/therapists with answers about the most common questions about PTSD-assessments.

Overview over the most used assessments

The National Center for PTSD provides a catalogue of many assessments used to measure trauma exposure and PTSD. You will find lots of information about the scales and interviews, and the significance of each. You will not find the assessments themselves here (some can be purchased via website).

The Best Online PTSD Support Groups

First, it’s important to understand that support groups aren’t the same as professional treatment. Formal group therapy is typically run by a mental health professional. Meanwhile, support groups may not be run by a professional. In therapy, you’ll have a safe and confidential space to share your experiences of trauma and PTSD with a trained mental health professional.

The Linen Cupboard Metaphor – Treatment of Post Traumatic Stress Disorder (PTSD)

A good metaphor for why and how to work with PTSD.

Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium

The stress that results from traumatic events precipitates a spectrum of psycho-emotional and physiopathological outcomes. Post-traumatic stress disorder (PTSD) is a psychiatric disorder that results from the experience or witnessing of traumatic or life-threatening events. PTSD has profound psychobiological correlates, which can impair the person’s daily life and be life threatening. In light of current events (e.g. extended combat, terrorism, exposure to certain environmental toxins), a sharp rise in patients with PTSD diagnosis is expected in the next decade.