The original versions of the Harvard Trauma Questionnaire and Hopkins Symptoms Checklist-25 were written and subsequently validated in the Cambodian, Laotian, and Vietnamese languages. For use in a Dutch treatment center, with refugee patients mostly speaking other languages, additional translations were made. The objective of this study was examination of the psychometric properties of some of these new translations, i.e., the Arabic, Farsi, Serbo-Croatian, Russian, and English bilingual adaptations. It is concluded that the psychometric properties of both tests are adequate across those different cultures and are, in general, applicable to measure symptoms of depression, anxiety, and posttraumatic stress disorder.

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Nowadays, the PTSD diagnosis is often a prerequisite for the survivor's access to specialized treatment services and for obtaining legal recognition or financial compensation when exposed to violence. However, some survivors do not meet all necessary criteria for the PTSD diagnosis, particularly not in the long term. Therefore, they run the risk of being misdiagnosed, inadequately helped or undertreated, and may remain legally unrecognized and unprotected. In this article the "hidden" long-term impacts of exposure to war and violence, beyond the PTSD diagnosis, are presented, discussed, and illustrated with case presentations. They include dissociative states, attachment problems, personality changes, guilt, shame, rage, identity issues, moral injury, substances abuse, damaged core beliefs, and bodily sensations linked to stress activation. These phenomena are not persistent, but fluctuate over the survivor's life trajectories. Moreover, the "hidden" impacts are framed within theoretical models for understanding long-term impacts of exposure to violence. The models help us grasp the dynamics of interactions between resilience, psychological damage, context and time. These interactions are non linear, and contingently result in development of psychopathological phenomena when reaching a threshold during a process of accumulating potentially traumatic experiences over a survivors' lifetime. Understanding psychological impacts of exposure to violence as a spectrum of interchangeable phenomena over a lifetime, and learning to recognize the "hidden" manifestations of psychological trauma will help to improve mental and legal assistance to the survivors both on a short and long term.

was suspected of causing reversible neutro penia during a cold (Meylan et a!, 1995). The same patient did not develop neutrope nia at re-challenge two years later (Bondolfi eta!, 1996). In anothercase, agranulocytosis was reported after risperidone was com bined with clozapine (Godleski & Sernyak, 1996). We report a case of risperidone induced leucopenia and neutropenia in a patient who had previously developed blood dyscrasia on clozapine. A 63-year-old White male patient with a 45-year history of chronic paranoid schizophrenia was unsuccessfully treated with almost every antipsychotic that came on the market. Clozapine treatment was stopped because of leucopenia (white blood count (WBC) 2.5 x i0@/l, neutrophil count 1.2 x 10'Il). During the next 10 months the patient did not receive antipsychotics and the psychotic symptoms gradually wor sened. One week after risperidone 2 mg b.i.d was added to 100 mg methotrimepra zinc the WBC fell from 4.5 to 3.2 x i0@/l and the neutrophil count from 3.7 to 2.3 x 10@/l.During the next six months the WBC and neutrophil counts were slowly

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