Global refugee crisis around the world has displaced millions of people from their homes. Although some of them adjust well, many suffer from significant psychological distress, such as post-traumatic stress disorder (PTSD), owing to exposure to traumatic events and hardships. Here, diagnosis and access to psychological health care present particular challenges for various human-centered design issues. Therefore, analyzing the case of Rohingya refugees in Bangladesh, we propose a two-way diagnosis of PTSD using (i) short inexpensive questionnaire to determine its prevalence, and (ii) low-cost portable EEG headset to identify potential neurobiological markers of PTSD. To the best of our knowledge, this study is the first to use consumer-grade EEG devices in the scarce-resource settings of refugees. Moreover, we explored the underlying structure of PTSD and its symptoms via developing various hybrid models based on Bayesian inference by combining aspects from both reflective and formative models of PTSD, which is also the first of its kind. Our findings revealed several key components of PTSD and its neurobiological abnormality. Moreover, challenges faced during our study would inform design processes of screening tools and treatments of PTSD to incorporate refugee experience in a more meaningful way during contemporary and future humanitarian crisis.

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Post-traumatic stress disorder (PTSD) negatively influences a person's ability to cope and increases psychiatric morbidity. The existing diagnostic tools of PTSD are often difficult to administer within marginalized communities due to language and cultural barriers, lack of skilled clinicians, and stigma around disclosing traumatic experiences. We present an initial proof of concept for a novel, low-cost, and creative method to screen the potential cases of PTSD based on free-hand sketches within three different communities in Bangladesh: Rohingya refugees (n = 44), slum-dwellers (n = 35), and engineering students (n = 85). Due to the low overhead and nonverbal nature of sketching, our proposed method potentially overcomes communication and resource barriers. Using corner and edge detection algorithms, we extracted three features (number of corners, number and average length of strokes) from the images of free-hand sketches. We used these features along with sketch themes, participants' gender and group to train multiple logistic regression models for potentially screening PTSD (accuracy: 82.9-87.9%). We improved the accuracy (99.29%) by integrating EEG data with sketch features in a Random Forest model for the refugee population. Our proposed initial assessment method of PTSD based on sketches could potentially be integrated with phones and EEG headsets, making it widely accessible to the underrepresented communities.