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

Abstract

This study profiles the family-directed anger of traumatized Cambodian refugees, all survivors of the Pol Pot genocide (1975)(1976)(1977)(1978)(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.

Paternal predictors of the mental health of children of Vietnamese refugees

“…Several studies of Vietnam veterans document the disruption of the family environment [3,4], in parallel with a recent study of Cambodian refugee families investigating the relation between PTSD and long-term family dysfunction after Pol Pot [55]. In the reported study however, the absence of association between a father's PTSD and family environment variables does not support this hypothesis.…”

The Adjustment of Asian American Families to the U.S. Context: The Ecology of Strengths and Stress

“…These effects may last for years, even after they have settled in the host country. For instance, a study conducted by Hinton, Rasmussen, Leakhena, Pollack, and Good (2009), with 143 Cambodian refugee patients at a psychiatric clinic in Massachusetts, highlights these important issues. The refugees in the sample had survived the Pol Pot genocide (1975)(1976)(1977)(1978)(1979), in which more than 1.7 million Cambodians were executed or died of starva-tion (Hinton et al).…”

A Historical Analysis of Southeast Asian Refugee Communities: Post-war Acculturation and Education in the U.S.

“…It is estimated that about one fourth of the entire Cambodian population died from torture, starvation, sickness, or exhaustion during the years of Pol Pot's rule (Kim, 2002). The Cambodian refugees who had survived the years of the Khmer Rouge regime thus generally consisted of the uneducated and unskilled laborers who had survived the genocide; additionally, they were more likely to arrive with symptoms of mental illness and to be headed by widowed mothers rather than fully intact families (Desbarats, 1985;Hinton, Rasmussen, Nou, Pollack, & Good, 2009;Rumbaut, 1989).…”

“…It was first noted at the processing camps in the U.S. that the refugees had need of psychological services at a level that had been unexpected (Montero & Dieppa, 1982). Cambodians had seen unparalleled atrocities, and have been especially prone to suffer from Post-Traumatic Stress Disorder as well as depression and other mental illnesses as a result, which has impacted their ability to effect upward social mobility not only for themselves, but also for their children (Carlson & RosserHogan, 1991;Hinton et al, 2009;Kinzie, Sack, Angell, Manson, & Rath, 1986). While the factor of psychological health is absent from the modes of Asian incorporation framework in use for this analysis, it is necessary to consider this issue as an additional barrier experienced by all Southeast Asian groups.…”