Entering exile: Trauma, mental health, and coping among Tibetan refugees arriving in Dharamsala, India

Abstract

Each year thousands of Tibetans escape Chinese-controlled Tibet. The authors present findings on the experiences, coping strategies, and psychological distress (depression, anxiety, somatization, and posttraumatic stress disorder) of 769 Tibetan refugees arriving in Dharamsala, India (2003-2004). Distress increased significantly with greater trauma exposure. However, despite a high prevalence of potentially traumatizing events, levels of psychological distress were extremely low. Coping activity (primarily religious) and subjective appraisals of trauma severity appeared to mediate the psychological effects of trauma exposure. The potential impact of other variables, including culturally determined attitudes about trauma and timing of assessment, are discussed.

Efficient identification of mental health problems in refugees in Germany: the Refugee Health Screener

“…Further, manifest PTSD symptoms in refugees often appear after some time, when the so-called ‘honeymoon phase’ of euphoria and relief has passed (e.g. Sachs, Rosenfeld, Lhewa, Rasmussen, & Keller, 2008), but it can be detected quite early using the predictive utility of early depression and anxiety symptoms (Smid, Lensvelt-Mulders, Knipscheer, Gersons, & Kleber, 2011). …”

Trauma and the Making of Flexible Minds in the Tibetan Exile Community

“…But while the exile community is well established, India does not formally recognize the Tibetan government-in-exile as a legitimate political body. Tibetans come to India for a variety of reasons including: education and economic opportunities, cultural or religious persecution, to join a monastery/nunnery, and to meet the Dalai Lama (Sachs et al 2008). Many Tibetans come to the exile community destitute and uneducated; some have been political prisoners and survivors of torture.…”

“…We know little about those who manage to thrive in spite of personal histories of political violence and what kinds of sociocultural practices enhance their resilience. A relatively new body of research suggests that the Tibetan exile community is unusually resilient (Lhewa et al 2007; Ruwanpura et al 2006;Sachs et al 2008;Terheggen et al 2001). These studies cite testimony from Tibetan refugees who claim their religion allows them to thrive.…”

El exilio como campo de estudios en ciencias sociales: análisis bibliométrico

“…Otra línea de los estudios publicados ha fijado su atención en los efectos del exilio sobre el funcionamiento psicológico y emocional de las personas; esta área ha sido de mayor variedad en los enfoques, pues algunos trabajos focalizan el exilio como un componente esencial para la configuración de problemáticas serias como la desintegración familiar, la angustia, el desarraigo y problemas de salud mental (Roniger y Yankelevich, 2009), mientras que otros le han tomado como el escenario de fondo para la evaluación de variables individuales como la capacidad de afrontamiento o, en particular, las características del trauma (Sachs, Rosenfeld, Lhewa, Ramussen, & Keller, 2008;Plata y Rodríguez, 2012), estos últimos estudios son de un enfoque positivista, con fines de asociación de variables o explicación del fenómeno psicoemocional; entretanto, los primeros tienen una connotación sociocrítica.…”