Measuring Trauma and Health Status in Refugees

Hollifield, Michael; Warner, Teddy D.; Lian, Nityamo; Krakow, Barry; Jenkins, Janis H.; Kesler, James; Stevenson, Jayne; Westermeyer, Joseph

doi:10.1001/jama.288.5.611

Cited by 581 publications

(460 citation statements)

References 111 publications

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“…Similar to other refugee populations (Fazel, Wheeler, & Danesh, 2005; Hollifield, Warner, & Lian et al, 2002), NKRs are often exposed to traumatic events while in North Korea and during their escape (Jeon, Yu, Cho, & Eom, 2008). Even after a successful escape, they tend to experience difficulties in adapting to the unfamiliar culture of the country in which they settle (Jeon, Min, Lee, & Lee, 1997).…”

Section: Introductionmentioning

confidence: 94%

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

Lee¹,

Lee²,

Park³

2017

European Journal of Psychotraumatology

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Background: North Korean refugees (NKRs) are often exposed to traumatic events in North Korea and during their defection. Furthermore, they face sociocultural barriers in adapting to the new society to which they have defected. Objective: To integrate previous findings on this mentally vulnerable population, we systematically reviewed articles on the mental health of NKRs in South Korea. Method: We searched for empirical studies conducted in the last 10 years in six online databases (international journals: Embase, PubMed, Scopus, Web of Science; Korean journals: DBPIA, KMbase) through June 2017. Only quantitative studies using new empirical data on the mental health of NKRs were included. We summarized the 56 studies ultimately selected in terms of NKRs’ mental health status and three domains of associated factors: pre- and post-settlement factors and personal factors. Results: NKRs had a high prevalence and severity of psychiatric symptoms, particularly post-traumatic stress disorder and depression. We identified nine risk factors consistently found in previous studies, including traumatic experience, longer stay periods in third country, forced repatriation, acculturative stress, low income, older age, poor physical health, and female and male sex, as well as four protective factors, including educational level in North Korea, social support, family relationship quality, and resilience. Conclusions: We suggest that future studies focus on the causal interactions between different risk and protective factors and mental health outcomes among NKRs from a longitudinal perspective. Furthermore, comprehensive policies for NKRs’ psychological adaptation are needed, particularly the development of evidence-based mental health interventions.

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Section: Introductionmentioning

confidence: 94%

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

Lee¹,

Lee²,

Park³

2017

European Journal of Psychotraumatology

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“…Ces deux instruments, bien validés, ont été utilisés dans de nombreuses études auprès de réfugiés et de demandeurs d'asile (Kleijin et al, 2001 ;Hollifi eld et al, 2002), incluant quatre autres études quantitatives sur la santé mentale des demandeurs d'asile détenus (Keller et al, 2003 ;Ichikawa et al, 2006 ;Momartin et al, 2006 ;Steel et al, 2006). Pour les besoins de notre étude, les instruments ont été traduits en français, espagnol, arabe, farsi, tamoul et ourdou, selon la procédure reconnue (Kleijin et al, 2001).…”

Section: L'impact De La Détention Sur La Santé Mentale Des Demandeursunclassified

L’expérience des demandeurs d’asile détenus au Canada

Cleveland

Dionne-Boivin

Rousseau

2013

crimino

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Au Canada, les demandeurs d’asile détenus en vertu des lois sur l’immigration sont enfermés dans des établissements de type carcéral, même si moins de 6 % d’entre eux sont soupçonnés de criminalité ou de dangerosité. Nous présentons un survol de la situation canadienne, incluant des données tirées de notre récente étude sur l’impact de la détention sur la santé mentale des demandeurs d’asile. Cette étude fut menée auprès de 122 demandeurs d’asile adultes détenus dans des centres de surveillance de l’immigration, à Montréal et à Toronto, et d’un groupe témoin de 66 demandeurs d’asile non détenus. Les demandeurs d’asile détenus vivent un sentiment de disempowerment et de perte d’agentivité en raison du régime de surveillance et de règles strictes dans lequel ils sont placés et de la durée indéterminée de leur détention. Après une incarcération moyenne de 31 jours, le niveau de symptômes psychiatriques était nettement plus élevé chez les demandeurs d’asile détenus que chez les non-détenus ayant eu une exposition traumatique prémigratoire équivalente. La Loi visant à protéger le système d’immigration du Canada (projet de loi C-31) prévoit que des demandeurs d’asile désignés par le ministre, incluant des jeunes de 16 ans et plus, seront automatiquement détenus avec une possibilité très limitée de demander la libération. Il faudrait, au contraire, envisager des solutions de rechange moins contraignantes.Under Canadian immigration law, detained asylum seekers are held in prison-like facilities although less than 6 % of them are suspected of criminality or dangerousness. We present an overview of the Canadian situation, including data drawn from our recent study on the impact of detention on asylum seekers’ mental health. The study involved 122 adult asylum seekers detained in Immigration Holding Centres in Montreal and Toronto and a comparison group of 66 nondetained asylum seekers. Detained asylum seekers experience a sense of disempowerment and loss of agency linked to the regime of surveillance and strict rules to which they are subjected, as well as to the indeterminate length of their detention. After an average imprisonment of 31 days, detained asylum seekers had a considerably higher level of psychiatric symptoms than did non-detained asylum seekers, although the two groups had undergone equivalent premigration trauma exposure. Under the Protecting Canada’s Immigration System Act (Bill C-31), asylum seekers designated by the Minister, including youth 16 years old and over, will be automatically detained with very limited access to review by an independent tribunal. On the contrary, less restrictive alternative should be considered.En Canadá, los demandantes de asilo detenidos en virtud de las leyes sobre la inmigración son encerrados en establecimientos de tipo carcelario, incluso si menos del 6 % de ellos son sospechados de ser criminales o peligrosos. Presentamos un panorama de la situación canadiense, incluyendo datos extraídos de nuestro reciente estudio sobre el impacto de la detención sobre la salud mental ...

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“…No 28% Table 3 Summary of standards and criteria of adequacy applied in the systematic reviews of measurement properties Cronbach's alpha is calculated for either the whole scale or for subscales depending on the outcome of the factor analysis (59) Rasch analysis (29) Rating system not specified (29) Alpha [ Rating system not specified (29) Reliability Standards (299) Criteria of adequacy (579) ICC: (189) Kappa (109) Correlation coefficient (e.g., Pearson's or Spearman) (119) Correlation not adequate (39) Time interval mentioned (39) Other measures, e.g., MDC, CV, Kendall's tau, t-test, Goodman-Kruskall gamma, odds ratio, percentage agreement (79)…”

Section: Yes 72%mentioning

confidence: 99%

Evaluation of the methodological quality of systematic reviews of health status measurement instruments

et al. 2009

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A systematic review of measurement properties of health-status instruments is a tool for evaluating the quality of instruments. Our aim was to appraise the quality of the review process, to describe how authors assess the methodological quality of primary studies of measurement properties, and to describe how authors evaluate results of the studies. Literature searches were performed in three databases. One hundred and forty-eight reviews were included. The purpose of included reviews was to identify health status instruments used in an evaluative application and to report on the measurement properties of these instruments. Two independent reviewers selected the articles and extracted the data. Reviews were often of low quality: 22% of the reviews used one database, the search strategy was often poorly described, and in many cases it was not reported whether article selection (75%) and data extraction (71%) was done by two independent reviewers. In 11 reviews the methodological quality of the primary studies was evaluated for all measurement properties, and of these 11 reviews only 7 evaluated the results. Methods to evaluate the quality of the primary studies and the results differed widely. The poor quality of reviews hampers evidence-based selection of instruments. Guidelines for conducting and reporting systematic reviews of measurement properties should be developed.

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Measuring Trauma and Health Status in Refugees

Cited by 581 publications

References 111 publications

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

L’expérience des demandeurs d’asile détenus au Canada

Evaluation of the methodological quality of systematic reviews of health status measurement instruments

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