Effects of Post-migration Factors on PTSD Outcomes Among Immigrant Survivors of Political Violence
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ORIGINAL PAPER
Effects of Post-migration Factors on PTSD Outcomes Among Immigrant Survivors of Political Violence Tracy Chu • Allen S. Keller • Andrew Rasmussen
Ó Springer Science+Business Media, LLC 2012
Abstract This study examined the predictors of posttraumatic stress disorder (PTSD) in a clinical sample of 875 immigrant survivors of political violence resettled in the United States, with a specific aim of comparing the relative predictive power of pre-migration and postmigration experiences. Results from a hierarchical OLS regression indicated that pre-migration experiences such as rape/sexual assault were significantly associated with worse PTSD outcomes, as were post-migration factors such as measures of financial and legal insecurity. Post-migration variables, which included immigration status in the US, explained significantly more variance in PTSD outcomes than premigration variables alone. Discussion focused on the importance of looking at postmigration living conditions when treating trauma in this population. Keywords PTSD Immigrants Mental health Political violence
T. Chu (&) Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, 2900 Bedford Avenue, Brooklyn, NY 11210, USA e-mail: [email protected] A. S. Keller New York University School of Medicine, Bellevue/NYU Program for Survivors of Torture, New York, NY, USA A. Rasmussen Fordham University, New York, NY, USA
Background Survivors of political violence, which includes individuals forced to flee their country due to political persecution as well as those who have been subject to physical or psychological torture at the hands of government actors, evidence high rates of anxiety disorders such as posttraumatic stress disorder (PTSD) [1–3], whether they are resettled in the developing world [4–8] or in Western countries [9–15]. Research with this population often focuses on pre-migration traumatic events with little regard to post-migration deprivation and structural needs in countries of resettlement [16]. However studies that do account for post-migration factors indicate that they are important in moderating pre-migration traumatic experiences. In a meta-analysis of 56 studies of refugees, asylum-seekers, and other displaced persons, Porter and Hassam [3] found that numerous structural post-migration conditions, such as housing accommodation and restricted economic opportunities, moderated mental health outcomes, regardless of resettlement location. Among a sample of Bosnian refugees in the Netherlands, Knipscheer and Kleber [17] found that the ability to perform adequate occupational skills for functioning in their post-migration society was a significant predictor of mental health status, and that respondents reported issues such as financial troubles and daily hassles and stressors as their worst mental health problems. In a study of Latin-American and Middle-Eastern refugees, also in the Netherlands, Hondius et al. [18] found that in addition to pre-migration experiences of violence and tort
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