In a large national survey in Cambodia (N = 2689), the present study investigated the prominence of certain culturally salient symptoms and syndromes in the general population and among those with anxious-depressive distress (as determined by the Hopkins Symptom Checklist-25, or HSCL). Using an abbreviated Cambodian Symptom and Syndrome Addendum (CSSA), we found that the CSSA complaints were particularly elevated among those with anxious-depressive distress. Those with anxious-depressive distress had statistically greater mean scores on all the CSSA items as well as severity of endorsement analyzed by percentage: among those with HSCL caseness, 75.3% were bothered “quite a bit” or “extremely” by “thinking a lot” (vs. 27.5% without caseness); 53.8% were bothered by “standing up and feeling dizzy” (vs. 13.8%); and 45.6% by blurry vision (vs. 16.8%). In a logistic regression analysis to predict anxious-depressive distress, 51% of the variance was accounted for by five predictors: “weak heart,” “thinking a lot,” dizziness, “ khyâl hitting up from the stomach,” and sleep paralysis. Using ROC analysis, a cut-off score of 1.81 on the CSSA was optimal as a screener to indicate anxious-depressive distress, giving a sensitivity of 0.86. The study results suggest that to avoid category truncation (i.e., the omission of key complaints that are part of an assessed distress domain) when profiling anxious-depressive distress among Cambodia population that items other than those in standard psychopathology measures should be assessed such as “thinking a lot,” “weak heart,” “blurry vision,” and “dizziness upon standing up.”

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Global suicide rates are steadily increasing, and suicide completions in Asia outnumber those in Western countries. Young females are especially at risk, with higher rates of completion and lack of suicide support because of familial and cultural stigma and constraints. Lack of infrastructure to systematically record suicide deaths and attempts makes studying suicide in low- and middle-income countries challenging. Given the critical public health need for suicide intervention and prevention, research on suicide is crucial. The present study adds to the lack of information regarding suicide in Cambodia by exploring reports of attempted suicide by women from a nationally representative sample of Cambodian women (N = 1813). In a series of logistic regression models, findings indicate that a culturally salient measure of Cambodian syndromes, symptoms of depression, and posttraumatic stress disorder contributed to increased odds of attempting to commit suicide. Implications for policymakers and interventionists within Cambodia and Asian contexts are discussed.

Trauma literature has proposed multiple theories of trauma development, maintenance, and transmission, which has led to a lack of clarity surrounding trauma in individuals, families, and communities. We investigated the impact of community‐level trauma experiences on individual posttraumatic stress disorder (PTSD) symptoms using a sociointerpersonal model of PTSD (Maerker & Horn, 2013). A nationally representative sample (N = 2, 690) of Cambodian households across all regions of the country was surveyed regarding individual trauma experiences during and after the Khmer Rouge regime, symptoms of PTSD, and current stressors. Individual experiences of war trauma and current stressors were aggregated based on the district in which each individual lived. District mean and individual war trauma and current stressors were included in a multilevel model as predictors of individual levels of PTSD. Findings indicated that mean trauma experiences, β = .05, p < .001, and current stressors, β = .10, p < .001, in the district in which individuals live were positively and significantly associated with their individual PTSD symptoms. Individual war trauma, β = .02, p < .001, and current stressors, β = .08, p < .001, were also positively and significantly associated with individual PTSD symptoms. District trauma experiences accounted for 7% of the variance in individual PTSD symptoms, R2Level 1 = .21, R2Level 2 = .80. Additionally, current stressors at both the individual and district levels had a greater impact on individual PTSD symptoms than war trauma at either level of the model. Implications for policy and intervention are presented.

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