Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. In this article we report rates of past trauma and current stressors among Darfur refugees and gauge the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in two refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress (r's = .19-.31) than were war-related traumatic events (r's = .09-.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees' hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events.The crisis in Darfur, Sudan and neighboring countries presents a convergence of festering ethnic tension, multiple armed groups, a largely undefined border region, and an unforgiving natural environment. Such conditions make humanitarian intervention extremely difficult. An estimated 300,000 people have been killed, and 2.5 million have been displaced from their homes (WHO, 2008). Approximately 250,000 of the displaced have fled to twelve

While a growing body of literature addresses the psychological consequences of torture and war trauma, there are few empirical examinations of treatment for survivors of torture. This study offers a program evaluation of a comprehensive torture treatment program in New York City. We present literature surrounding the interdisciplinary "wraparound" approach to treating survivors of torture, and examine the relationship between clinical services and symptom reduction in a multinational sample of refugees (N ϭ 172) receiving treatment over a 6-month period. Clients were administered the Brief Symptom Inventory (BSI) and the Harvard Trauma Questionnaire (HTQ) during their intake interview and six months later. We found that approximately 45% (n ϭ 77) of treated clients displayed clinically significant improvement on either the HTQ, or the BSI subscales of Depression, Anxiety, or Somatization, over the six months following their intake evaluation. Generalized linear models revealed that gaining secure immigration status was the strongest correlate of clinical improvement. However, psychotherapy and attendance at educational sessions predicted improvement in symptoms beyond adjusting to a more secure immigration status. While this study's correlational design does not establish that treatment caused the observed improvement, results point to the pivotal role of both clinical and "nonclinical" services and provide preliminary support for the value of an interdisciplinary approach. More research is needed to understand mechanisms of change and improvement in this sensitive population.

Results suggest that topiramate enhances both nicotine withdrawal and reward. These findings question the utility of topiramate treatment for smoking cessation.

The present study aims to fill a gap in the study of resilience to trauma by examining resilience in a culturally diverse population. Approximately 70% of adults across the globe experience at least one traumatic event in their lifetime, yet resilience is a common response trajectory. This pilot study explored reactions to trauma and psychological resilience in an international sample of trauma-exposed participants. Participants were recruited online using the Amazon Mechanical Turk software and after completing an informed consent, were determined eligible to participate if they endorsed experiencing at least one traumatic event. Eligible participants then completed The Stressful Life Events Questionnaire, Brief Resiliency Scale, Ego Resiliency Scale, Posttraumatic Stress Disorder Checklist-Civilian Version, Brief Religious Coping Scale, and Multigroup Ethnic Identity Measure. The final sample included 200 trauma exposed adults from nineteen different countries worldwide, with a majority hailing from the United States, India, Sri Lanka and the Philippines. Results revealed that Asian participants scored significantly higher on resilience scales and endorsed higher levels of spiritually focused coping than other subgroups. Multivariate analyses revealed that these differences in resilience remained significant even after controlling for sense of ethnic identity and spiritual coping, suggesting that there may be culturally specific predictors of resilience within the Asian subgroup. Understanding variations in resilience will aid in developing culturally tailored interventions and pursuing a strengths-based approach to recovery from trauma. Limitations and implications are discussed.

ASHA was effective in improving depression and increasing financial independence. Using a culturally synchronous approach to psychological treatment may be effective in ameliorating distress in immigrant populations.