Factor structures of Complex Posttraumatic Stress Disorder and PTSD in a community sample of refugees from West Papua

Tay, Alvin Kuowei; Mohsin, Mohammed; Rees, Susan; Tam, Natalino; Kareth, Moses; Silove, Derrick

doi:10.1016/j.comppsych.2018.05.001

Cited by 21 publications

(28 citation statements)

References 36 publications

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“…This suggests that a distinct CPTSD symptom profile is evident among a cohort of traumatized refugees characterized by co-occurring moderateto-high PTSD and DSO symptoms (Brewin et al, 2017;Cloitre et al, 2013). These findings also reflect outcomes from previous studies conducted with displaced populations and torture survivors (Nickerson, Cloitre, et al, 2016;Palic et al, 2016;A. K. Tay et al, 2018).…”

Section: Discussionsupporting

confidence: 78%

“…Similarly, distinct PTSD, CPTSD, and low symptom classes were also observed in a heterogenous highly trauma-exposed group that included a refugee sample, alongside a fourth "anxiety" class in which members exhibited high levels of hyperarousal PTSD symptoms and affective dysregulation DSO symptoms (Palic et al, 2016). Moreover, a survey conducted in a large sample of West Papuan refugees found support for the six-factor structure of CPTSD, comprising three PTSD three DSO symptom clusters (Tay et al, 2018), which is in accord with the majority of the literature (Brewin et al, 2017). Despite these differences between studies regarding number of classes and factors observed in forcibly displaced populations, they all provide supporting evidence for distinguishing CPTSD and PTSD symptoms in refugee populations.…”

mentioning

confidence: 87%

“…However, some commentators have criticized this assumption, suggesting that CPTSD can only arise from exposure to traumatic events (de Jongh et al, 2017). The only study to directly examine this association to date found that CPTSD symptom scores were positively associated with the degree of trauma exposure as well as with the severity of perceived postmigration living difficulties (Tay et al, 2018). Accordingly, most of this discussion has been theoretical, and there has been a lack of empirical data with which to examine this issue.…”

mentioning

confidence: 99%

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Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees

Liddell

Nickerson

Felmingham

et al. 2019

Journal of Traumatic Stress

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Although it is well documented that exposure to severe, cumulative trauma and postdisplacement stress increases the risk for posttraumatic stress symptom disorder (PTSD), less is known about the representation and predictors of complex PTSD (CPTSD) symptoms in refugee populations. We examined PTSD and CPTSD symptom profiles (co-occurring PTSD and disturbances in self-organization [DSO] symptoms) and their premigration, postmigration, and demographic predictors, using latent class analysis (LCA), in a cohort of 112 refugees resettled in Australia. The LCA identified a four-factor model as the best fit to the data, comprising classes categorized as: (a) CPTSD, exhibiting high levels of PTSD and DSO symptoms (29.5%); (b) PTSD only (23.5%); (c) high affective dysregulation (AD) symptoms (31.9%); and (d) low PTSD and DSO symptoms (15.1%). Membership in the CPTSD and PTSD classes was specifically associated with cumulative traumatization, CPTSD OR = 1.56, 95% CI [1.15, 2.12], and PTSD OR = 1.64, 95% CI [1.15, 2.34]; and female gender, CPTSD OR = 14.18, 95% CI [1. 66, 121.29], and PTSD OR = 16.84, 95% CI [1.78, 159.2], relative to the low-symptom class. Moreover, CPTSD and AD class membership was significantly predicted by insecure visa status, CPTSD OR = 7.53, 95% CI [1. 26, 45.08], and AD OR = 7.19, 95% CI [1.23, 42.05]. These findings are consistent with the ICD-11 model of CPTSD and highlight the contributions of cumulative trauma to CPTSD and PTSD profiles as well as of contextual stress from visa uncertainty to DSO symptom profiles in refugee cohorts, particularly those characterized by AD.

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Section: Discussionsupporting

confidence: 78%

mentioning

confidence: 87%

mentioning

confidence: 99%

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Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees

Liddell

Nickerson

Felmingham

et al. 2019

Journal of Traumatic Stress

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“…Superiority of one treatment over the other therefore should be judged on relatively small differences in effect sizes and, more importantly, on the consistency in the pattern of differences across a range of relevant measures [23]. For that reason, we include symptoms of the comorbid common mental disorders (CMD) known to be relevant to refugees, including PTSD [13], Complex PTSD (CPTSD) [24,25], Major Depressive Disorder (MDD) [26], Generalised Anxiety Disorder (GAD) [26], and Persistent Complex Bereavement Disorder (PCBD) [11,27].…”

Section: Introductionmentioning

confidence: 99%

An Integrative Adapt Therapy for common mental health symptoms and adaptive stress amongst Rohingya, Chin, and Kachin refugees living in Malaysia: A randomized controlled trial

et al. 2020

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Background This randomised controlled trial (RCT) aims to compare 6-week posttreatment outcomes of an Integrative Adapt Therapy (IAT) to a Cognitive Behavioural Therapy (CBT) on common mental health symptoms and adaptive capacity amongst refugees from Myanmar. IAT is grounded on psychotherapeutic elements specific to the refugee experience. Methods and findings We conducted a single-blind RCT (October 2017-May 2019) with Chin (39.3%), Kachin (15.7%), and Rohingya (45%) refugees living in Kuala Lumpur, Malaysia. The trial included 170 participants receiving six 45-minute weekly sessions of IAT (97.6% retention, 4 lost to follow-up) and 161 receiving a multicomponent CBT also involving six 45-minute weekly sessions (96.8% retention, 5 lost to follow-up). Participants (mean age: 30.8 years, SD = 9.6) had experienced and/or witnessed an average 10.1 types (SD = 5.9, range = 1-27) of traumatic events. We applied a single-blind design in which independent assessors of preand posttreatment indices were masked in relation to participants' treatment allocation status.

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“…The studies and screening tools analysed in this article are all derived from DSM IV diagnostic criteria. Future research conducted around youth and adolescent PTSD should use the updated criteria of DSM 5 (Diehle et al 2013) and ICD-11 (Tay et al 2018) as points of departure when considering the culture-specific manifestations of the disorder in non-Western cultural contexts and carefully consider the calls to action regarding cultural sensitivity in mental health screening now included in both manuals.…”

Section: Conclusion and Implications For Future Researchmentioning

confidence: 99%

Culturally Sensitive PTSD Screening in Non-Western Youth: Reflections and Indications for Mental Health Practitioners

Perry

Modesti

Talamo

et al. 2019

Journal of Refugee Studies

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Children around the world are exposed to traumatic events and research confirms that cultural factors play a central role in the psychological experience of trauma and the manifestation of symptoms in trauma and stress-related disorders. The DSM-5 and ICD-11 call on practitioners to consider the role of culture and context in the manifestation, assessment, and treatment of mental health disorders. This article analyzes peer-reviewed literature involving youth and adolescent PTSD screening in non-Western contexts, revealing only few instruments that have undergone validation for cultural contexts outside those for which they were developed. Studies that include cultural validation show marked differences in methodology and conceptual framework for adaptation, translation, and validation, and disagreement on the scale and scope of tools necessary to assess the impact of trauma in non-Western youth. The discussed studies reveal a need to debate a uniform methodology for cultural adaptation and validation of PTSD screening instruments.

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Factor structures of Complex Posttraumatic Stress Disorder and PTSD in a community sample of refugees from West Papua

Cited by 21 publications

References 36 publications

Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees

Complex Posttraumatic Stress Disorder Symptom Profiles in Traumatized Refugees

An Integrative Adapt Therapy for common mental health symptoms and adaptive stress amongst Rohingya, Chin, and Kachin refugees living in Malaysia: A randomized controlled trial

Culturally Sensitive PTSD Screening in Non-Western Youth: Reflections and Indications for Mental Health Practitioners

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