Mental Health and Health-Related Quality of Life Among Adult Latino Primary Care Patients Living in the United States With Previous Exposure to Political Violence

Abstract

OLITICAL VIOLENCE IS INCREASingly recognized as a threat to public health and includes many types of violence such as war, torture, forced disappearances, and extrajudicial killings. 1-3 Much research on the long-term health consequences of political violence has focused on torture and not on the wider problem of political violence experienced by immigrants and refugees. 4,5-8 This is especially pertinent to immigrants from Mexico, Central America, and South America, who experienced war-related violence and political violence (including forced disappearance of family members and witnessing a massacre 9) during the wars, military repressions, guerrilla insurgencies, and human rights abuses of the 1970s to the present. Prior studies examining the impact of torture and related violence have limited relevance to US-based populations of immigrants and refugees and to primary care clinicians practicing in the United States. These studies focused mainly on posttraumatic stress disorder (PTSD) and depression 10-13 ; were performed among asylum seekers, 14 refugees living in refugee camps Author Affiliations are listed at the end of this article.

Witnessing Community Violence in Residential Neighborhoods: A Mental Health Hazard for Urban Women

“…In a predominantly female clinical sample surveyed between 2001 and 2002, Eisenman reported a high percentage of participants from Mexico, El Salvador, Guatamala, and other groups who experienced political violence (54%), including 8% who reported torture. 54 Higher levels of psychological distress were reported in that sample, and statistically significant increases were found among those reporting political violence (36% versus 20% for depression, 18% versus 8% for posttraumatic stress symptoms). 54 The response of Latinas to recent and remote exposures in our cohort were more similar to results found by Aisenberg who assessed community violence in an urban US neighborhood.…”

“…54 Higher levels of psychological distress were reported in that sample, and statistically significant increases were found among those reporting political violence (36% versus 20% for depression, 18% versus 8% for posttraumatic stress symptoms). 54 The response of Latinas to recent and remote exposures in our cohort were more similar to results found by Aisenberg who assessed community violence in an urban US neighborhood. As reported by Aisenberg, we found no statistically significant associations between witnessing neighborhood violence and the experience of depression among Latinas.…”

Intersections Between Grief and Trauma: Toward an Empirically Based Model for Treating Traumatic Grief

“…In this study, the majority of people expressed optimism and self-efficacy regarding their ability to function in a terrorist attack. Similarly, a study of Latino primary care patients in the United States revealed that of those who had experienced political violence in their homeland, 18% met the criteria for PTSD (Eisenman, Gelberg, Liu, & Shapiro, 2003). The lifetime prevalence of PTSD in the general population of the United States is reported to be 5% for men and 10% for women (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995).…”

The South Africa Stress and Health Study: Rationale and Design

“…However, our current knowledge base is limited. Prior research suggests that only a very small proportion of individuals who have been exposed to political violence report this to their health care providers (Carey et al, 2003;Eisenman et al, 2003).…”