Predicting post‐traumatic stress disorder treatment response in refugees: Multilevel analysis

Haagen, Joris; Heide, F. Jackie June ter; Mooren, Trudy; Knipscheer, Jeroen W.; Kleber, Rolf J.

doi:10.1111/bjc.12121

Cited by 57 publications

(65 citation statements)

References 60 publications

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“…However the studies differ in terms of relating factors (such as the mean age of the participants, the length of received treatment, the origin of the participants), which might have affected treatment outcome. In line with Haagen et al (2017) and Stenmark et al (2013), we did not find gender to influence treatment outcome. It can thus be concluded that potential factors influencing the therapy outcome are not yet sufficiently investigated and should be examined more systematically in further studies, including factors such as asylum status, housing, family reunification or personality factors.…”

Section: Discussionsupporting

confidence: 91%

“…Similar to the results of the current study, most studies found no or only weak predictors for symptom change during treatment of traumatized refugees (e.g. Buhmann et al, 2015; Haagen et al, 2017; Sonne et al, 2016). In the current study, the course of somatoform symptoms was predicted by the age of the participants, i.e.…”

Section: Discussionsupporting

confidence: 87%

“…In terms of sociodemographic variables predicting treatment outcome, the results are mixed. Stenmark, Guzey, Elbert, and Holen (2014) found that female participants responded better to a treatment programme for PTSD than male participants, while other studies did not find gender to predict treatment outcome (Carlsson et al, 2005; Haagen et al, 2017; Stenmark, Catani, Neuner, Elbert, & Holen, 2013). In terms of age being associated with treatment outcome, a study with refugees from Bosnia-Herzegovina suggests that younger refugees might respond better to group treatment and/or medication in terms of PTSD symptom reduction than older ones (Drozdek, 1997), while Carlsson et al (2005) did not find associations between age and treatment outcome.…”

Section: Introductionmentioning

confidence: 99%

“…Most studies examining different possible predictors report no, few or weak factors predicting treatment outcome (Buhmann, Mortensen, Nordentoft, Ryberg, & Ekstrøm, 2015; Haagen, Ter Heide, Mooren, Knipscheer, & Kleber, 2017; Sonne et al, 2016). Sonne and colleagues (2016) found significant but weak correlations between psychosocial resources (such as employment status, lack of social relationships and poor integration) and treatment outcome during a multidisciplinary treatment programme.…”

Section: Introductionmentioning

confidence: 99%

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Multidisciplinary treatment for traumatized refugees in a naturalistic setting: symptom courses and predictors

Stammel

Knaevelsrud

Schock³

et al. 2017

European Journal of Psychotraumatology

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Background: Multidisciplinary treatment approaches are commonly used in specialized psychosocial centres for the treatment of traumatized refugees, but empirical evidence for their efficacy is inconsistent. Objective: In order to obtain more evidence on the development of mental health and well-being of traumatized refugees who receive multidisciplinary treatment, symptom courses of posttraumatic stress disorder (PTSD), anxiety, depression and somatoform symptoms as well as in the subjective quality of life were investigated in the course of a multidisciplinary treatment. In addition, it was analysed if sociodemographic variables were predictors for possible changes in symptomatology and quality of life. Method: N = 76 patients of the outpatient clinic of a psychosocial centre for traumatized refugees receiving regular multidisciplinary treatment were surveyed using standardized questionnaires at three measurement points (at the beginning of treatment, and after an average of 7 and 14 months of treatment) in a single-group design. Results: Multilevel analysis showed significant improvements of symptoms of PTSD (p < .001), depression (p < .001), anxiety (p < .001), and somatoform symptoms (p = .002) as well as of the subjective quality of life (p < .001) over time. Among the tested predictors (gender, age, country of origin), age was a significant predictor for the course of somatoform symptoms (p < .05). Younger patients showed greater improvements in symptomatology over time than older ones. Conclusions: The results suggest that the received multidisciplinary treatment had a positive effect on trauma-related symptoms as well as on quality of life of traumatized refugees. There was no indication that sociodemographic characteristics predicted the symptom courses of the patients, except for somatoform symptoms. Younger patients benefitted more from multidisciplinary treatment than older ones.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multidisciplinary treatment for traumatized refugees in a naturalistic setting: symptom courses and predictors

Stammel

Knaevelsrud

Schock³

et al. 2017

European Journal of Psychotraumatology

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show abstract

“…Comorbidity has also been found to be extremely prevalent in clinical settings. A study conducted in the Netherlands found that 63.9% of treatment‐seeking refugees and asylum‐seekers with PTSD also had comorbid depression (Haagen, Ter Heide, Mooren, Knipscheer, & Kleber, ). Another study conducted in outpatient clinics in Norway found that 80.0% of patients with PTSD also met criteria for major depression (Teodorescu, Heir, Hauff, Wentzel‐Larsen, & Lien, ).…”

mentioning

confidence: 99%

Comorbidity of Posttraumatic Stress Disorder and Depression in Tortured, Treatment‐Seeking Refugees

Nickerson

Schick

Schnyder

et al. 2017

Journal of Traumatic Stress

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Comorbid posttraumatic stress disorder (PTSD) and depression is common in refugee groups; however, little is known about the predictors and correlates of comorbidity in treatment-seeking refugees. Participants in this study were 134 refugees resettled in Switzerland. Most participants were from Turkey, Iran, and Sri Lanka, and 92.7% had been exposed to torture. Self-report measures were implemented to assess PTSD, depression, mental and physical health-related quality of life (QoL), as well as pre- and postmigration experiences. Findings indicated that approximately half the sample met criteria for PTSD and depression, 33.6% met criteria for depression only, and only 2.2% met criteria for PTSD only. Several variables emerged as predictors of comorbidity in contrast to no diagnosis: female gender, odds ratio (OR) = 0.17; age, OR = 0.93; time in Switzerland, OR = 1.16; and trauma exposure, OR = 1.19. Postmigration stress was also associated with greater likelihood of comorbidity compared with no diagnosis, OR = 1.32, and a single diagnosis, OR = 1.14. Further, dual diagnosis was associated with significantly poorer mental health-related and physical health-related QoL (mental health-related QoL: dual diagnosis vs. single diagnosis, d = -0.52 and dual diagnosis vs. no diagnosis, d = -1.30; physical health-related QoL: dual diagnosis vs. single diagnosis, d = -0.73 and dual diagnosis vs. no diagnosis: d = -1.04). Findings indicated that comorbidity was highly prevalent in this sample of treatment-seeking refugees and was associated with a substantial impairment burden. Psychological interventions for refugees should consider the dual impact of PTSD and depression symptoms to optimally decrease distress and improve QoL in this vulnerable group.

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Depression Suppresses Treatment Response for Traumatic Loss–Related Posttraumatic Stress Disorder in Active Duty Military Personnel

Jacoby

Hale

Dillon

et al. 2019

Journal of Traumatic Stress

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There are multiple well-established evidence-based treatments for posttraumatic stress disorder (PTSD). However, recent clinical trials have shown that combat-related PTSD in military populations is less responsive to evidence-based treatments than PTSD in most civilian populations. Traumatic death of a close friend or colleague is a common deployment-related experience for active duty military personnel. When compared with research on trauma and PTSD in general, research on traumatic loss suggests that it is related to higher prevalence and severity of PTSD symptoms. Experiencing a traumatic loss is also related to the development of prolonged grief disorder, which is highly comorbid with depression. This study examined the association between having traumatic loss-related PTSD and treatment response to cognitive processing therapy in active duty military personnel. Participants included 213 active duty service members recruited across two randomized clinical trials. Results showed that service members with primary traumatic loss-related PTSD (n = 44) recovered less from depressive symptoms than those who reported different primary traumatic events (n = 169), B = −4.40. Tests of mediation found that less depression recovery suppressed recovery from PTSD symptoms in individuals with traumatic loss-related PTSD, B = 3.75. These findings suggest that evidence-based treatments for PTSD should better accommodate loss and grief in military populations. Jeffrey S. Yarvis is now at the 21st Combat Support Hospital at Fort Hood, Texas.

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Predicting post‐traumatic stress disorder treatment response in refugees: Multilevel analysis

Cited by 57 publications

References 60 publications

Multidisciplinary treatment for traumatized refugees in a naturalistic setting: symptom courses and predictors

Multidisciplinary treatment for traumatized refugees in a naturalistic setting: symptom courses and predictors

Comorbidity of Posttraumatic Stress Disorder and Depression in Tortured, Treatment‐Seeking Refugees

Depression Suppresses Treatment Response for Traumatic Loss–Related Posttraumatic Stress Disorder in Active Duty Military Personnel

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