PTSD and Key Somatic Complaints and Cultural Syndromes among Rural Cambodians: The Results of a Needs Assessment Survey

Abstract

This article describes a culturally sensitive assessment tool for traumatized Cambodians, the Cambodian "Somatic Symptom and Syndrome Inventory" (SSI), and reports the outcome of a needs assessment conducted in rural Cambodia using the instrument. Villagers locally identified (N = 139) as still suffering the effects of the Pol Pot genocide were evaluated. All 139 had post-traumatic stress disorder (PTSD) as assessed by the PTSD Checklist (PCL), and they had elevated SSI scores. The severity of the SSI items varied by level of PTSD severity, and several items--for example, dizziness, dizziness on standing, khyâl (a windlike substance) attacks, and "thinking a lot"--were extremely elevated in those participants with higher levels of PTSD. The SSI was more highly correlated to self-perceived health (Short Form Health Survey-3) and past trauma events (Harvard Trauma Questionnaire) than was the PCL. The study shows the SSI items to be a core aspect of the Cambodian trauma ontology.

Development and validation of a Haitian Creole screening instrument for depression

“…Kalkile twòp and synonyms reflechi twòp , maladi kalkilasyon and zaminem reflect what seems to be a worldwide concern for excessive negative cognition. Versions of “thinking too much” have been reported in distressed populations in Zimbabwe (Patel, Simunyu, & Gwanzura, 1995), Ghana (Avotri & Walters, 1999), Sudan (Rasmussen et al, 2010), Uganda (Bolton, Abbo, Okello, Ekblad, Waako, & Musisi, 2008; Betancourt, Rubin-Smith, Beardslee, Stulac et al, 2011), Cambodians in the U.S. (Hinton, Hinton, Eng, & Choung, in press), and among South Asians living in Britain (Fenton & Sadiq-Sangster, 1996) and the U.S. (Karasz, 2005) – and even previously among Haitians in Haiti (as moun yo panse anpil ; Bolton et al, 2012). In Haiti, “thinking too much” is strongly associated with sadness and, if allowed to persist, is thought to potentially lead to psychosis (Fullard, 2012).…”

The Chronic Traumatic Stress Framework: A conceptual model to guide empirical investigation and mental health treatment for refugees and survivors of torture

“…Specifically, posttraumatic stress, anxiety and depression are among the most frequently cited psychological symptoms experienced by refugees and survivors of torture (Schubert & Punamäki, 2011). Sleep disturbances (e.g., insomnia and nightmares) and somatic complaints (e.g., gastrointestinal problems, headaches, dizziness, and chronic pain) have all been empirically demonstrated to be associated with war trauma (Hinton, Hinton, Eng, & Choung, 2012;Hinton, Hinton, Pich, Loeum, & Pollack, 2009;Kirmayer, Groleau, Looper, & Dao, 2004). Rates of traditionally defined physical ailments such as hypertension, diabetes, and obesity have also been shown to be higher in refugee populations as compared to non-refugees (Bhatta, Shakya, Assad, & Zullo, 2015).…”

A Qualitative Study of Mental Health Problems Among Orphaned Children and Adolescents in Tanzania

“…The majority of the available research, however, has predominantly relied on quantitative assessment using western conceptualizations, which may result in missing important cultural syndromes or symptoms that differ from those in high-income/western contexts (e.g., Hinton et al, 2012; Kleinman, 2004). Qualitative methods, which take an open-ended, exploratory approach, are particularly important for mental health research in LMIC.…”