Relationship of Pretreatment Rorschach Factors to Symptoms, Quality of Life, and Real-Life Functioning in a 3-Year Follow-Up of Traumatized Refugee Patients

Opaas, Marianne; Hartmann, Ellen; Wentzel‐Larsen, Tore; Varvin, Sverre

doi:10.1080/00223891.2015.1089247

Cited by 17 publications

(25 citation statements)

References 62 publications

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“…The study is part of an ongoing prospective study on severely traumatized adult refugees in treatment (Treatment and Rehabilitation of Traumatized Refugees) at Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS; Opaas et al, 2016; Opaas and Hartmann, 2013; Opaas and Varvin, 2015). A total of 16 young adults who have grown up in a refugee family in Norway were recruited by using two different strategies.…”

Section: Methodsmentioning

confidence: 99%

I tell my mother that … sometimes he didn’t love us–Young adults’ experiences of childhood in refugee families: A qualitative approach

Johansen

Varvin

2019

Childhood

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In addition to managing dual cultural identities, children of refugees face the potential burden of living with caregivers struggling in the aftermath of trauma, loss, and adversity. Using an ecological and transactional understanding of child development, this qualitative study explored the subjective experiences of young adults who grew up in a refugee family in Norway. Findings show that parental suffering have affected their daily life and development in different ways. This article elucidates how children of refugees have experienced the relationship with their parents through childhood, adolescence, and into early adulthood, and how they have managed and negotiated developmental tasks, and explored patterns of strategies developed to regulate feelings of relational distress.

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Section: Methodsmentioning

confidence: 99%

I tell my mother that … sometimes he didn’t love us–Young adults’ experiences of childhood in refugee families: A qualitative approach

Johansen

Varvin

2019

Childhood

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“…The significant improvements found over the entire 10 years of data collection, indicated that gains obtained at the three-year follow-up [56] were more or less maintained. However, we observed extensive individual differences in treatment response/long-term outcome among the participants at the end of the study, and many of the participants still had a high symptom burden.…”

Section: Plos Onementioning

confidence: 96%

“…Results from intake assessment [12,55] and from 1-and 3-year follow-up [56] have previously been published. The pre-treatment analyses demonstrated that the participants had suffered extensive potentially traumatic events related to war and persecution [55] as well as adverse and potentially traumatic events during childhood [12].…”

Section: Plos Onementioning

confidence: 99%

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The 10-year course of mental health, quality of life, and exile life functioning in traumatized refugees from treatment start

2020

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Refugee patients with severe traumatic experiences may need mental health treatment, but treatment results vary, and there is scarcity of studies demonstrating refugees’ long-term health and well-being after treatment. In a 10-year naturalistic and longitudinal study, 54 multi-origin traumatized adult refugee patients, with a background of war and persecution, and with a mean stay in Norway of 10.5 years, were recruited as they entered psychological treatment in mental health specialist services. The participants were interviewed face-to-face with multiple methods at admittance, and at varying points in time during and after psychotherapy. The aim was to study the participants’ trajectories of symptoms of post-traumatic stress, anxiety and depression, four aspects of quality of life, and two aspects of exile life functioning. Linear mixed effects analyses included all symptoms and quality of life measures obtained at different times and intervals for the participants. Changes in exile life functioning was investigated by exact McNemar tests. Participants responded to the quantitative assessments up to eight times. Length of therapy varied, with a mean of 61.3 sessions (SD = 74.5). The participants improved significantly in symptoms, quality of life, and exile life functioning. Improvement in symptoms of posttraumatic stress, anxiety, and depression yielded small effect sizes (r = .05 to .13), while improvement in quality of psychological and physical health yielded medium effect sizes (r = .38 and .32). Thus, long-time improvement after psychological therapy in these severely traumatized and mostly chronified refugee patients, was more notable in quality of life and exile life functioning than in symptom reduction. The results imply that major symptom reduction may not be attainable, and may not be the most important indication of long-term improvement among refugees with long-standing trauma-related suffering. Other indications of beneficial effects should be applied as well.

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“…This implies that any event can be traumatic; it is the subjective experience of shock and its lasting effect that defines the event as traumatic. Opaas and colleagues (Opaas & Varvin, ; Opaas et al ., ) found in a highly war‐traumatized population, that childhood hardship explained more of the variance in symptoms and aspects of quality of life than war, torture and other more recent traumatizing experiences. We can make an expert guess as to what it is about the experience that has made it unbearable or shocking to the patient, but we cannot know without knowing how the individual has perceived the event and how it has been integrated into existing dynamics and structures of meaning.…”

Section: The Concept Of Traumamentioning

confidence: 99%

‘Janet vs Freud’ on Traumatization: A Critique of the Theory of Structural Dissociation from an Object Relations Perspective

Lesley¹,

Varvin²

2016

Brit J Psychotherapy

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It is still 'Janet vs Freud'. We present 'The theory of structural dissociation' and the three-phase treatment programme that provides the basis for treatment of traumatized patients in many services in Europe, exploring its shortcomings. With roots in Janet's work it displays a behaviouristic, systemic view of the human being that allows for an understanding of traumatic experience as preventing natural development of the personality towards an integrated unit, or disrupting integration, causing splits along fault lines between major personality systems. Traumatization, structural dissociation, produces patients with multiple inner parts, each with a subjective first person perspective of experience not (necessarily) shared with other parts. With our roots in Freud, from an object relations perspective, we illustrate, through clinical example with two traumatized female patients, how (1) the transference and countertransference provides a unique, alternative understanding of the traumatized patient determining the direction of the therapeutic process, thus making a phase-orientated therapy moot; (2) the patient's functioning prior to traumatization influences the actual traumatic experience, reactions to it and the treatment process; and (3) a patient's attachment needs and way of handling these, brings the traumatic experience into the treatment room from the first contact, providing a core process in the transference and countertransference throughout the therapy.

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Relationship of Pretreatment Rorschach Factors to Symptoms, Quality of Life, and Real-Life Functioning in a 3-Year Follow-Up of Traumatized Refugee Patients

Cited by 17 publications

References 62 publications

I tell my mother that … sometimes he didn’t love us–Young adults’ experiences of childhood in refugee families: A qualitative approach

I tell my mother that … sometimes he didn’t love us–Young adults’ experiences of childhood in refugee families: A qualitative approach

The 10-year course of mental health, quality of life, and exile life functioning in traumatized refugees from treatment start

‘Janet vs Freud’ on Traumatization: A Critique of the Theory of Structural Dissociation from an Object Relations Perspective

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