Remembering and Responding to Distressing Autobiographical Memories: Exploring Risk and Intervention Targets for Posttraumatic Stress in Traumatized Refugees

Abstract

Refugees and asylum seekers are among the 65.3 million people currently forcibly displaced due to civil war, ethnic cleansing, genocide, and hunger (United Nations High Commissioner for Refugees, 2016). It is tragic that forced migration in such conditions often leads to further traumatic and chronic stress due to human trafficking and related forms of sexual or labor exploitation (Slobodin & de Jong, 2015; Steel et al., 2004). Consequently, forcibly displaced persons (FDPs) suffer at high rates of traumaand stress-related mental health problems. Yet, only a small proportion receives specialized and evidence-based mental health interventions (Carlsson, Sonne, & Silove, 2014; Collins et al., 2011). This global public mental health crisis is not only driven by a lack of resources and the complexity of providing treatment to FDPs worldwide, but made worse by a lack of essential experimental clinical research. Indeed, strong empirical understanding of risk processes and related mental health intervention targets is critical for the development of targeted, efficient, easily implemented, and effective interventions tailored to FDPs (Collins et al., 2011; Nickerson, Bryant, Silove, & Steel, 2011; Yuval, Zvielli, & Bernstein, 2016). Models of risk and maintenance factors of psychopathology and related mental health interventions for FDPs often rely largely or solely on research in WEIRD (Westerneducated industrialized rich democratic) populations

A Functional Network Perspective on Posttraumatic Stress in Refugees: Implications for Theory, Classification, Assessment, and Intervention

“…The HTQ is a commonly used self-report measure of trauma exposure and PTSD symptoms in diverse populations including forcibly displaced persons such as asylum seekers. The Arabic language version of the HTQ has been used and validated in previous studies (Badri, Crutzen, & Van den Borne, 2012; Reebs et al., 2017; Yuval et al., 2016; Yuval & Bernstein, 2017). Trauma exposure severity was computed by an algorithm based on the mean levels of exposure (i.e., 1 = not exposed , 2 = heard about , 3 = witnessed , 4 = experienced ) to each of the 17 traumatic events relevant to refugees’ experiences (see Table 1).…”

“…These asylum seekers survived multiple potentially traumatic events and reside in a nearly identical post-migration context in Israel, where they sought refuge. These asylum seekers are at elevated risk for trauma-related psychopathology yet express variable levels of symptomatology (Reebs, Yuval, & Bernstein, 2017; Yuval et al., 2016). Furthermore, this particular population of forcibly displaced person is particularly important from a global public health perspective.…”

We Can’t Step Back: Women Specially…A Narrative Case Study on Resilience, Independence, and Leadership of a Bhutanese Refugee Woman

“…By 2015, the global population of forcibly displaced people had increased 70% over the previous two decades (UNHCR, 2016). Refugees are forcibly displaced by war, genocide, or ethnic cleansing (Reebs, Yuval, & Bernstein, 2017). They experience an ongoing accumulation of stressors and pressure from adjustment during exile (Martin, 1994) as a result of their pre- and post-displacement traumatic experiences (Schmidt, Kravic, & Ehlert, 2008).…”

“…They experience an ongoing accumulation of stressors and pressure from adjustment during exile (Martin, 1994) as a result of their pre- and post-displacement traumatic experiences (Schmidt, Kravic, & Ehlert, 2008). The collective suffering of refugees is one of the fastest emerging global public health crises (Reebs et al, 2017). Although women make up half the global refugee population (UN, 2013), they remain underrepresented (Shishehgar, Gholizadeh, DiGiacomo, Green, & Davidson, 2017) and often neglected in research.…”

Mindfulness-Based Trauma Recovery for Refugees (MBTR-R): Randomized Waitlist-Control Evidence of Efficacy and Safety

“…It may therefore be useful to draw on therapeutic approaches with a strong clinical evidence-base relevant to the trauma-and stress-related mental health needs of refugees, that are also pragmatically well-suited to the implementation challenges facing refugee mental health intervention efforts (Patel et al, 2018). Work over the past number of years led us to speculate that mindfulness-based interventions (MBIs) may represent one such promising approach (Bernstein et al, 2019;Reebs et al, 2017;Wielgosz et al, 2019;.…”