Cross-Cultural Assessment of Psychological Trauma and PTSD (eBook)

John P. Wilson is a Professor of Psychology and Fulbright Scholar at Cleveland State University. He is co-founder and past president of the International Society for Traumatic Stress Studies and the author of 10 books; 40 chapters and many articles on PTSD. Catherine So-kum Tang graduated from the University of North Texas with a Ph.D. in Clinical Psychology. She is a Professor in the Department of Psychology at the Chinese University of Hong Kong. She was the former Director of the Graduate Studies in clinical Psychology and Gender Studies Program, and is currently Director of the new postgraduate program in trauma-related studies. She has published widely in international journals on violence against women, family violence, clinical aspects of social issues, AIDS/HIV prevention, and trauma psychology.

Foreword 6
Preface 8
Contents 19
Contributors 21
Theoretical and Conceptual Considerations in the Cross- cultural Assessment of Psychological Trauma 27
The Lens of Culture: Theoretical and Conceptual Perspectives in the Assessment of Psychological Trauma and PTSD 28
INTRODUCTION 28
CASE HISTORY 29
THE MYTHOLOGY OF THE HERO, TRAUMATIC ENCOUNTERS, AND PERSONAL TRANSFORMATION 31
TRAUMA, CULTURE, AND POSTTRAUMATIC SYNDROMES: THE CORE QUESTIONS 33
CULTURE AND TREATMENT FOR POSTTRAUMATIC SYNDROMES 42
Native American 43
South African (Zulu) 44
Indian (Ayurveda) 44
Traditional Chinese Medicine 45
CULTURAL CONVERGENCE IN TRADITIONAL HEALING 45
THE TREATMENT OF TRAUMATIC STRESS SYNDROMES IN CULTURAL CONTEXTS 45
POSTTRAUMATIC INTERVENTIONS: WHAT WORKS BEST FOR WHOM UNDER WHAT CONDITIONS? 46
TEN HYPOTHESES CONCERNING TRAUMA, CULTURE, AND POSTTRAUMATIC MENTAL HEALTH INTERVENTIONS 47
REFERENCES 54
Cultural-Ecological Perspectives on the Understanding and Assessment of Trauma 56
CULTURE AND TRAUMA: CONCEPTUAL AND PRACTICE ISSUES 57
CONTRIBUTIONS FROM ECOLOGICAL PERSPECTIVES 60
LINKING THE CULTURAL WITH THE ECOLOGICAL IN HUMAN SECURITY 63
ASSESSMENT APPROACHES CONSISTENT WITH A CULTURALÒ ECOLOGICAL PERSPECTIVE 64
IMPLICATIONS FOR THEORY, RESEARCH, AND PRACTICE 68
REFERENCES 70
Ethnomedical Best Practices for International Psychosocial Efforts in Disaster and Trauma 76
OVERVIEW AND CONTEXTUAL PERSPECTIVE 77
CASE STUDY USING ETHNOMEDICAL CRITIQUE Ò HEALING RESPONSES TO THE TSUNAMI 78
EVIDENCE FOR SHORTFALLS IN ETHNOMEDICAL COMPETENCE Back Pressure from the Field and Afar 80
CULTURAL COMPETENCE AS NECESSARY BUT NOT SUFFICIENT FOR ETHNOMEDICAL COMPETENCE 83
SUBJECTING VICTIMS Ò VICTIMIZING SUBJECTS 84
ETHNOMEDICAL STRATEGY AND TACTICS Guidelines to Counteract Neocolonial Transference Dynamics 85
CONCLUSION 87
REFERENCES 88
Assessing Trauma Across Cultures from a Multigenerational Perspective 90
CONSPIRACY OF SILENCE 90
TRAUMA AND THE CONTINUITY OF SELF: A MULTIDIMENSIONAL, MULTIDISCIPLINARY INTEGRATIVE ( TCMI) FRAMEWORK 92
TRAUMA EXPOSURE AND ÏFIXITYÓ 93
THE INTERGENERATIONAL CONTEXT 94
UTILITY OF THE MULTIDIMENSIONAL INTEGRATIVE ( TCMI) FRAMEWORK 95
RESILIENCE AND TRAUMA ASSESSMENT AMONG GENERATIONS 99
MECHANISMS OF THE TRANSMISSION OF TRAUMA 100
THE IMPORTANCE OF CULTURE AS TRANSMITTER, BUFFER, AND HEALER 103
SOME RECOMMENDATIONS FOR THE FUTURE 104
ON JUSTICE 106
REFERENCES 108
Refugee Assessment Practices and Cultural Competency Training 115
INTRODUCTION 115
'WELCOME' General Issues 116
ASSESSMENT PRACTICE IN THE UNITED STATES 122
MULTICULTURAL ASSESSMENT OBJECTIVES AND INSTRUMENT EXAMPLES 123
TRAINING FOR REFUGEE ASSESSMENT 129
PERORATION 131
REFERENCES 132
Wrestling with the Ghosts from the Past in Exile: Assessing Trauma in Asylum Seekers 137
INTRODUCTION 137
TRAUMA DOES NOT HAPPEN IN A VACUUM, NEITHER DOES THE ASSESSMENT 138
OBSTACLES IN COMMUNICATION BETWEEN A HEALTH PROFESSIONAL AND AN ASYLUM SEEKER 140
HOW TO CREATE SAFETY AS A PREREQUISITE FOR ASSESSMENT 141
EXPLANATORY MODELS AND CULTURAL RELATIVITY OF NOTIONS AND CONCEPTS 144
ACCURACY OF THE TRAUMA STORY: IS IT IMPORTANT AND HOW TO CHECK IT? 147
ADVOCACY Ò SOME ETHICAL DILEMMAS 149
USING INTERPRETERS IN ASSESSMENT OF TRAUMA 150
SOME TECHNICAL ISSUES IN ASSESSMENT OF TRAUMA 151
REFERENCE 153
Assessment Methods 156
Assessment of PTSD and Psychiatric Comorbidity in Contemporary Chinese Societies 157
TRADITIONAL CHINESE HEALTH BELIEFS AND COPING ORIENTATIONS 158
CLASSIFICATION SYSTEMS OF MENTAL DISORDERS AND PTSD 159
ASSESSMENT OF PTSD AND PSYCHIATRIC COMORBIDITY 161
Assessment of Trauma and Life Event 161
Diagnostic Interviews for Psychiatric Disorders and PTSD 162
Screening and Assessment Instruments for PTSD Symptoms 163
Assessment Instruments for Psychiatric Comorbidity 166
NEURO-IMMUNO-BIOLOGY OF PTSD AND HUMAN NEUROIMAGING RESEARCH 168
Animal Studies 168
Neuroimmunological Studies with Psychiatric Patients 169
Human Neuroimaging Studies 170
PREVALENCE, COMORBIDITY, AND PREDICTORS OF PTSD 171
CHALLENGES AND FUTURE DIRECTIONS 182
REFERENCES 184
APPENDIX 1 190
Culture and the Assessment of Trauma in Youths 191
ASSESSING CULTURALLY DIVERSE GROUPS 191
ETHNICITY: MIXED FINDINGS IN US SAMPLES 193
Confounding Variables 193
Additional Stressors 194
Reporting Patterns 194
Birth Cohorts 195
NATIONAL, REGIONAL, AND EXPERIENTIAL CULTURES 195
Trauma-Related Subcultures 195
National Cultures 196
Multicultural Groups 202
PREPARING FOR ASSESSMENT 203
The Interviewer 203
Preludes to Rapport 204
Preparing Individuals and Environments for Assessment 205
ADAPTING MEASURES The Culture of Youths 207
Testing Translations 208
Assessing Treatment Methods 208
Regression and Reversion 209
INTERPRETATION OF FINDINGS: ASSOCIATED VARIABLES 209
Locus of Control and Culture 210
Self-View and Social Support 211
CONCLUSIONS 212
REFERENCES 213
The Peritraumatic Dissociative Experiences Questionnaire: An International Perspective 219
EMPIRICAL STUDIES OF TRAUMA AND DISSOCIATION 219
INTRODUCTION TO THE PDEQ: DISSOCIATIVE REACTIONS AT THE TIME OF TRAUMA EXPOSURE 221
THE PERITRAUMATIC DISSOCIATIVE EXPERIENCES QUESTIONNAIRE: A MEASURE OF IMMEDIATE DISSOCIATIVE RESPONSES TO TRAUMATIC EVENTS 223
INDEPENDENT STUDIES OF THE ENGLISH LANGUAGE VERSION OF THE PDEQ 226
INTERNATIONAL STUDIES WITH THE PDEQ: DUTCH VERSION 229
INTERNATIONAL STUDIES WITH THE PDEQ: FRENCH VERSION 229
INTERNATIONAL STUDIES WITH THE PDEQ: GERMAN VERSION 230
INTERNATIONAL STUDIES WITH THE PDEQ: ISRAELI VERSION 230
INTERNATIONAL STUDIES WITH THE PDEQ: JAPANESE VERSION 231
INTERNATIONAL STUDIES WITH THE PDEQ: BRAZILIAN PORTUGUESE VERSION 231
INTERNATIONAL STUDIES WITH THE PDEQ: PALESTINIAN VERSION 231
INTERNATIONAL STUDIES WITH THE PDEQ: TURKISH VERSION 232
INTERNATIONAL STUDIES WITH THE PDEQ: SUMMARY AND NEXT STEPS 232
REFERENCES 233
APPENDIX A 237
APPENDIX B 238
The Impact of Event Scale: Revised 240
INTRODUCTION 240
THE INITIAL PILOT WORK ON THE IES-R 243
ISSUES IN ALTERNATE VERSIONS IN A DIFFERENT LANGUAGE 245
INTERNATIONAL VERSIONS OF THE IES-R 249
A SAMPLING OF USE OF THE IES-R INTERNATIONAL VERSIONS 251
SUMMARY AND CONCLUSIONS 256
REFERENCES 257
Posttraumatic Stress in Asylum Seekers from Chechnya, Afghanistan, and West Africa: Differential Findings Obtained by Quantitative and Qualitative Methods in Three Austrian Samples 260
INTRODUCTION 260
METHOD Participants 266
Quantitative Methods: Psychometrics 267
Qualitative Methods: Diagnostic Interviews 270
RESULTS 271
DISCUSSION 287
ACKNOWLEDGMENT 291
REFERENCES 292
Trauma and Cultural Adaptation 297
The Cross-Cultural Assessment of Dissociation 298
DEFINITIONS OF DISSOCIATION 298
SOMATOFORM DISSOCIATION 299
DISSOCIATION AND PSYCHOSIS 300
RELATIONSHIP BETWEEN TRAUMA AND DISSOCIATION 302
NORMAL AND PATHOLOGICAL DISSOCIATION 304
CROSS-CULTURAL PHENOMENOLOGY 305
GENERAL ASSESSMENT ISSUES 308
PUERTO RICO AND PUERTO RICAN COMMUNITIES IN THE US 313
Translation and Adaptation of Dissociation Measures 313
Research with Psychiatric Populations 314
Community Studies of Dissociation and Related Conditions 316
Studies with Undergraduates 317
Case Studies 317
Summary 318
TURKEY 318
CONCLUSION 327
REFERENCES 329
Mass Psychological Trauma and PTSD: Epidemic or Cultural Illusion? 337
INTRODUCTION 337
VIETNAMESE REFUGEES AS A CASE EXAMPLE 341
VIETNAMESE REFUGEES AND THE TRAUMA MODEL 342
CULTURAL INFLUENCES ON MENTAL HEALTH AMONG THE VIETNAMESE 343
DEVELOPING AN INDIGENOUS MEASURE OF MENTAL DISTRESS: THE PHAN VIETNAMESE PSYCHIATRIC SCALE ( PVPS) 344
HOW IMPORTANT IS PTSD? 347
HEALTH SERVICE UTILIZATION FOR PTSD 347
CULTURAL DIMENSIONS AND SOMATIZATION AMONG VIETNAMESE REFUGEES 347
DISABILITY AND HEALTH SERVICE UTILIZATION PREDICTED BY THE PVPS 348
DISCUSSION 348
CONCLUSIONS 351
REFERENCES 351
Assessment of Trauma for Aboriginal People 355
ASSESSING CHRONIC, PERVASIVE AND COLLECTIVE TRAUMA 356
RESEARCHING POPULATION DATA ON TRAUMA: ASSESSING PSYCHOLOGICALLY TRAUMATIC EXPOSURES AND IMPACTS 359
THEMES IN ASSESSMENT OF TRAUMA AT THE CLINICAL LEVEL 361
ASSESSMENT STRATEGIES 370
CONCLUSION 375
REFERENCES 375
Combined Psychosocial and Pharmacological Treatment of Traumatized Refugees 377
INTRODUCTION 377
CASE PRESENTATION 378
FORMULATION AND STATEMENT TO THE PATIENT 379
NEGOTIATING A TREATMENT PLAN 380
RATIONALE FOR TREATMENT 380
FOLLOW-UP VISITS 381
NONSPECIFIC FACTORS IN PHARMACOLOGICAL TREATMENT 382
SPECIFIC INFORMATION ABOUT MEDICATION FOR REFUGEES 384
SPECIFIC GUIDELINES FOR COMBINED TREATMENT 385
REFERENCES 386
Western Psychiatry and Difficulty: Understanding and Treating Hmong Refugees 388
INTRODUCTION 388
HMONG SOCIAL ORGANIZATION: RESOURCES AND CHALLENGES 394
OPIUM: PRODUCTION, COMMERCE, AND ADDICTION 397
REFUGEE-RELATED MENTAL HEALTH PROBLEMS 398
THE HMONG WORLDVIEW: CAUSES OF MENTAL, EMOTIONAL, AND BEHAVIOR DISORDERS 400
HMONG FAMILY ORGANIZATION AND MENTAL HEALTH 403
CHILDBIRTH, CHILD RAISING, AND CHILDHOOD 406
APPLICATION OF PSYCHOTHERAPIES TO HMONG PATIENTS 407
REFERENCES 408
Index 411