Psychological sequelae of torture and organised violence suffered by refugees from Iraq

TLDR

Refugees who have suffered traumatic events present complex therapeutic challenges, yet little research exists on post‑exile factors that could reduce morbidity. The study examined how social and trauma factors in exile influence psychological sequelae of severe trauma. Eighty‑four male Iraqi refugees were interviewed, with adverse events, social support, and established psychological morbidity measures assessed. Affective social support in exile strongly predicts PTSD and depression severity, especially when coupled with severe trauma, and is a stronger predictor of depressive morbidity than trauma itself; these findings suggest that integrated rehabilitation and family reunion could mitigate psychological morbidity.

Abstract

Background Refugees who have suffered traumatic events present complex therapeutic challenges to health professionals. There is little research into post-exile factors that may be amenable to change, and therefore reduce morbidity. We examined the importance of social factors in exile and of trauma factors in producing the different elements of psychological sequelae of severe trauma. Method Eighty-four male Iraqi refugees were interviewed. Adverse events and level of social support were measured. Various measures of psychological morbidity were applied, all of which have been used in previous trauma research. Results Social factors in exile, particularly the level of ‘affective’ social support, proved important in determining the severity of both post-traumatic stress disorder and depressive reactions, particularly when combined with a severe level of trauma/torture. Poor social support is a stronger predictor of depressive morbidity than trauma factors. Conclusions Some of the most important factors in producing psychological morbidity in refugees may be alleviated by planned, integrated rehabilitation programmes and attention to social support and family reunion.