Unemployment in Iraqi Refugees: The Interaction of Pre and Post-Displacement Trauma

Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N = 286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the US. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee\u27s country of origin

Mental Illness and Chronic Disease in a Random Sample of Newly-Arrived Refugees and Immigrants to the U.S.

The goal of this research is to examine the prevalence of chronic diseases [Hypertension, Heart diseases, Asthma and Diabetes] among newly arrived refugees and immigrants to U.S., to predict the risk factors for each of the four chronic diseases studied, and to discuss whether self-reported mental illnesses [Depression and PTSD] have an impact on the occurrence of chronic diseases

Predictors of self-rated health: a 12-month prospective study of IT and media workers

OBJECTIVE: The aim of the present study was to determine health-related risk and salutogenic factors and to use these to construct prediction models for future self-rated health (SRH), i.e. find possible characteristics predicting individuals improving or worsening in SRH over time (0–12 months). METHODS: A prospective study was conducted with measurements (physiological markers and self-ratings) at 0, 6 and 12 months, involving 303 employees (187 men and 116 women, age 23–64) from four information technology and two media companies. RESULTS: There were a multitude of statistically significant cross-sectional correlations (Spearman's Rho) between SRH and other self-ratings as well as physiological markers. Predictors of future SRH were baseline ratings of SRH, self-esteem and social support (logistic regression), and SRH, sleep quality and sense of coherence (linear regression). CONCLUSION: The results of the present study indicate that baseline SRH and other self-ratings are predictive of future SRH. It is cautiously implied that SRH, self-esteem, social support, sleep quality and sense of coherence might be predictors of future SRH and therefore possibly also of various future health outcomes

Refinement and Preliminary Testing of an Imagery-Based Program to Improve Coping and Performance and Prevent Trauma among Urban Police Officers

Police officers are regularly exposed to traumatic critical incidents. The substantial mental, behavioral, and social costs of police trauma indicate a substantial need for prevention. We have refined and enhanced a previously tested Swedish program to the harsh conditions of U.S. inner cities. The program was designed to strengthen resilience during stressful encounters and teach methods of coping after exposure, thereby preventing the emergence of maladaptive symptoms and behaviors with adverse effects on professionalism. In an uncontrolled demonstration project, junior officers were trained by senior officers to engage in imaginal rehearsal of specific dangerous situations while incorporating optimal police tactics and healthy emotional reactions. A class of 32 officers in the police academy engaged in the program, and they and the trainers reported high satisfaction with it. After their first year of field work, 22 officers were reassessed. Compared to pre-training, these officers showed significant increases in the use of positive reframing and humor and significant reductions in anxiety and alcohol use over the year. Trauma symptoms did not increase. These results offer preliminary evidence for the feasibility and effectiveness of this trauma prevention program for new police officers

Tinnitus and Self-Perceived Hearing Handicap in Firefighters: a Cross-Sectional Study

Firefighters are susceptible to auditory dysfunction due to long-term exposure to noise from sirens, air horns, equipment, and tools used in forcible entry, ventilation, and extrication. In addition, they are exposed to ototoxic chemicals, particularly, during overhaul operations. Studies indicate that 40% of firefighters have hearing loss in the noise-sensitive frequencies of 4 and 6 kHz. Noise-induced hearing loss (NIHL) is often accompanied by tinnitus, which is characterized by ringing noise in the ears. The presence of phantom sounds can adversely affect the performance of firefighters. However, there has been limited research conducted on the prevalence of tinnitus in firefighters. We enrolled firefighters from Michigan, with at least 5 years of continuous service. The hearing handicap inventory for adults (HHIA) was used to determine the difficulty in hearing perceived by the firefighters and the tinnitus functional index (TFI) was used to determine the severity of tinnitus. Self-perceived hearing handicap was reported by 36% of the participants, while tinnitus was reported by 48% of the participants. The TFI survey indicated that 31% perceived tinnitus as a problem. More importantly, self-perceived hearing handicap was significantly associated with the incidence of tinnitus in firefighters, suggesting a potential link between occupational exposure to ototraumatic agents and tinnitus in firefighters

Somatic and psychiatric disorders and health care utilization among Iraqi refugees and Yemeni immigrants.

Abstract Background: Prior studies have reported increased prevalence of mental and somatic health disorders among refugees. However, many of these studies fail to include appropriate comparison groups. Moreover, there is a lack of studies focusing on health care utilization among refugee populations. Patients and Methods: We examined the distribution of somatic and mental health disorders as well as patterns of health care utilization among 116 Iraqi refugees as compared to 232 non-refugee Arab immigrants. Results: Refugees as compared to nonrefugee immigrants exhibit different distributional patterns with regards to several somatic and psychiatric disorders. In addition, specific somatic disorders (e.g., dermatologic and cardiovascular disorders) were found to be associated with greater health care consumption in refugees as compared to regular immigrants with identical diagnoses

Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees

Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10 %, respectively) than did the cumulative trauma index (7 and 3 %, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations

Kidnapping and Mental Health in Iraqi Refugees: The Role of Resilience

Although kidnapping is common in war-torn countries, there is little research examining its psychological effects. Iraqi refugees (N = 298) were assessed upon arrival to the U.S. and 1 year later. At arrival, refugees were asked about prior trauma exposure, including kidnapping. One year later refugees were assessed for posttraumatic stress disorder (PTSD) and major depression disorder (MDD) using the SCID-I. Individual resilience and narratives of the kidnapping were also assessed. Twenty-six refugees (9 %) reported being kidnapped. Compared to those not kidnapped, those who were had a higher prevalence of PTSD, but not MDD, diagnoses. Analyses examining kidnapping victims revealed that higher resilience was associated with lower rates of PTSD. Narratives of the kidnapping were also discussed. This study suggests kidnapping is associated with PTSD, but not MDD. Additionally, kidnapping victims without PTSD reported higher individual resilience. Future studies should further elucidate risk and resilience mechanisms

Resilience as a Protective Factor Against the Development of Psychopathology Among Refugees

Abstract: Refugee research, to date, has predominantly focused on factors that make refugees more vulnerable for developing posttraumatic stress disorder (PTSD) and/or psychological distress. Few articles have studied potential protective factors such as resilience. A targeted nonrandom sample of Iraqi refugees (n = 75) and a control group of non-Iraqi Arab immigrants (n = 53) were recruited from a number of Iraqi/Arab community institutions in Michigan to complete a questionnaire that included measures for psychological distress, PTSD symptoms, exposure to trauma, and resilience. The refugees reported significantly more PTSD symptoms (t-test, p G 0.01) and psychological distress (p G 0.05) compared with the immigrants. There was no difference in resilience between the two groups. In linear regression, premigration exposure to violence was a significant predictor of psychological distress (p G 0.01) and PTSD symptoms (p G 0.01). After controlling for migrant status and violence exposure, resilience was a significant inverse predictor of psychological distress (p G 0.001) but not of PTSD. Resilience is associated with less trauma-related psychological distress and should be considered in assessing risk and protective factors among victims of war-related violence

Differential Effects of Physiological Arousal Following Acute Stress on Police Officer Performance in a Simulated Critical Incident

Background: Police officer response in a critical incident is often a life-or-death scenario for the officer, the suspect, and the public. Efficient and accurate decisions are necessary to ensure the safety of all involved. Under these conditions, it is important to understand the effects of physiological arousal in response to acute stress on police officer performance in critical and dangerous incidents. Prior research suggests that physiological arousal following a stressor differentially affects police performance – communication may be impaired, whereas well-rehearsed, tactical behaviors may be resilient.Objectives: In this study, we examine the differential effects of physiological arousal across three police skill domains: verbal communication, nonverbal communication, and tactical skill.Methods: A sample of Swedish police cadets (N = 17) participated in a critical incident simulation, which was a reenactment of a real-life incident that had resulted in a police officer death; the simulation included multiple calls, dynamic environments, and surprise threats. An expert rater evaluated the cadets across multiple domains of skill, and physiological arousal was monitored by continuous heart rate monitoring and measures of circulating cortisol and antithrombin taken before and after the incident simulation.Results: The simulation increased police officer arousal, as reflected in elevated heart rate, but this alone did not predict differences in performance. Greater increase in antithrombin was associated with better general performance, but a specific deficit in verbal communication as compared to tactical performance and nonverbal communication. Change in cortisol was unrelated to the skill assessments.Conclusions: Police officer performance during a critical incident simulation is affected by physiological arousal. The findings are discussed with implications for police officer decision-making and real-world performance