Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss

Year Published:

Abstract

Background: While a large proportion of conflict-affected populations have been dually exposed to trauma and loss, there is inadequate research identifying differential symptom profiles related to bereavement and trauma exposure in these groups. The objective of this study were to (1) determine whether there are distinct classes of posttraumatic stress disorder (PTSD) and prolonged grief disorder (PGD) symptoms in bereaved trauma survivors exposed to conflict and persecution, and (2) examine whether particular types of refugee experiences and stressors differentially predict symptom profiles. Methods: Participants were 248 Mandaean adult refugees who were assessed at an average of 4.3 years since entering Australia following persecution in Iraq. PTSD, PGD, trauma exposure, adjustment difficulties since relocation, and English proficiency were measured. Latent class analysis was used to elucidate symptom profiles of PTSD and PGD in this sample. Results: Latent class analysis revealed four classes of participants: a combined PTSD/PGD class (16%), a predominantly PTSD class (25%), a predominantly PGD class (16%), and a resilient class (43%). Whereas membership in the PTSD/PGD class was predicted by exposure to traumatic loss, those in the PGD class were more likely to have experienced adaptation difficulties since relocation, and individuals in the PTSD class were more likely to have experienced difficulties related to loss of culture and support. Conclusions: This study provides evidence that specific symptom patterns emerge following exposure to mass trauma and loss. These profiles are associated with distinct types of traumatic experiences and post-migration living difficulties. These results have substantial public health implications for assessment and intervention following mass trauma.

Citation

Relevant Evidence Summaries

The evidence was reviewed and included in the following summaries: 

What can help refugees process traumatic grief?

There is limited strong evidence on interventions that specifically target traumatic grief. –  Prolonged and traumatic grief are usually closely associated with post-traumatic stress disorder (PTSD) and therefore many interventions targeted PTSD with grief symptoms as an auxiliary diagnosis –  There appear to be some differences in interventions that target grief as a result of…

About this study

AGE: Adults

DIRECTION OF EVIDENCE: No evidence about impact

FULL TEXT AVAILABILITY: Free

HOST COUNTRY: Australia

HOST COUNTRY INCOME: High

OUTCOME AREA: Mental Health

OUTCOME: PTSD/PGD

POPULATION: Refugees

REGION OF ORIGIN OF PARTICIPANT(S): Middle East

STRENGTH OF EVIDENCE: Suggestive

TYPE OF STUDY: Suggestive evidence

YEAR PUBLISHED: 2014

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