268325 An evaluation of the role of psychological distress in the loss to social resources among Kurdish torture survivors

Monday, October 29, 2012 : 9:15 AM - 9:30 AM

Brian Hall, PhD, MA , Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ahmed Amin, MD , Trauma Rehabilitation and Training Center (TRTC), Heartland Alliance, Sulaimaniya, Iraq
Paul Bolton, MBBS, DTMH, MPH , Department of International Health, Applied Mental Health Research Group, Center for Refugee and Disaster Response, Johns Hopkins School of Public Health, Baltimore, MD
Judith Bass, PhD, MPH , Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD
     
Social resources buffer individuals from the effects of traumatic life events. Loss of these resources contributes to psychological distress such as posttraumatic stress disorder (PTSD). Although social resources are commonly evaluated as protective factors, research has demonstrated that psychological distress can lead to a deterioration of these resources (i.e., reverse causation). This has not been evaluated within low- and middle-income countries. The present longitudinal study investigated whether baseline psychological distress predicted losses of social resources at 6-month follow-up among 116 male and female torture survivors residing in Kurdistan, Iraq. All study measures were evaluated and adapted to the local context using qualitative field methods (e.g., free listing). Locally relevant symptoms were added to the Hopkins Symptom Checklist-25, Harvard Trauma Questionnaire, and the Traumatic Grief Scale in order to adequately capture the variation in anxiety, depression, PTSD and traumatic grief within this population. Social resources were assessed by three scales measuring perceived social support, social embeddedness (i.e., being a part of a community) and frequency of social contact. Each of these outcomes was categorized on three levels based on loss, gain and no change. After adjusting for potential confounding, multinomial logistic regressions indicated that depression, anxiety, and grief significantly increased the odds of the losing social support (OR=1.09; 1.13; 1.20, respectively). Anxiety and depression (OR=1.08; 1.10) predicted loss of social embeddedness. Psychological distress did not increase the odds of change in frequency of social contact. Social resources should be evaluated as treatment targets and secondary outcomes of global mental health interventions.

Learning Areas:
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the importance of evaluating how psychological distress can affect social resources. Identify how qualitative and mixed methods approaches increase the validity of mental health assessment. Discuss the effect of torture on mental health and quality of life in low and middle income countries.

Keywords: Mental Disorders, Torture

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinical psychologist with extensive training and experience treating people who have experienced psychological trauma. I have published multiple peer-reviewed papers focused on the mental health outcomes of traumatized populations within low- and middle-income contexts. My area of interest is the role of social resources on mental health outcomes and how the loss of these resources increase vulnerability to mental disorder.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3044.0: Global Issues in Mental Health