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Posttraumatic world assumptions among treatment-seeking refugees
F Jackie June Ter Heide1, Marieke Sleijpen1, Niels van der Aa2
1Foundation Centrum '45 | partner in Arq Psychotrauma Expert Group, the Netherlands.
Transcultural Psychiatry
|December 12, 2017
Summary
Traumatised refugees exhibit significantly more negative world assumptions than general populations, veterans, and whiplash victims. These negative cognitions, particularly regarding the benevolence of people and the world, are crucial for understanding refugee mental health.
Area of Science:
- Psychology
- Trauma Studies
- Mental Health Research
Background:
- Negative changes in cognitions about self, others, and the world are central to diagnostic criteria for posttraumatic stress disorder (PTSD) and complex PTSD.
- Such cognitive shifts are hypothesized to be particularly significant for traumatised refugees, yet empirical evidence in this population remains limited.
- Existing diagnostic frameworks, such as the DSM-5 and ICD-11, address these cognitive changes differently, necessitating further investigation into their applicability.
Purpose of the Study:
- To compare negative cognitions in adult, treatment-seeking refugees with reference samples from the general population, veterans with combat-related PTSD, and whiplash victims.
- To examine the relationship between negative world assumptions and demographic and trauma-related variables in a refugee sample.
- To assess the clinical relevance of DSM-5 and ICD-11 criteria concerning negative cognitive changes in refugees.
Main Methods:
- A cross-sectional study design was employed.
- Participants included 213 adult, treatment-seeking refugees.
- Measures comprised the World Assumptions Scale (WAS) and the Harvard Trauma Questionnaire (HTQ), assessing events and PTSD symptoms.
Main Results:
- Refugees reported significantly more negative world assumptions, particularly concerning the benevolence of the world, people, and luck, compared to all reference groups.
- Differences in negative cognitions were least pronounced regarding self-worth and self-controllability.
- Negative world assumptions correlated with gender and PTSD symptom severity, but not with age, duration of residence, or trauma types.
Conclusions:
- The DSM-5 criterion for negative belief changes appears more pertinent to refugees than the ICD-11's narrower focus on a diminished self.
- Interventions for refugees should prioritize preventing further erosion of trust and actively work towards restoring trust in others and the world.
- Understanding and addressing negative world assumptions is critical for effective mental health support for traumatised refugee populations.
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