Clinical relevance of grief and mourning among Cambodian refugees

From 1975 to 1979, one to two million Cambodians were executed or died of disease and starvation during the rule of the Pol Pot government. In the aftermath of that catastrophe, many survivors have developed symptoms of post-traumatic stress disorder. There is some evidence that the intrusive symptoms of this disorder, such as nightmares, sleep disorders, and startle reactions, can be treated with medication. But other psychosocial problems that are similar to those found in chronic grief, such as avoidance behavior, shame, and decreased involvement with other individuals, are more resistive to treatment. On a cross-cultural level, the interpretations of, or meanings given to, specific symptoms by the patient may be influenced by culturally-specific religious beliefs, rituals, and social traditions. For the clinician, these cultural factors have relevance not only for engaging the patient in treatment, but also in the planning of specific therapeutic interventions.