Schubert Carla C, Punamäki Raija-Leena
Department of Psychology, University of Tampere, Tampere, FIN-33014, Finland.
Nord J Psychiatry. 2011 Jun;65(3):175-82. doi: 10.3109/08039488.2010.514943. Epub 2010 Sep 21.
The experience of torture places the survivors at a heightened risk for somatic and mental health problems.
This study examined the role of culture, refugee status and gender in the mental and somatic health among help-seekers in a centre for torture survivors in Finland.
The 78 participants (29 women and 49 men) were interviewed and assessed with the Impact of Event Scale-Revised (IES-R) and the Hopkins Symptom Checklist-25 (HSCL-25) scales and their somatic complaints were registered. Groups with Middle Eastern, Central African, Southern Asian and South Eastern European cultural backgrounds were compared.
Group differences were found in post-traumatic stress disorder (PTSD) and depressive symptoms and somatic complaints. As hypothesized, Southern European torture survivors showed a higher level of PTSD than cultural groups from more traditional collective societies in Middle East, Asia and Africa, and more depressive symptoms than survivors from a Southern Asian background. Against the hypothesis, South Eastern European subjects reported also more somatic complaints than Central African survivors. Women suffered more from PTSD and depressive symptoms than men in all cultural groups. Asylum-seeking status was marginally associated with anxiety symptoms only in the South Eastern European group.
Health services should consider the influence of culture in the expression of psychological and somatic symptoms and avoid a simplistic distinction between somatic and psychological expressions of pain.
遭受酷刑的经历使幸存者面临更高的身心健康问题风险。
本研究探讨了文化、难民身份和性别在芬兰一家酷刑幸存者救助中心求助者的身心健康中所起的作用。
对78名参与者(29名女性和49名男性)进行访谈,并使用事件影响量表修订版(IES-R)和霍普金斯症状清单-25(HSCL-25)量表进行评估,同时记录他们的躯体主诉。对具有中东、中非、南亚和东南欧文化背景的群体进行了比较。
在创伤后应激障碍(PTSD)、抑郁症状和躯体主诉方面发现了群体差异。正如所假设的,南欧酷刑幸存者的PTSD水平高于中东、亚洲和非洲更传统集体社会文化群体的幸存者,且抑郁症状比南亚背景的幸存者更多。与假设相反,东南欧受试者报告的躯体主诉也比中非幸存者更多。在所有文化群体中,女性比男性更容易患PTSD和抑郁症状。寻求庇护身份仅在东南欧群体中与焦虑症状有微弱关联。
卫生服务机构应考虑文化对心理和躯体症状表现的影响,避免对疼痛的躯体和心理表现进行简单区分。