Department of Global Health and Population, Harvard University, Boston, MA, USA.
Department of Education, Universidad de Monterrey, Monterrey, Mexico.
Transcult Psychiatry. 2022 Aug;59(4):492-505. doi: 10.1177/1363461520906008. Epub 2020 Mar 16.
More than half of all children in Cambodia experience direct abuse and over 70% experience other traumatic events, which significantly increase their risks for a range of physical and mental health problems. Additionally, Cambodian children face longstanding sociopolitical, intergenerational, and cultural factors that compound the impact of other trauma. As a result, rates of posttraumatic stress symptoms among Cambodian youth are high. However, care providers often rely on Western-based nosology that does not account for culturally specific expressions of trauma. A greater understanding of culturally-salient expressions of distress can help inform diagnostic assessment accuracy and treatment effectiveness and monitoring. The current study utilized a qualitative design to interview 30 Cambodian caregivers of children with trauma experiences and 30 Cambodian children (ages 10-13 years) with trauma experiences to identify key local expressions of trauma. Findings reveal certain PTSD symptoms and culturally-specific frequent and severe trauma-related problems for Cambodian children and domains of functioning impacted by trauma. Certain symptoms seem particularly important to evaluate in this group, such as anger, physical complaints (e.g., headache and palpitations), and cognitive-focused complaints (in particular, "thinking too much"). All caregivers and children reported physical health as impacted by trauma-related problems, highlighting a particularly salient domain of functioning for this population. Expressions of distress explored in the current study are discussed in the context of assessment and intervention development to inform diagnostic and clinical efforts for those working with trauma-exposed Cambodian children.
柬埔寨超过一半的儿童经历过直接虐待，超过 70%的儿童经历过其他创伤事件，这大大增加了他们出现一系列身心健康问题的风险。此外，柬埔寨儿童还面临长期存在的社会政治、代际和文化因素，这些因素加剧了其他创伤的影响。因此，柬埔寨青年创伤后应激症状的发生率很高。然而，护理人员通常依赖于不考虑创伤文化特异性表达的基于西方的分类学。对文化上突出的痛苦表达有更深入的了解，可以帮助提高诊断评估的准确性、治疗效果和监测。本研究采用定性设计，对 30 名有创伤经历的柬埔寨儿童的照顾者和 30 名有创伤经历的柬埔寨儿童（10-13 岁）进行了访谈，以确定创伤的关键当地表达。研究结果揭示了柬埔寨儿童的某些创伤后应激症状和特定文化的常见且严重的创伤相关问题，以及受创伤影响的功能领域。某些症状在该群体中似乎特别重要，例如愤怒、身体投诉（如头痛和心悸）和以认知为中心的投诉（特别是“想太多”）。所有照顾者和儿童都报告说，与创伤相关的问题影响了他们的身体健康，突出了这一人群特别重要的功能领域。本研究探讨的痛苦表达在评估和干预发展的背景下进行了讨论，以为那些与经历过创伤的柬埔寨儿童一起工作的人提供诊断和临床工作。
