伊拉克和黎凡特伊斯兰国（ISIS）奴役与暴力行为的雅兹迪族女性幸存者中抑郁症、广泛性焦虑症和创伤后应激障碍的测量
Measures of depression, generalized anxiety, and posttraumatic stress disorders amongst Yazidi female survivors of ISIS slavery and violence.
作者信息
Taha Perjan Hashim, Slewa-Younan Shameran
机构信息
Psychiatry Unit, College of Medicine, University of Duhok, Duhok, Iraq.
School of Medicine, Humanitarian and Development Research Initiative, Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South DC NSW, Sydney, 1797, Australia.
出版信息
Int J Ment Health Syst. 2020 Nov 10;14(1):80. doi: 10.1186/s13033-020-00412-4.
BACKGROUND
In 2014 the Islamic State of Iraq and Syria (ISIS) undertook a systematic and deliberate campaign against minority groups and non-Sunni Muslim communities. Amongst some of the greatest atrocities were those targeted towards Yazidi communities and in particular their women. The mental health outcomes of those women held in captivity requires investigation. This study sought to examine and compare levels of general psychological distress, depression, generalized anxiety, posttraumatic stress disorder (PTSD) and self-reported suicidal thoughts and behaviors amongst Yazidi women held in captivity compared with those without such experiences.
METHOD
Between January to May 2019, a total 348 Yazidi women located in internal displaced person (IDP) camps were interviewed. Of these 348, 139 females were survivors of ISIS captivity. Measures used included Kessler Psychological Distress Scale (K10), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Harvard Trauma Questionnaire part IV (HTQ part IV).
RESULTS
Formerly enslaved Yazidi females showed a significantly higher prevalence of severe mental distress (97.1%; P < 0.001), more severe levels of depression (36.7%; P < 0.001) and general anxiety symptoms (37.4%; P < 0.001), greater rates of PTSD (90.6%; P < 0.001) and higher reported rates of suicidal ideation (38.1%; P < 0.001). Logistic regression analysis undertaken to examine the role of sociodemographic factors as predictors of the assessed mental health conditions. Amongst the formerly enslaved group, no such significance was found, however amongst the non-enslaved group, unemployment was found to statistically determine depression, generalized anxiety and PTSD. Specifically, women from the non-enslaved group who were unemployed were 2.5 times more likely to have depression, 3 times more likely to have generalized anxiety and 3.3 times more likely to have PTSD. Finally, amongst the non-enslaved group, those women with between 5 to 8 siblings were significantly less likely to have depression than those with fewer siblings.
CONCLUSION
Rates of distress and trauma related symptomology were significantly higher amongst those with history of enslavement. Sociodemographic factors and duration of enslavement do not seem to predict mental disorders among enslaved females.
背景
2014年，伊拉克和叙利亚伊斯兰国（ISIS）对少数群体和非逊尼派穆斯林社区发起了一场有系统、有预谋的行动。其中一些最严重的暴行是针对雅兹迪社区，尤其是针对该社区的女性。被囚禁女性的心理健康状况需要进行调查。本研究旨在调查和比较被囚禁的雅兹迪女性与没有此类经历的女性在一般心理困扰、抑郁、广泛性焦虑、创伤后应激障碍（PTSD）以及自我报告的自杀念头和行为方面的水平。
方法
2019年1月至5月期间，对位于境内流离失所者（IDP）营地的348名雅兹迪女性进行了访谈。在这348名女性中，139名是ISIS囚禁的幸存者。所使用的测量工具包括凯斯勒心理困扰量表（K10）、患者健康问卷（PHQ - 9）、广泛性焦虑障碍量表（GAD - 7）以及哈佛创伤问卷第四部分（HTQ第四部分）。
结果
曾被奴役的雅兹迪女性中，严重心理困扰的患病率显著更高（97.1%；P < 0.001），抑郁程度更严重（36.7%；P < 0.001），广泛性焦虑症状更严重（37.4%；P < 0.001），创伤后应激障碍发生率更高（90.6%；P < 0.001），自杀意念报告率也更高（38.1%；P < 0.001）。进行逻辑回归分析以检验社会人口学因素作为评估心理健康状况预测指标的作用。在曾被奴役的群体中，未发现此类显著关联，然而在未被奴役的群体中，失业在统计学上被发现可决定抑郁、广泛性焦虑和创伤后应激障碍。具体而言，未被奴役群体中失业的女性患抑郁症的可能性是其他女性的2.5倍，患广泛性焦虑症的可能性是其他女性的3倍，患创伤后应激障碍的可能性是其他女性的3.3倍。最后，在未被奴役的群体中，有5至8个兄弟姐妹的女性患抑郁症的可能性明显低于兄弟姐妹较少的女性。
结论
有被奴役经历的人群中，困扰和创伤相关症状的发生率显著更高。社会人口学因素和被奴役的时长似乎无法预测被奴役女性的精神障碍。
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