Contractor Ateka A, Rafiuddin Hanan S, Kaur Kiran, Asnaani Anu
Department of Psychology, University of North Texas, Denton, TX, USA.
Trauma Violence Abuse. 2023 Oct;24(4):2395-2411. doi: 10.1177/15248380221097435. Epub 2022 May 11.
. Limited research has examined trauma and posttraumatic stress disorder (PTSD) among Asian Indians in the U.S. Thus, we (1) synthesize literature on trauma, PTSD, disparities in treatment for PTSD, the burden of untreated PTSD, and culturally-adapted (CA) PTSD interventions; and (2) discuss recommendations for clinicians/researchers working with this population. We searched two databases using keywords related to Asian Indians, PTSD, and interventions. Of 238 identified articles, we used content from 26 articles to inform our review. Asian Indians report traumatic experiences before, during, or after immigration to the U.S. and consequential PTSD symptoms. Further, Asian Indians in the U.S. are disproportionately impacted by socio-cultural and economic determinants of poor mental health (e.g., shame/stigma associated with seeking mental health services, few culturally-responsive services), which may contribute to the under-reporting of PTSD and (interpersonal) traumas and less willingness to seek treatment. Additionally, CA PTSD interventions tailored to Asian Indians in the U.S. have not been developed. Socio-cultural considerations that can inform CA PTSD interventions for Asian Indians include: causal conditions (e.g., culturally-rooted beliefs about trauma/PTSD), intervening conditions/barriers (e.g., emotional inhibition), and mitigating/coping strategies (e.g., religious/spiritual practices, cultural idioms of distress). These considerations influence clinician/treatment preferences (e.g., solution-oriented and structured therapy, less emotional exposure). Lastly, we outline recommendations for clinicians/researchers: (1) need for national studies on trauma, PTSD, treatment utilization, and the burden of untreated PTSD; (2) consideration of immigration-related experiences influencing PTSD; (3) consideration of socio-cultural elements for CA PTSD interventions; and (4) need for culturally-valid PTSD assessments.
在美国,针对亚洲印度裔人群中创伤及创伤后应激障碍(PTSD)的研究有限。因此,我们(1)综合了关于创伤、PTSD、PTSD治疗差异、未治疗PTSD的负担以及文化适应(CA)PTSD干预措施的文献;(2)讨论了针对与该人群打交道的临床医生/研究人员的建议。我们使用与亚洲印度裔、PTSD和干预措施相关的关键词搜索了两个数据库。在238篇已识别的文章中,我们使用了26篇文章的内容来为我们的综述提供信息。亚洲印度裔报告了在移民到美国之前、期间或之后的创伤经历以及由此产生的PTSD症状。此外,美国的亚洲印度裔人群受到心理健康状况不佳的社会文化和经济决定因素的影响尤其严重(例如,与寻求心理健康服务相关的羞耻/污名、缺乏文化响应性服务),这可能导致PTSD和(人际)创伤报告不足,以及寻求治疗的意愿较低。此外,尚未开发出针对美国亚洲印度裔人群的CA PTSD干预措施。可为亚洲印度裔人群的CA PTSD干预措施提供参考的社会文化因素包括:因果条件(例如,关于创伤/PTSD的文化根源信念)、干预条件/障碍(例如,情绪抑制)以及缓解/应对策略(例如,宗教/精神实践、痛苦的文化习语)。这些因素会影响临床医生/治疗偏好(例如,以解决问题为导向的结构化治疗、较少的情绪暴露)。最后,我们为临床医生/研究人员概述了建议:(1)需要开展关于创伤、PTSD、治疗利用情况以及未治疗PTSD负担的全国性研究;(2)考虑影响PTSD的与移民相关的经历;(3)在CA PTSD干预措施中考虑社会文化因素;(4)需要进行具有文化效度的PTSD评估。