Refugee-related trauma patterns and mental health symptoms across three generations of Hmong Americans.

Refugee-related trauma patterns and mental health symptoms across three generations of Hmong Americans.
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DOI:
10.1002/jts.22813
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发表时间:
2022-08
影响因子:
3.3
通讯作者:
Krahn, Dean D
Krahn, Dean D
中科院分区:
医学3区
文献类型:
--
作者:
Lor, Maichou;Yu, Zhiyuan;Chen, Wenyi;Xiong, Yee;Yonker, James A;Brown, Roger;Krahn, Dean D

文献摘要

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越南战争难民苗族成年人曾遭受过与难民相关的创伤,但人们对苗族成年人创伤暴露模式与心理健康结果之间的关系知之甚少。我们检查了三代苗族成年人 (N = 219) 的创伤暴露和心理健康症状(即躯体化、抑郁、焦虑和可能的创伤后应激障碍 [PTSD])的模式。使用哈佛创伤问卷-苗族版来测量创伤暴露和可能的创伤后应激障碍。使用简短症状量表来测量躯体化、抑郁和焦虑症状。进行了潜在类别分析(LCA)以及社会人口学特征和心理健康症状的辅助分析。最合适的 LCA 模型描述了三个不同的类别:复杂且普遍的创伤(60.3%)、战斗情境和剥夺创伤(26.0%)以及低度接触难民相关创伤(13.7%)。复杂而普遍的创伤类别的参与者年龄最大,在美国居住的时间最短,英语最不熟练,并且报告了最严重的心理健康症状;那些处于战斗情境和剥夺创伤类别的人最年轻,英语水平中等,并报告了中等的心理健康症状;那些遭受难民相关创伤程度较低的人英语最流利,在美国居住的时间最长,并且报告的心理健康症状最轻。我们的研究结果呼吁对英语水平有限的苗族老年人进行监测和采取创伤知情的方法,他们遭受难民相关创伤累积影响的风险很高,并且容易受到不良心理健康结果的影响。
Hmong adults who are Vietnam War refugees have been exposed to refugee-related trauma, but little is known about associations between patterns of trauma exposure and mental health outcomes in Hmong adults. We examined patterns of trauma exposure and mental health symptoms (i.e., somatization, depression, anxiety, and probable posttraumatic stress disorder [PTSD]) in three generations of Hmong adults (N = 219). Trauma exposure and probable PTSD were measured using the Harvard Trauma Questionnaire–Hmong Version. Somatization, depression, and anxiety symptoms were measured using the Brief Symptom Inventory. Latent class analysis (LCA) and auxiliary analysis of sociodemographic characteristics and mental health symptoms were performed. The best-fitting LCA model described three distinct classes: complex and pervasive trauma (60.3%), combat situation and deprivation trauma (26.0%), and low exposure to refugee-related trauma (13.7%). Participants in the complex and pervasive trauma class were the oldest, had the shortest U.S. residency, were the least proficient in English, and reported the most severe mental health symptoms; those in the combat situation and deprivation trauma class were the youngest, moderately proficient in English, and reported moderate mental health symptoms; and those in the low exposure to refugee-related trauma class were the most proficient in English, had the longest U.S. residency, and reported the least severe mental health symptoms. Our findings call for surveillance and a trauma-informed approach for Hmong elders with limited English proficiency, who have a high risk of experiencing accumulative effects of refugee-related trauma and are susceptible to poor mental health outcomes.