The Geopolitics of Trauma: The Role of Post-Traumatic Stress Disorder in Admission and Resettlement of Iraqi Refugees in the U.S.

本项目探讨了难民安置的实践和经验如何重塑战争和暴力的创伤，从而在伊拉克和美国之间建立新的地缘政治联系。由于最近的战争，有200多万伊拉克人流离失所，伊拉克人是过去十年在美国重新安置的三大难民人口之一。难民越来越多地通过创伤后应激障碍（PTSD）的医学诊断来定义和照顾，但通过PTSD范式的创伤医学化在难民接纳，重新安置和福祉方面所起的作用尚不为人所知。在美国以及约旦和土耳其的难民筛选/接收点进行的多地点研究的研究结果将对心理健康筛查和治疗的不均匀地理分布产生新的见解，这将有助于制定接纳和重新安置过程。这些发现也将有助于卫生从业人员照顾难民的关键需求，并有兴趣发展跨文化的创伤后应激障碍的方法。更好地了解服务提供者和伊拉克难民如何参与创伤后应激障碍框架及其影响，将加强美国的国家安全，并为流离失所者的福祉履行人道主义责任。这项研究有助于了解地缘政治以及移民和少数民族人口的公共卫生，并将通过培训一名博士后和两名研究生研究助理，加强代表性不足的少数民族对研究的参与。本项目有三个具体目的：1)确定创伤后应激障碍范式在伊拉克难民海外心理健康筛查和入境中的作用；2)评估创伤后应激障碍范式如何影响难民抵达美国后的安置管理；3)研究伊拉克难民如何经历和解释重新安置的过程，特别是心理健康筛查、诊断和治疗，并分析这些经历在地理上、年龄、性别、教育程度和重新安置时间上的差异。采用深入的定性方法，该研究首先建立了对当代海外难民安置实践中接纳和排斥难民的心理健康筛查工作的见解。其次，研究人员希望发现创伤的医学化，如创伤后应激障碍，将难民以一种特殊的方式插入他们重新安置后的新生活中，唤起对难民、过去和幸福的具体理解。第三，该研究将揭示难民自身如何经历筛选过程、服务提供者和治疗，从申请到在美国不同地方定居。研究创伤后应激障碍范式在难民安置轨迹上跨越多个地点和空间的作用，将追踪创伤的地缘政治，挑战地缘政治关系的规模和稳定性假设。

This project examines how refugee resettlement practices and experiences rework the trauma of war and violence to create new geopolitical connections between Iraq and the United States. With over two million Iraqis displaced from their country by the recent war, Iraqis have been one of the top three refugee populations resettled in the U.S. in the past decade. Refugees are increasingly defined and cared for through a medical diagnosis of Post-Traumatic Stress Disorder (PTSD), but the role that the medicalization of trauma through the PTSD paradigm plays in refugee admission, resettlement, and well-being is not well known. Research findings from multi-sited research in the U.S. and in refugee screening/admissions sites in Jordan and Turkey will yield new insights into the uneven geography of mental health screening and treatment that will be useful for shaping admission and resettlement processes. These findings will also be helpful to health practitioners attending to the critical needs of refugees and interested in developing intercultural approaches to PTSD. A better understanding of how both service providers and Iraqi refugees engage with the PTSD framework and its implications will enhance U.S. national security and fulfill a humanitarian responsibility for the well-being of the displaced. This study contributes to knowledge of geopolitics and the public health of immigrant and minority populations, and will enhance the participation of underrepresented minorities in research by including training for a postdoctoral fellow and two graduate research assistants.This project pursues three specific aims: 1) to determine the role that the PTSD paradigm plays in the overseas mental health screening and admission of Iraqi refugees; 2) to assess how the PTSD paradigm influences the administration of resettlement once refugees arrive in the U.S.; and 3) to examine how Iraqi refugees experience and interpret the process of resettlement and especially mental health screening, diagnosis, and treatment, and analyze how these experiences vary geographically and by age, gender, education, and time of resettlement. Using in-depth qualitative methods, the research first establishes insights into the workings of mental health screening in the admission and exclusion of refugees in contemporary refugee resettlement practices overseas. Second, the investigators expect to find that the medicalization of trauma as PTSD inserts refugees into their new, post-resettlement lives in a particular way, calling forth specific understandings of what a refugee, the past, and well-being are. Third, the research will reveal how refugees themselves experience screening processes, service providers, and treatment from the point of application to settlement in different places in the U.S. Examining the role of the PTSD paradigm across multiple sites and spaces along the refugee resettlement trajectory will trace out a geopolitics of trauma that challenges assumptions about the scale and fixity of geopolitical relations.