PSYCHOSOCIAL IMPACT OF TRAUMA ON BOSNIAN REFUGEES

描述（改编自申请人的摘要）：拟议的研究 需要首次对一般人群的作用进行大规模研究 修改时的个人、环境和其他风险因素 创伤、精神症状和功能状态之间的关系。 该研究将产生第一个难民的后续精神病学数据 允许检查之间的剂量效应关系的人群 创伤、精神症状和功能状态，以及能力 遣返前后从事经济活动。 的一个模型 随着时间的推移，创伤对人群的影响也将得到研究。 的 拟议的研究填补了理解创伤对人的影响的重大空白 一个人发挥作用和参与经济活动的能力 分析剂量效应关系的持续时间和特征。 该设计是两个时间段的前瞻性队列研究。 数据关于 对 1996 年收集的波斯尼亚难民群体（n=536）进行分析 建立创伤、症状、功能状态的基线估计， 参与创收活动的能力。 队列成员将 遣返后重新面谈，以便对情况进行前瞻性评估 创伤的精神和功能结果。 标准化的个人 面试将使用先前验证的哈佛创伤进行管理 问卷调查和霍普金斯症状检查表 25 以获得回顾性信息 创伤报告、期间经历的创伤的同期报告 遣返，并重复测量抑郁症、创伤后应激障碍和功能障碍 结果。 个人和环境特征的并行测量 还将获得创收活动的衡量标准。 这些测量将用于评估剂量效应的变化 创伤与精神和身体健康结果的关系，并进行测试 从相互作用的概念模型得出的假设 创伤及其随时间的精神和功能结果。 定量 分析将采用图形方法、描述性统计和 结构方程模型。

DESCRIPTION (Adapted from applicant's abstract): The proposed research entails the first large scale, general population study of the role of personal, environmental, and other risk factors in modifying the relationship between trauma, psychiatric symptoms, and functional status. The study will produce the first follow-up psychiatric data on a refugee population allowing examination of dose--effect relationships between trauma, psychiatric symptoms, and functional status, and the ability to engage in economic activity before and after repatriation. A model of the impact of trauma on populations over time will also be developed. The proposed research fills a major gap in understanding the impact of trauma on a person s ability to function and to participate in economic activity, by analyzing the duration and character of the dose-effect relationship. The design is a prospective cohort study in two time periods. Data on a Bosnian refugee cohort (n=536), collected in 1996, will be analyzed to establish baseline estimates of trauma, symptoms, functional status, and ability to participate in income-generating activities. Cohort members will be re-interviewed post repatriation, allowing prospective assessment of the psychiatric and functional outcomes of trauma. A standardized personal interview will be administered using the previously validated Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25 to obtain retrospective reports of trauma, contemporaneous reports of trauma experienced during repatriation, and replicate measures of depression, PTSD, and functional outcomes. Concurrent measures of personal and environmental characteristics will also be obtained, along with measures of income-generating activity. These measurements will be used to assess change in the dose-effect relationship of trauma to mental and physical health outcomes, and to test hypotheses deriving from a conceptual model of the interaction between trauma and its psychiatric and functional outcomes over time. Quantitative analyses will employ graphical methods, descriptive statistics, and structural equation models.