BRAIN INJURY IN TORTURE SURVIVORS: MENTAL HEALTH IMPACT

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EXCEED THE SPACE PROVIDED. The proposed research is the first community study of a population of torture survivors that investigates the impact of head injury, common in torture, on psychiatric and functional outcomes. The study will determine the amount of torture and head injury events in Vietnamese torture survivors. It will test the hypotheses that a) torture survivors with head injury have higher levels of psychiatric symptoms and functional impairment than torture survivors or controls without head injury; b) torture survivors with head injury will have brain abnormalities on neuropsychological testing and neuroimaging distinct from survivors and controls without head injury; and c) torture survivors with depression and PTSD will have brain abnormalities on neuropsychological testing and neuroimaging distinct from survivors and controls without these diagnoses. The design is a cross-sectional study of a complete census of all Vietnamese torture survivors (i.e., ex-political detainees) on the roster of Massachusetts' leading Vietnamese resettlement agency (n = 400) and a control group of similar age/gender Vietnamese immigrants who are not ex-political detainees, have not been tortured and have not had head injury (n=125). All subjects will receive an initial survey which measures personal and environmental risk factors, self-report of torture and head injury, and psychiatric and functional outcomes. Next, all subjects will receive culture-fair neuropsychological tests capable of detecting deficits including executive function, complex attention and memory. Based on the results of the general survey, the sample will be divided into six comparison groups: torture with head injury with/without psychiatric symptoms, torture without head injury with/without psychiatric symptoms, controls with/without psychiatric symptoms. Subjects from each of the six groups (n=140) will be randomly selected to undergo neuroimaging (brain MRI and DSC fMRI). Graphical methods, descriptive statistics, ANOVA, logistic regression, and structural equation models will be used to test the hypotheses. PERFORMANCE SITE ========================================Section End===========================================