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

这个项目考察了难民重新安置的做法和经历如何重塑战争和暴力的创伤，以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里被重新安置在美国的三大难民之一。通过创伤后应激障碍(PTSD)的医学诊断越来越多地界定和照顾难民，但通过创伤后应激障碍范例对创伤进行医学化在难民接纳、重新安置和福祉方面所起的作用并不为人所知。在美国以及约旦和土耳其的难民筛查/收容地点进行的多地点研究发现，将对心理健康筛查和治疗的不均衡地理位置产生新的见解，这将有助于制定接纳和重新安置程序。这些发现也将有助于卫生从业者关注难民的关键需求，并对制定应对创伤后应激障碍的跨文化方法感兴趣。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，并履行对流离失所者福祉的人道主义责任。这项研究有助于增进移民和少数民族人口的地缘政治和公共卫生知识，并将通过培训一名博士后研究员和两名研究生研究助理，加强代表不足的少数族裔参与研究。该项目追求三个具体目标：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接纳中所起的作用；2)评估一旦难民抵达美国，创伤后应激障碍范式如何影响重新安置的管理；以及3)考察伊拉克难民如何经历和解释重新安置的过程，特别是精神健康筛查、诊断和治疗，并分析这些经历如何在地理和年龄、性别、教育和重新安置的时间上有所不同。使用深入的定性方法，这项研究首先建立了对当代海外难民重新安置实践中接纳和排除难民的心理健康筛查的工作原理的见解。其次，调查人员希望发现，创伤和创伤后应激障碍的医学化以一种特殊的方式将难民插入他们重新安置后的新生活中，唤起人们对难民、过去和幸福是什么的具体理解。第三，这项研究将揭示难民本身是如何经历从申请到在美国不同地方定居的筛选过程、服务提供者和治疗的。考察创伤后应激障碍范式在难民重新安置轨迹上的多个地点和空间的作用，将追踪到一种创伤的地缘政治，挑战关于地缘政治关系规模和稳定性的假设。

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.