'Means of survival' as moderator of the relationship between cumulative torture experiences and posttraumatic stress disorder among refugees .

摘要

Refugee torture survivors often present with a myriad of psychological challenges, such as posttraumatic stress and depression, stemming from their exposure to torture and other pre- and post-settlement experiences (Gong-Guy and colleagues, 1991). The present study examined the moderating effect of four coping processes (i.e., family support, religious beliefs, political beliefs, and will to survive) on the relationship between cumulative torture and posttraumatic stress disorder (PTSD) among a sample of 204 (N=204) adult refugee torture survivors. Subjects completed a demographic questionnaire, the Torture Severity Scale (TSS; Kira, Lewandowski, Templin, Ramaswamy, Ozkan, Hammad, & Mohanesh, 2006), the Clinician Administered PTSD Scale (CAPS-2; Weathers, Keane, & Davidson, 2001), and the Means of Survival Scale (MOS; Kira, 2012). Twenty-three percent (N = 74) of the sample endorsed clinically significant levels of PTSD. Torture and PTSD were positively associated, indicating that greater exposure to cumulative torture is associated with greater trauma symptoms (r[2] = .18, p<.01). Significant positive correlations were found between will to survive and cumulative torture (r[2] = .31, p<.01), PTSD and political beliefs (r[2] = .13, p<.05), PTSD and will to survive (r[2] = .141, p<.05), religious beliefs and will to survive (r[2] = .15, p<.01), and family support and will to survive (r[2] = .130, p<.05). Results of the regression analyses demonstrated that CTE (b=.12, p=.035) and political beliefs (b=.17, p=.002) were significant predictors of PTSD symptoms in this sample, R2 = .039; F (2,323) = 7.55, p=.001. None of the interaction terms examined accounted for significant variation in PTSD symptoms. Study findings will help counseling psychologists devise the most appropriate treatment plans and strategies to treat posttraumatic stress reactions among refugee torture survivors, as well as inform future interventions developed for this vulnerable population.