Access Type

Open Access Dissertation

Date of Award

January 2012

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Psychology

First Advisor

Mark A. Lumley

Abstract

There are millions of refugees and displaced persons around the world. Refugees often experience multiple stressors and traumas across the various stages of their journey such as witnessing political upheaval, loss of property and loved ones, a perilous journey, and difficulty in countries of resettlement. The multiple stressors that refugees experience place them at significant risk for various mental health problems, especially depression and post traumatic stress disorder, as well as physical health problems. Yet, despite the growing number of refugees and their vulnerability to various mental and physical health problems, knowledge about appropriate treatments for PTSD and other conditions among refugees is still growing and at times suffers from methodological problems. One promising treatment developed specifically for survivors of organized violence, such as refugees, is Narrative Exposure Therapy (NET), which combines elements of traditional exposure therapy as well as the construction of detailed life narratives found in testimony therapy. There is growing evidence from various trials that NET is effective in reducing PTSD symptoms to remission, as well as effectively reducing other

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symptoms such as depression and physical complaints. NET has also demonstrated effectiveness across a variety of cultural groups, resettlement countries and contexts, and severity/chronicity of PTSD symptoms. The goal of this study was to evaluate NET in a sample of Arabic speaking, mostly Iraqi, refugees, who have come to the Metro Detroit area. Fifty three Iraqi refugees who experienced a traumatic incident and reported related distress due to the incident were recruited and randomized into an experimental group that received three sessions of NET or into a wait-list control group. Both groups completed baseline assessments of their trauma symptoms, depression, sleep quality, physical health problems, overall wellbeing, daily functioning, and post traumatic growth. They were re-assessed at 2-month and at 4-month follow-up to report their symptom levels. Results indicate that the group that received NET reported significantly higher levels of post traumatic growth at the 4-month follow-up compared to the control group. The group that received NET also reported small but meaningful trends towards lower depression and PTSD scores and higher levels of psychological wellbeing and frequency of spending time with family and friends at the 2-month follow-up compared to the control group. This study shows that a trauma focused intervention, such as NET, can increase levels of post traumatic growth among trauma survivors. Moreover, the study suggests some promise of NET in treating psychological symptoms in Middle Eastern samples.

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