Fabrice Brodard

Posttraumatic Stress, Somatization, and Quality of Life Among Ivorian Refugees: Posttraumatic Stress in Ivorian Refugees

The present study examined the relationship between peritraumatic reactions, posttraumatic stress disorder (PTSD) symptoms, somatization, and quality of life (QoL) in a sample of refugees, two years after the 2011 Ivory Coast sociopolitical crisis. Participants were 101 Ivorian adult refugees (mean age = 31.61 years, SD = 7.84; 45.5% women) who completed several questionnaires relating to peritraumatic reactions, PTSD symptoms, somatization, and QoL. Most participants (86.1%) scored above the cutoff for probable PTSD. Peritraumatic dissociation and peritraumatic distress were significantly associated with PTSD symptoms, (r = .64, p < .001) and (r = .60, p < .001), respectively, and somatization, (r = .21, p = .038) and (r = .35, p < .001), respectively, as well as with QoL, (r = -.20, p = .045) and (r = -.21, p = .037), respectively. Similarly, QoL was significantly negatively correlated with PTSD symptoms (r = -.33, p < .001) and somatization (r = -.39, p < .001). In multivariate analyses, somatization was the strongest predictor of QoL (β = -.31, p = .003). Finally, somatization statistically mediated the association between peritraumatic distress and QoL. These findings suggest that PTSD may be frequent among Ivorian refugees, and that somatization may be an important feature of the traumatic experiences. Targeting somatization in conjunction with trauma-centered therapy may improve outcomes in sub-Saharan Africans with PTSD.

Narcissistic tendencies differences between French and Togolese patients with a major depressive disorder

Previous studies have reported that participants from around the world perceived Americans as more narcissistic than their fellow countrymen (Miller et al., 2015), that narcissism is higher in Western than non-Western countries (Foster, Campbell, & Twenge, 2003) and that narcissistic traits are associated with depressive symptoms (Kealy, Tsai, & Ogrodniczuk, 2012). However, there is a paucity of research on narcissism traits among patients with a major depressive disorder (MDD) across Western and African populations and few research investigated differences in narcissistic tendencies between French and subSaharan Africa populations. We conducted this study aiming to examine differences in narcissistic traits between French and Togolese adults with MDD. Inpatients without psychosis or mental retardation admitted for primary clinical diagnoses of MDD were enrolled in one of two academic medical centers in Toulouse, France (N = 75; M (standard deviation, SD) age = 41.0 (12.0); 71% women) and in Lomé, Togo (N = 75; M (SD) age = 38.9 (9.2); 63% women). In French sample, 43% of participants were married, 75% were employed and 40% reported a prior history of severe somatic pathology, while in Togolese sample, 48% of patients were married, 84% were employed and 41% mentioned at least one prior history of severe somatic pathology. In each sample, patients received mainly medical treatment for MDD. This study was approved by the ethics committee of the University Hospital Campus of Lomé. The 16-item of Narcissistic Personality Inventory (NPI-16; Ames, Rose, & Anderson, 2006) was used to assess the narcissistic traits. Togolese participants scored higher on the NPI-16 score (M = 4.4, SD = 2.5) than their French counterparts (M = 3.2, SD = 2.2), t(148) = 3.3, p < .001. More specifically, Togolese MDD patients scored higher levels in leadership/authority factor of NPI than the French, t(148) = 3.2, p < .01 and in the NPI grandiosity trait, t(148) = 3.0, p < .01. For the exploitation tendency, Togolese participants scored significantly lower than the French patients, t(148) = −2.79, p < .01. These findings are in line with our previous study (Kounou et al., 2015) which discussed ethnical and cultural background influences on personality disorders with MDD patients. Our results suggest cultural differences’ existence in the levels of narcissism with MDD patients and contrast with previous research which found that Western individuals reported higher levels of narcissism than individuals of any other cultural group (Foster et al., 2003). Our explanatory hypothesis about the high narcissistic personality traits with Togolese sample is that they are in less prestigious culture whereas French are from the Western culture which is considered as the most prestigious. Togolese in their collective unconscious had negative feelings about themselves due to the less prestigious culture and should develop narcissistic traits to hide these vulnerabilities despite their depression. Togolese people may develop a collective narcissism, may function as individuals who harbor negative feelings about themselves and develop a façade of grandiosity to disguise these vulnerabilities (Zeigler-Hill & Wallace, 2011). Future studies on a large and representative population in Western and African countries, with validated tools and taking into account biologic factors of narcissism, to replicate our current results seemed necessary.