Marline Spring

Somali and Oromo Refugees: Correlates of Torture and Trauma History

OBJECTIVES This cross-sectional, community-based, epidemiological study characterized Somali and Ethiopian (Oromo) refugees in Minnesota to determine torture prevalence and associated problems. METHODS A comprehensive questionnaire was developed, then administered by trained ethnic interviewers to a nonprobability sample of 1134. Measures assessed torture techniques; traumatic events; and social, physical, and psychological problems, including posttraumatic stress symptoms. RESULTS Torture prevalence ranged from 25% to 69% by ethnicity and gender, higher than usually reported. Unexpectedly, women were tortured as often as men. Torture survivors had more health problems, including posttraumatic stress. CONCLUSIONS This study highlights the need to recognize torture in African refugees, especially women, identify indicators of posttraumatic stress in torture survivors, and provide additional resources to care for tortured refugees.

Sampling in difficult to access refugee and immigrant communities

We evaluated sampling strategies and trust-building activities in a large multiphase epidemiologic study of torture prevalence in populations that were difficult to locate and enroll. Refugee groups under study were Somalis from Somalia and Oromos from Ethiopia who were living in Minneapolis and St. Paul, Minnesota, in 1999–2002. Without a complete sampling frame from which to randomly recruit participants, we employed purposive sampling methods. Through comparative and statistical analyses, we found no apparent differences between our sample and the underlying population and discovered no effects of recruiting methods on study outcomes, suggesting that the sample could be analyzed with confidence. Ethnographic trust and rapport-building activities among investigators, field staff, and immigrant communities made it possible to obtain the sample and gather sensitive data. Maintaining a culture of trust was crucial in recovering from damaging environmental events that threatened data collection.

Ethnopharmacologic analysis of medicinal plants used by laotian hmong refugees in minnesota

Laotian Hmong refugees in the Twin Cities of Minneapolis and St. Paul, Minnesota, cultivate many plants and employ them as a first line of defense against illness and disease. Thirty-seven medicinal plants have been identified, phytochemical components catalogued through literature research, and potential pharmacological activities correlated with Hmong medicinal uses. Using western biomedical criteria of efficacy, 92% of the medicinal plants being cultivated were found to be potentially efficacious. The frequent use of these plants in diet (81%) suggests that they have served to mediate against illness and disease states in the cultural and natural environment in which the practices evolved. A listing of 37 plants with Hmong names, uses and potentially active constituents is provided.

Pathological and Problem Gambling among Veterans in Clinical Care: Prevalence, Demography, and Clinical Correlates

BACKGROUND AND OBJECTIVES The aim of the study was to estimate prevalence rates of pathological gambling and problem gambling among veterans receiving VA care, since several studies have suggested that VA patients may be at increased risk to these conditions. SAMPLE consisted of 1,999 veterans randomly selected from VA centers and community clinics in the Albuquerque and Minneapolis catchment areas. Women and younger veterans were oversampled, due to anticipated low rates in these two groups. RESULTS revealed that the lifetime prevalence rate of pathological gambling weighted for current VA patients was 2.0%, twice the general adult population rate. Current 1-year weighted prevalence of pathological gambling was .9%, with an additional .2% having continued problem gambling and .9% recovered. Lifetime weighted problem gambling rate was 8.8%. Altogether, 10.7% had lifetime pathological gambling or problem gambling. Women had higher rates of pathological gambling, but similar rates of problem gambling compared to men. The greater prevalence of pathological gambling for younger veterans aged 20-29 (1.3%) compared to veterans aged 30-39 (.8%) was unusual and warrants further investigation. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Veterans in VA care have higher rates of gambling problems than the general adult population. Female and young veterans have rates higher than those observed in other surveys of women and young adults.

HADStress screen for posttraumatic stress: replication in Ethiopian refugees.

Purpose was to assess whether a 4-symptom somatic screen, shown to correlate with current post-traumatic stress symptoms in 1 refugee group, could function as a screening instrument in another group of refugees. Sample consisted of 512 community-dwelling refugees from Ethiopia. Data collection included demography, types of torture and nontorture trauma experienced a decade earlier in Africa, and current posttraumatic stress symptoms. Somatic symptoms included headaches (H), appetite change (A), dizziness and faintness (D), and sleep problems (S), added with equal weighting into the HADStress Screen, ranging from 0 to 4. Results showed that age, gender, torture, and other trauma experiences from a decade ago, and current posttraumatic stress symptoms predicted current somatic symptoms on univariate analyses. On a negative binomial regression model, current posttraumatic stress symptoms, male gender, and number of torture types predicted a high HADStress score. Post hoc tests supported cut-off levels at 3 and at 4 symptoms. Conclusion is that the HADStress Screen can serve as an efficient, nonthreatening screen for posttraumatic stress symptoms among refugees.