Papers by Jeroen Knipscheer
Health, 2014
Compared to psychosocial programs implemented in post-conflict settings those executed in areas o... more Compared to psychosocial programs implemented in post-conflict settings those executed in areas of ongoing conflicts may have different effects. Their evidence of efficacy has never been systematically reviewed. We searched PubMed, PsychInfo and the Dutch Tropical Institute Literature Portal from inception to31 January 2013 to identify studies on community-oriented psychosocial and psychiatric/clinical services for adults during ongoing man-made conflict or its direct aftermath. Of 6358 articles screened, 16 met our inclusion criteria. The interventions varied from psycho-educational to psychotropic drugs. The review is presented using outcome indicators such as PTSD, anxiety, depression, physical health, functioning and well being. A substantial improvement of some outcome was found though the small number of studies and their heterogeneity did not justify strong conclusions. PTSD symptoms improved significantly by treatments that included exposure (such as narrative exposure therapy). A number of studies (eight) showed notable improvement of the client's functioning through counseling interventions. Depression and anxiety both improved considerably using that culturally adapted interventions (two studies), whereas non-culturalized interventions did not. We found a notable lack of studies on the efficacy of medication and on preferred western, evidence-based interventions for PTSD such Eye Movement Desensitization. To measure outcomes only two studies applied locally-developed diagnostic labels and validated instruments. Future research should encourage the use of robust research methods that are culturally valid, including mixed-methods research to combine measurable outputs with qualitative research aimed at improved understanding from the client's perspective.
PsycEXTRA Dataset, 2000
Purpose To present a review of the literature concerning medically unexplained physical symptoms ... more Purpose To present a review of the literature concerning medically unexplained physical symptoms in refugees. Methods We outline a variety of definitions and explanations of somatization, as well as the role of culture in the concept of disease. In addition, we present a review of the epidemiological literature about somatization in refugees. Results Refugees from non-Western countries exhibit more unexplained somatic symptoms than the general Western population. Although different studies have employed different methodologies and are therefore difficult to compare, it can be concluded that refugees form a particular population in which somatization is prominent. Conclusions Potential, not mutually exclusive, explanations of the high number of somatic symptoms in the refugee population include general psychopathology, specifically traumatisation, results of torture, and stigmatisation of psychiatric care. There are implications for assessment, clinical treatment and further research concerning somatization in refugees.
Journal of EMDR Practice and Research, 2014
ABSTRACT Many refugees resettled in Western countries suffer from an accumulation of traumatic an... more ABSTRACT Many refugees resettled in Western countries suffer from an accumulation of traumatic and current stressors that contribute to mental health problems and may complicate trauma-focused treatment. Consequently, the acceptability, safety, and efficacy of trauma-focused treatment with refugees have been a matter of clinical and scientific interest. In recent years, the evidence has accumulated for narrative exposure therapy and culturally adapted cognitive behavioral therapy. Although eye movement desensitization and reprocessing (EMDR) is practiced with resettled refugees, only five small studies of limited quality have been conducted on EMDR with this population. In the absence of strong evidence, therapists practising EMDR with refugees may be aided by transcultural psychiatric principles, especially matching of explanatory models. In addition, high-quality research is needed to reliably determine acceptability, safety, and efficacy of EMDR with traumatized refugees.
Traumatology, 2010
In Turkey, the large scale of internal displacement is caused by armed conflict that occurs becau... more In Turkey, the large scale of internal displacement is caused by armed conflict that occurs because of the struggle of Kurds to obtain political recognition and rights in Turkey. As a result, many asylum requests were conducted in Europe and a massive wave of internal displacement took place in Turkey. Forced migration is known to influence mental health. This empirical study conducted with migrated Kurdish women (N = 1,127) both in the European Union (EU) and in Turkey aimed to explore the relationships between posttraumatic stress reactions, forced migration, and mental health status. Posttraumatic reactions were discovered to be highly related to mental health state. In addition, being internally displaced as well as having fled for war and oppression was significantly related to mental health status. The implications of these findings for posttraumatic stress theory and mental health professionals working with traumatized migrant populations are considered.
Social Psychiatry and Psychiatric Epidemiology, 2014
Purpose To present a review of the literature concerning medically unexplained physical symptoms ... more Purpose To present a review of the literature concerning medically unexplained physical symptoms in refugees. Methods We outline a variety of definitions and explanations of somatization, as well as the role of culture in the concept of disease. In addition, we present a review of the epidemiological literature about somatization in refugees. Results Refugees from non-Western countries exhibit more unexplained somatic symptoms than the general Western population. Although different studies have employed different methodologies and are therefore difficult to compare, it can be concluded that refugees form a particular population in which somatization is prominent. Conclusions Potential, not mutually exclusive, explanations of the high number of somatic symptoms in the refugee population include general psychopathology, specifically traumatisation, results of torture, and stigmatisation of psychiatric care. There are implications for assessment, clinical treatment and further research concerning somatization in refugees.
Psychology and Psychotherapy: Theory, Research and Practice, 2004
Psychologie & gezondheid, 2011
Psychologie & gezondheid, 2011
In this paper, the theme of the special issue on Culture and Trauma is introduced. In both empiri... more In this paper, the theme of the special issue on Culture and Trauma is introduced. In both empirically oriented articles as well as theoretical and contemplative contributions, the role of culture and migration context in the development of psychological problems following trauma, culturespecific or generic coping with the consequences, help-seeking behavior, and the need for culturally sensitive treatment is explored. First, the influence of the migration context is considered with regard to the possible sickening role of the asylum procedure, the burden for immigrant women who have undergone female genital mutilation and now live in a society that seriously condemns it, and the dilemma of Islamic migrants who experience homosexual feelings while living in a secularized society. Following are some contributions on cultural diversity in the expression of trauma symptoms, like somatization among refugees and the articulation of rage and embitterment among labor migrants. The impact of trauma in combination with migration on families and how children can be affected by the traumatization of their parents is the topic of two contributions in which the role of the (extended) family is explored and a contextual approach to working with families with trauma-related symptoms (a mentalizationbased multifamily therapy) is described. The factors that impede therapyseeking behaviour and drop-out are discussed in a study on Moroccan or Turkish girls who were raped. Finally, the applicability and efficacy of evidence-based interventions for treating ethnic minority patients with posttraumatic stress disorder is illustrated by a study on Eye Movement Desensitization and Reprocessing with refugees and an article on specific elements of intercultural trauma therapy that appear to be culturally sensitive.
Journal of Community Psychology, 2008
Journal of Community Psychology, 2000
s Ghanaians are a relatively unknown migrant group in the Netherlands. Due to a plane crash in a ... more s Ghanaians are a relatively unknown migrant group in the Netherlands. Due to a plane crash in a densely populated suburb of Amsterdam, the Ghanaian population in 1992 suddenly became a "hot item" in national media. It was assumed that they would be a group at risk: many Ghanaians were either directly or indirectly victims of this disaster. Moreover, Ghanaians were assumed to be unfamiliar with the Dutch society and the health care system. A study was conducted using self-report questionnaires to investigate mental health and help-seeking orientation. Findings show that migration factors, acculturative stress, and legal status have an impact on health status. . Electronic mail may be sent to [email protected].
Journal of Clinical Psychology, 2014
Objective: To examine sustainability of symptom outcomes of a 1-year phase-based traumafocused, m... more Objective: To examine sustainability of symptom outcomes of a 1-year phase-based traumafocused, multimodal, and multicomponent group therapy in a day treatment program for posttraumatic stress disorder (PTSD) over an average period of 7 years. Method: Iranian and Afghan patients (N = 69) were assessed with self-rated symptom checklists for PTSD, anxiety, and depression symptoms before (T1), after (T2), and up to 11 years upon completion of the treatment (T3). A series of mixed model regression analyses was applied to determine the course of the measured symptoms over time.
Journal of Behavior Therapy and Experimental Psychiatry, 2009
BMC Psychiatry, 2013
Background: Legal status and other resettlement stressors are known to impact mental health of as... more Background: Legal status and other resettlement stressors are known to impact mental health of asylum seekers and refugees. However, the ways in which they interact with treatment of posttraumatic stress disorder (PTSD) with these populations is still poorly understood. The aim of this study was to examine whether legal status and other resettlement stressors influence outcomes of a trauma-focused group PTSD treatment within a day-treatment setting with asylum seekers and refugees. Methods: Sixty six male Iranian and Afghan patients with PTSD residing in the Netherlands were assessed with selfrated symptom checklists for PTSD, anxiety and depression, and a demographic questionnaire one week before and two weeks after the treatment. Multivariate linear regression analysis was used to examine the impact of legal status and living arrangements on the treatment outcomes per symptom domain.
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Papers by Jeroen Knipscheer