Psychiatric emergencies of minors with and without migration background.

BACKGROUND: The conditions of children and adolescents with migration background receiving emergency psychiatric care in Europe are not well known. Migrants usually attend regular psychiatric care less frequently than the autochthonous population. We therefore speculated that, being undertreated, they would be overrepresented among psychiatric emergency care patients. METHODS: We retrospectively analyzed the records of 1093 minors aged 4­18 years treated during a period of three years at the psychiatric emergency outpatient clinic of the Department of Child and Adolescent Psychiatry at the Medical University of Vienna. RESULTS: More minors with migration background than natives consulted our emergency clinic. Most frequent reasons for referral were suicide attempts by Turkish patients, acute stress disorder in Serbian/Croatian/Bosnian and in Austrian patients. Psychiatric diagnoses like eating and personality disorders were mostly diagnosed in natives. We found gender specific differences between the groups. CONCLUSIONS: The reasons for these differences possibly relate to deficits of adequate mental health-care in Austria, to intercultural and intrafamiliar conflicts related to acculturation distress in the migrant population. Prospective longitudinal studies focusing on the utilization of mental health care by the migrant children and the impact of the migration background on their mental health are needed for improving adequate culture-sensitive mental-health care for this population.

Development and psychometric evaluation of child acute stress measures in Spanish and English.

Clinicians and researchers need tools for accurate early assessment of children's acute stress reactions and acute stress disorder (ASD). There is a particular need for independently validated Spanish-language measures. The current study reports on 2 measures of child acute stress (a self-report checklist and a semistructured interview), describing the development of the Spanish version of each measure and psychometric evaluation of both the Spanish and English versions. Children between the ages of 8 to 17 years who had experienced a recent traumatic event completed study measures in Spanish (n = 225) or in English (n = 254). Results provide support for reliability (internal consistency of the measures in both languages ranged from .83 to .89; cross-language reliability of the checklist was .93) and for convergent validity (with later PTSD symptoms, and with concurrent anxiety symptoms). Comparing checklist and interview results revealed a strong association between severity scores within the Spanish and English samples. Differences between the checklist and interview in evaluating the presence of ASD appear to be linked to different content coverage for dissociation symptoms. Future studies should further assess the impact of differing assessment modes, content coverage, and the use of these measures in children with diverse types of acute trauma exposure in English- and Spanish-speaking children.

Taxonomy of the psychosocial consequences caused by the violence of persecution of ETA's network.

This paper delimits and analyzes the effects of the harassment perpetrated by ETA's terrorist network in the Basque Country. The aim was to provide a taxonomy of the consequences of psychological violence and to validate this taxonomy, by means of a content analysis of 37 testimonies of victims of terrorist violence. The taxonomy of consequences of psychological violence is made up by four components: 1. the effects on the context of the persons affected, 2. on their emotional state, 3. on cognition and 4. on behavior. Results show a predominance of contextual consequences and negative cognitions. Intra-observer and inter-observer reliability analysis showed high stability and reproducibility coefficients. This study shows that harassment and psychological violence have major consequences not only for victims but also for family members, threatened collectives and even the society as a whole.

A comparison of the acute stress reactions between the Han and Tibetan ethnic groups in responding to devastating earthquakes.

OBJECTIVE: The purpose of the present study was to investigate whether there were differences in the acute stress reaction (ASR) between the Tibetan and the Han ethnic groups after experiencing devastating earthquakes. METHODS: One hundred twelve Han survivors of the Wenchuan earthquake and 112 Tibetan survivors of the Yushu earthquake were rated using the PTSD Checklist-Civilian (PCL-C) according to their trauma experiences, ages, genders, severity levels of injuries, and medical services received. RESULTS: Injured Tibetans had lower scores across symptom clusters of avoidance, numbing, and the total score of PCL-C as compared to Hans. Among Tibetans, severe ASR was associated with a higher education level and earthquake experience, whereas only earthquake experience was associated with severe ASR among injured Hans. CONCLUSION: Cultural factors may play significant roles in the acute stress reaction of survivors with different cultural backgrounds following an earthquake.

The psychological effects of Intifada Al Aqsa: acute stress disorder and distress in Palestinian-Israeli students.

The study assesses the effects of exposure to nationality-related and personal stressful events, threat appraisal and coping strategies on level of distress of Palestinian Israeli students. One hundred forty-eight Palestinian Israeli students filled out a battery of questionnaires that tapped their exposure to stressful life events, terrorism and political related violence, their primary and secondary appraisals, and coping strategies. Level of distress was evaluated by (1) acute stress disorder, and (2) psychiatric symptomatology. Results reveal relatively low exposure to terrorism-related traumatic events, yet considerable exposure (35.8%) to nationality-related stressful events during the last two years. Twenty-five percent of the students suffered from acute stress disorder, and their levels of psychiatric symptomatology exceeded norms for the general population. Primary appraisal processes and emotion-focused coping strategies made unique contribution to the respondents' level of (1) acute stress disorder and (2) psychiatric symptomatology. The implications of these findings are discussed.