Overcoming Panic

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Tol WA; Rees SJ; Silove DM, 2013, 'Broadening the scope of epidemiology in conflict-affected settings: Opportunities for mental health prevention and promotion', Epidemiology and Psychiatric Sciences, vol. 22, pp. 197 - 203, http://dx.doi.org/10.1017/S2045796013000188 Drožđek B; Silove D, 2019, 'Psychotherapy and Psychosocial Support in Host Countries: State-of-the-Art and Emerging Paradigms', in An Uncertain Safety, Springer International Publishing, pp. 257 - 281, http://dx.doi.org/10.1007/978-3-319-72914-5_11 As they were not stated in any of the included studies, the required sample sizes for prevalence estimates for treatment-seeking and population samples were calculated using the following formula 37: , where n is the sample size, Z is the level of confidence statistic, P is the anticipated prevalence and d is the precision. Expected CPTSD prevalence estimates of 31.4% in treatment-seeking samples and 4.9% in population samples were assumed by calculating the median values of the reported prevalence estimates within these two sample types. Median values were used owing to the variability in prevalence estimates among studies, so as to reduce sensitivity to outliers. In addition, 95% confidence intervals and 5% precision were used in sample size calculations for both treatment-seeking and population samples. Required sample sizes for treatment-seeking and population samples were 331 and 72, respectively. Thus, sample sizes were insufficient in all ten studies with treatment-seeking samples but were sufficient for studies with population samples.

Tay AK; Rees S; Chen J; Kareth M; Silove D, 2016, 'Factorial structure of complicated grief: associations with loss-related traumatic events and psychosocial impacts of mass conflict amongst West Papuan refugees', Social Psychiatry and Psychiatric Epidemiology, vol. 51, pp. 395 - 406, http://dx.doi.org/10.1007/s00127-015-1099-x Bernal G and Saez-Santiago E (2006) Culturally centered psychosocial interventions. Journal of Community Psychology 34, 121–132. [ Google Scholar]Silove D; Mares S, 2018, 'The mental health of asylum seekers in Australia and the role of psychiatrists', BJPsych International, vol. 15, pp. 65 - 68, http://dx.doi.org/10.1192/bji.2018.11 Tay AK; Rees SJ; Tam N; Savio E; Costa ZMD; Silove D, 2017, 'The Role of Trauma-Related Injustice in Pathways to Posttraumatic Stress Symptoms Among Conjugal Couples: A Multilevel, Dyadic Analysis in Postconflict Timor-Leste', SAGE Open, vol. 7, pp. 1 - 10, http://dx.doi.org/10.1177/2158244017723688 Rohingya refugees tend not to seek formal help for mental health problems partly because of a limited familiarity with concepts of mental health and counselling, or knowledge of where to seek services, but also because of stigma and feelings of shame associated with mental illness (R. Islam, personal communication, 2018). Furthermore, mental illness is often regarded as a sign of weakness and only in instances in which a problem is perceived as physical in origin, will medical care be sought (R. Islam, personal communication, 2018). Because of stigma, individuals with severe mental health problems are often taken care of by family members and are at risk of being ostracised by community members. Amongst 72 Rohingya in Malaysia, 63% expressed hesitancy in seeking professional help when feeling overwhelmed by difficulties, 89% would turn to family and close friends and a minority (15%) would be inclined to seek professional help (C. Welton-Mitchell, personal communication, 2018).

Dr Randi Hagerman (Behavioural and Developmental Paediatrician, MIND Institute, USA): Everybody has the Fragile X gene, but the mutation that we associate with Fragile X syndrome is an expansion of the front part of the gene. So, in a female who is a carrier of just a small expansion or a pre-mutation, as we call it, their other X is normal. So there’s a fifty-fifty chance that she would pass on the mutated X to her children.

Two studies reported prevalence estimates of DESNOS. In a culturally diverse sample of refugees in Norway, a point prevalence of 16% was reported. 3 Another study looked at a sample of Bosnian former refugees in Denmark, finding a prevalence of 34%. 32 Rees S and Silove D (2011) Sakit Hati: a state of chronic mental distress related to resentment and anger amongst West Papuan refugees exposed to persecution. Social Science & Medicine 73, 103–110. [ PubMed] [ Google Scholar]

robust across the majority of published studies (e.g. Reference Hauff and VaglumHauff & Vaglum, 1994; Reference Mollica, McInnes and PooleMollica et al, 1998). There are different types of traditional and informal healers for a range of mental health problems including nightmares, psychosomatic complaints, spirit possession and common physical ailments. Examples of Rohingya healers are (1) the spiritual healer ( bouid-dou) who can also serve as a fortune teller ( goi-noi-ya); (2) the religious scholar ( fóu-yirr); (3) the Quran reciter ( mou-loi/ habés, moulvi/ mullah) and (4) the unlicensed practitioner using western medication ( daac-torr). Within the refugee settings in Bangladesh, such religious and traditional healers are active and the population seeks their help (Chen, Reference Chen2018).Fulfilment of PTSD criteria, in addition to scores of ≥10 or ≥8, ≥8 and ≥6 for AD-hypoactivation or hyperactivation, NSC and DR, respectively. Daily stressors may arise from the context of refugee life but can also be related to the erosion of supportive social structures within refugee communities. Observations reported in qualitative research undertaken in Bangladesh and Malaysia highlight the pervasive sense of mistrust among Rohingya refugees together with fear of exploitation by fellow Rohingya (Prosser, Reference Prosser2006; Kiragu et al., Reference Kiragu, Li Rosi and Morris2011; Hinic, Reference Hinic2016). Kohlhoff J; Eapen V; Dadds M; Khan F; Silove D; Barnett B, 2017, 'Oxytocin in the postnatal period: Associations with attachment and maternal caregiving', Comprehensive Psychiatry, vol. 76, pp. 56 - 68, http://dx.doi.org/10.1016/j.comppsych.2017.03.010