Abstract
Aims and method To examine treatment response in traumatised refugees, we compared routine outcome monitoring data (Harvard Trauma Questionnaire) of two refugee populations with those of individuals experiencing profession-related trauma who were treated at a specialised psychotrauma institute.Results Asylum seekers/temporary refugees (n = 21) and resettled refugees (n = 169) showed significantly lower post-traumatic stress disorder (PTSD) symptom reduction between intake and 1 year after intake than did a comparison group of non-refugees (n = 37), but the interaction effect was clinically small (partial η2 = 0.03). Refugees who had more severe symptoms at intake showed significantly greater symptom reduction after 1 year.Clinical implications Therapists and refugee patients should have realistic expectations about response to treatment as usual. Additional treatment focusing on improving quality of life may be needed for refugees whose PTSD symptom severity remains high. At the same time, novel approaches may be developed to boost treatment response in refugee patients with low responsiveness.
Highlights
This study shows that asylum seekers/temporary refugees and resettled refugees experienced significantly lower posttraumatic stress disorder (PTSD) symptom reduction between intake and 1 year after intake than did a comparison group of multiply traumatised military veterans and police officers
Greatest differences between groups were found in PTSD symptom severity at intake and 1 year after intake rather than in PTSD symptom reduction
Explorations of PTSD symptom reduction in refugees showed that those who had more severe symptoms at intake experienced significantly greater symptom reduction after 1 year; other variables were not related to symptom reduction
Summary
For demographic and clinical characteristics of the final sample, see Table 1. Effect sizes for treatment response in asylum seekers/ temporary refugees and resettled refugees were moderate (Z2 = 0.12 and Z2 = 0.15, respectively); effect size for patients with profession-related trauma was large (Z2 = 0.38).[16] Repeated measures ANOVA showed a significant effect for time (F = 32.27, P50.001) with a medium effect size (partial Z2 = 0.13), and a significant group6time interaction effect (F = 3.65, P = 0.028) with a small effect size (partial Z2 = 0.03).[16]. We combined the two refugee groups and, using multiple regression analysis, we examined whether seven demographic and clinical variables were associated with PTSD symptom reduction (Table 2). The percentage of variance explained by the model (R2) was 21.5%
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