Terror at sea: Vietnamese victims of piracy

Abstract

Violent assault on noncombatants is a subject of continuing international concern. The Vietnamese "boat people" who were attacked by pirates during their flight from Vietnam, however, represent a victim group toward which the mental health community has shown relatively little interest° There is a striking sparsity of literature specifically addressing the psychiatric difficulties of this group. In light of the increasing appreciation of the role of trauma in the production of psychiatric symptomatology, it is reasonable to believe that the brutalities, for example, beatings, rapes, torture inflicted by the pirates upon the "boat people, n may have contributed to the production of psychiatric disturbances in many of them. As approximately 400,000 Vietnamese have arrived in the United States since 1975 (Economist, 1985), and many probably were attacked by pirates during their journey out of Vietnam (e.g., 77% of those who arrived via boat in Thailand in 1981 [United Nations High Commissioner for Refugees]), it is conceivable that there are large numbers of "boat people" living in the United States who may suffer from posttraumatic difficulties of which mental health workers have little knowledge or understanding. Furthermore, whether the largely occidentally based conceptualization of stress response syndromes (Horowitz, 1976) is applicable to this victim group remains unclear. Thus, this pilot study was conducted in order to investigate the psychiatric difficulties that may be present in this group (and may require treatment) and to achieve a better understanding of the response to trauma in a non-"Western" cultural group. Toward these goals, this study describes the psychiatric disturbances present among these victims and the methods they utilized to cope with the pirate attacks. Trauma may result in the production of a stress response syndrome (Table 1). This syndrome, although influenced by an individual's personality configuration, is a unique, reproducible entity (Horowitz, 1976, Horowitz, 1985). Posttraumatic stress disorder (PTSD) (Diagnostic and Statistical Manual, 3rd edition