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Worry, worry attacks, and PTSD among Cambodian refugees: A path analysis investigation

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  • Hinton, Devon E.
  • Nickerson, Angela
  • Bryant, Richard A.

Abstract

Among traumatized Cambodian refugees, this article investigates worry (e.g., the types of current life concerns) and how worry worsens posttraumatic stress disorder (PTSD). To explore how worry worsens PTSD, we examine a path model of worry to see whether certain key variables (e.g., worry-induced somatic arousal and worry-induced trauma recall) mediate the relationship between worry and PTSD. Survey data were collected from March 2010 until May 2010 in a convenience sample of 201 adult Cambodian refugees attending a psychiatric clinic in Massachusetts, USA. We found that worry was common in this group (65%), that worry was often about current life concerns (e.g., lacking financial resources, children not attending school, health concerns, concerns about relatives in Cambodia), and that worry often induced panic attacks: in the entire sample, 41% (83/201) of the patients had "worry attacks" (i.e., worry episodes that resulted in a panic episode) in the last month. "Worry attacks" were highly associated with PTSD presence. In the entire sample, generalized anxiety disorder was also very prevalent, and was also highly associated with PTSD. Path analysis revealed that the effect of worry on PTSD severity was mediated by worry-induced somatic arousal, worry-induced catastrophic cognitions, worry-induced trauma recall, inability to stop worry, and irritability. The final model accounted for 75% of the variance in PTSD severity among patients with worry. The public health and treatment implications of the study's findings that worry may have a potent impact on PTSD severity in severely traumatized populations are discussed: worry and daily concerns are key areas of intervention for these worry-hypersensitive (and hence daily-stressor-hypersensitive) populations.

Suggested Citation

  • Hinton, Devon E. & Nickerson, Angela & Bryant, Richard A., 2011. "Worry, worry attacks, and PTSD among Cambodian refugees: A path analysis investigation," Social Science & Medicine, Elsevier, vol. 72(11), pages 1817-1825, June.
    • Handle: RePEc:eee:socmed:v:72:y:2011:i:11:p:1817-1825
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    References listed on IDEAS

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    1. Beiser, Morton & Hou, Feng, 2001. "Language acquisition, unemployment and depressive disorder among Southeast Asian refugees: a 10-year study," Social Science & Medicine, Elsevier, vol. 53(10), pages 1321-1334, November.
    2. Hinton, Devon E. & Rasmussen, Andrew & Nou, Leakhena & Pollack, Mark H. & Good, Mary-Jo, 2009. "Anger, PTSD, and the nuclear family: A study of Cambodian refugees," Social Science & Medicine, Elsevier, vol. 69(9), pages 1387-1394, November.
    3. Miller, Kenneth E. & Rasmussen, Andrew, 2010. "War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks," Social Science & Medicine, Elsevier, vol. 70(1), pages 7-16, January.
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    2. Jayawickreme, Nuwan & Mootoo, Candace & Fountain, Christine & Rasmussen, Andrew & Jayawickreme, Eranda & Bertuccio, Rebecca F., 2017. "Post-conflict struggles as networks of problems: A network analysis of trauma, daily stressors and psychological distress among Sri Lankan war survivors," Social Science & Medicine, Elsevier, vol. 190(C), pages 119-132.
    3. C. Annique Un & Chhomran Ou & Silvy Un Lafayette, 2022. "From the liability to the advantage of refugeeness," Journal of International Business Policy, Palgrave Macmillan, vol. 5(4), pages 530-561, December.
    4. Keys, Hunter M. & Kaiser, Bonnie N. & Kohrt, Brandon A. & Khoury, Nayla M. & Brewster, Aimée-Rika T., 2012. "Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau," Social Science & Medicine, Elsevier, vol. 75(3), pages 555-564.

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