Post Traumatic Stress Disorder:: The Basics in Cameroonian Refugees

By Dr. Bibi Nomo Neumann

This study is a review of the literature on the psychological issues faced by refugees to the United States and on empirically supported treatments with potential implication for Cameroonian refugees with Post Traumatic Stress Disorder (PTSD). Relevant themes from the literature include: (a) historical perspectives; (b) the phenomenology of PTSD; (c) current treatments; (d) empirically supported treatments and evidence-based practices; (e) behavioral therapies that aim to reduce reactance to traumatic memories; (f) cognitive therapies focusing on the management of the appraisal of the trauma; (g) anxiety management therapies aimed at managing the anxiety evoked by traumatic memories; (h) eye movement desensitization and reprocessing therapy (EMDR); and (i) culturally-relevant considerations. The writers original contribution to practice consists of adapted practice recommendations for the treatment of Cameroonian refugees with PTSD. They are intended for therapist use with Cameroonian refugees to the United States diagnosed with PTSD.

• Language: English
• Publisher: Xlibris US
• Release date: Jan 31, 2015
• ISBN: 9781503539839

Book preview

Copyright © 2015 by Dr. Bibi Nomo Neumann.

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Rev. date: 01/29/2015

Xlibris

1-888-795-4274

www.Xlibris.com

542905

Contents

Section 1: Introduction

Statement of the Problem

Statement of Significance

Statement of the Purpose

Terminology Overview

Diagnostic Category Addressed

Post-Traumatic Stress Disorder

Culturally Relevant Practice

Section 2: Literature Review

Methodology

Organization

Historical Perspectives

Post-Traumatic Stress Disorder

Treatment of Post-Traumatic Stress Disorder

Behavioral Therapies

Cognitive Therapies

Stress Inoculation Training

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

Imagery Rehearsal Therapy (IRT)

Psychodynamic Therapy

Post-Traumatic Stress Disorder Psychoeducation

Group Therapy

Dialectical Behavior Therapy (DBT)

Hypnosis

Spirituality

Pharmacotherapies

Empirically Supported Treatments and Evidence-Based Practices

Trauma in Refugees and Asylum Seekers

Concluding Caveats

Section 3: Original Contribution to Practice

Brief Synopsis

Adapted Recommendations for Clinicians Providing Services to Cameroonian Refugees with PTSD

Initial Assessment

Socioemotional Management

Treatment Selection

Specific Treatment Strategies

Practice Recommendations

A Case Illustration: Mr. Changa

Concluding Comments

References

Appendix A: Diagnostic Criteria for PTSD

Appendix B: Adult Self-Report Instrument and Treatment Manual

Appendix C: Minnesota Community Resources for Refugee Groups

Appendix D: Adapted Practice Recommendations

Bibliography

IMAGE1.JPG

SECTION 1

Introduction

C ameroon is generally considered a stable African society but is ruled authoritatively, with incidences of human rights violations and torture, comprising the current civil war (Atang 2007). Cited killings by police, detentions in unsanitary and overcrowded cells, rapes, denial of access to food and water, and other acts of violence perpetrated by individuals are among the reasons Cameroonian refugees name for migration to the United States (Center for Victims of Torture 2007).

In 1961, the Foumban Constitutional Conference served as the vehicle through which the former British territory of the Southern Cameroons and the former French territory La Republique du Cameroun were federated under the guidance of the United Nations (Atang 2007). From 1962 to 1982, Ahmadou Ahidjo served as president of La Republique du Cameroun. During his reign, President Ahidjo took steps to impose a Unitary Constitution by abolishing the Federal Constitution established under the guidance of the United Nations during the previous year at Foumbam (Stark 1976). Consequently, the English-speaking Southern Cameroons lost autonomy and was divided into two of the seven provinces of this reformulated nation. Since then, the French-speaking Cameroons has constituted the dominant group, relegating English-speaking nationals and their allies to the status of second-class citizens (Konings and Nyamnjoh 1997).

The current president Paul Biya was nominated by former president Ahidjo and placed in office in 1982. According to sources from Cameroon, this transition of power remains controversial. However, the most cited rendition articulates how French physicians initially convinced former president Ahidjo that he had a terminal illness, and under instruction from the French government, he then nominated President Biya as his successor. Once former president Ahidjo discovered that he was not terminally ill, his attempt to regain power was successfully deterred by President Biya, and the former president remains in exile today.

Former president Ahidjo was attempting to unify Cameroon by merging the Anglophones of Southern Cameroon with the Francophones that constituted the rest of the country (Stark 1969). However, Anglophones did not want to be relegated to the status of second-class citizens within their own country and mobilized to form a number of liberation movements in order to regain their autonomy (Atang 1996). This self-described struggle for self-determination has been fraught with arrest, torture, killings, forcing its nationals into exile, blackmail, [and] misinformation … (Atang 2007, p. 200). As large numbers of Cameroonians continue to flee to Europe and to the United States, some scholars assert that the memories of the past greatly influence how the Cameroonian refugee adjusts to her/his present circumstance as a displaced individual (Pineteh 2005). Hence, the goal of this doctoral project is to develop specialized treatment recommendations for Cameroonian refugees with post-traumatic stress disorder (PTSD) based upon a similarly formatted document from the International Society for Traumatic Stress Studies (ISTSS).

Statement of the Problem

The ISTSS guidelines combine recommendations of the US Department of Veteran Affairs (VA), the Department of Defense, the American Psychiatric Association, and of Great Britain’s and Australia’s national health-care guidelines, among others, for the treatment of PTSD (DeAngelis 2008). The PTSD practice guidelines were developed in response to (a) the lack of uniformity in the treatment information accessible to the mental health community and (b) the need for practical and comprehensive and evidence based information regarding assessing and treating individuals diagnosed with PTSD (Foa et al. 2000).

Statement of Significance

Present migration rates worldwide are the largest in history, and the great majority stem from developing countries whose refugees carry severe burdens of deprivation and hardship (Gorman 2001, p. 443). In Minnesota, statistics from the Immigration and Naturalization Service (INS) reflect the following: in 1996, the largest numbers of legal immigrants were African, and about 8 percent of Africans (Cameroonians included) seeking asylum chose Minnesota as their refuge.

This project seeks to develop practice recommendations for treatment of Cameroonian refugees with PTSD. The treatment of PTSD when other psychological and medical conditions are present will not be examined, thus limiting the transferability of the treatment strategies identified.

The literature review (section 2) encompasses recent scientific literature relative to diagnostic aspects of PTSD and identification of empirically supported treatments.

Statement of the Purpose

Given the literature review findings, it is this writer’s objective to identify and adapt current treatments for PTSD to the target population of Cameroonian refugees (section 3). Utilization of the practice recommendations should increase efficacy for psychological practitioners. This project is expected to contribute to the mental health system by adding to the body of literature on clinical treatment of Cameroonian refugees with PTSD.

Terminology Overview

This section consists of a general description of information and terminology germane to the topic of PTSD and its treatment. The source for the diagnostic criteria for PTSD

Reviews for Post Traumatic Stress Disorder:

[zavalansko · Rating: 5 out of 5 stars]

Very informative. It really brought me into the world of psychology.