title: Entering exile: trauma, mental health, and coping among Tibetan refugees arriving in Dharamsala, India.
abstract: Each year thousands of Tibetans escape Chinese-controlled Tibet. The authors present findings on the experiences, coping strategies, and psychological distress (depression, anxiety, somatization, and posttraumatic stress disorder) of 769 Tibetan refugees arriving in Dharamsala, India (2003-2004). Distress increased significantly with greater trauma exposure. However, despite a high prevalence of potentially traumatizing events, levels of psychological distress were extremely low. Coping activity (primarily religious) and subjective appraisals of trauma severity appeared to mediate the psychological effects of trauma exposure. The potential impact of other variables, including culturally determined attitudes about trauma and timing of assessment, are discussed.
authors.affiliation: Department of Psychology, Fordham University, Bronx, NY 10458, USA. Esachs@fordham.edu
authors.forename: Emily
authors.initials: E
authors.lastname: Sachs
authors.forename: Barry
authors.initials: B
authors.lastname: Rosenfeld
authors.forename: Dechen
authors.initials: D
authors.lastname: Lhewa
authors.forename: Andrew
authors.initials: A
authors.lastname: Rasmussen
authors.forename: Allen
authors.initials: A
authors.lastname: Keller
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology* / Q000706:statistics & numerical data; D003469:Culture; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D012069:Religion and Psychology; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D018609:Tibet / Q000208:ethnology; D014104:Torture / Q000523:psychology / Q000706:statistics & numerical data; D014171:Transients and Migrants / Q000523:psychology / Q000706:statistics & numerical data