title: Adjustment to trauma exposure in refugee, displaced, and non-displaced Bosnian women.
abstract: The war in Bosnia resulted in the displacement of millions of civilians, most of them women. Ten years after the civil war, many of them are still living as refugees in their country of origin or abroad. Research on different refugee groups has continuously reported persistent levels of posttraumatic stress disorder (PTSD) and other mental-health problems in this population. The present study compared PTSD and self-concept in Bosnian refugee women (n = 29) with women who were internally displaced (IDP; n = 26) and non-displaced women (n = 32). Data were collected using the Bosnian Trauma Questionnaire and four scales assessing self-esteem, perceived incompetence, externality of control attribution, and persistence. IDPs scored significantly higher on PTSD symptoms, externality of control attribution and perceived incompetence, and lower on self-esteem than both refugee and non-displaced women. The level of education most strongly predicted PTSD symptom severity, followed by the type of displacement, and exposure to violence during the war. Associations of self-concept with displacement and psychopathology were inconsistent, with type of displacement predicting control attributions but not other aspects of self-concept and PTSD symptoms being partly related to perceived incompetence and self-esteem. These results support previous findings stating that, in the long run, refugees show better mental health than IDPs, and that witnessing violence is a traumatic experience strongly linked to the development of PTSD symptoms. Results further indicate that education plays an important role in the development of PTSD symptoms. Associations of control attributions and type of displacement were found; these results have not been previously documented in literature.
authors.affiliation: Department of Psychiatry, Outpatient Clinic for victims of torture and war, University Hospital Zurich, Culmannstrasse 8, Zurich, Switzerland.
authors.forename: Martina
authors.initials: M
authors.lastname: Schmidt
authors.forename: Nera
authors.initials: N
authors.lastname: Kravic
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017522:Bosnia and Herzegovina; D005260:Female; D006801:Humans; D008875:Middle Aged; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires; D014857:Warfare; D014947:Wounds and Injuries / Q000523:psychology*