title: Khyâl attacks: a key idiom of distress among traumatized cambodia refugees.
abstract: Traumatized Cambodian refugees with PTSD often complain of khyâl attacks. The current study investigates khyâl attacks from multiple perspectives and examines the validity of a model of how khyâl attacks are generated. The study found that khyâl attacks had commonly been experienced in the previous 4 weeks and that their severity was strongly correlated with the severity of PTSD (PTSD Checklist). It was found that khyâl attacks were triggered by various processes--such as worry, trauma recall, standing up, going to a mall--and that khyâl attacks almost always met panic attack criteria. It was also found that during a khyâl attack there was great fear that death might occur from bodily dysfunction. It was likewise found that a complex nosology of khyâl attacks exists that rates the attacks on a scale of severity, that the severity determines how the khyâl attacks should be treated and that those treatments are often complex. As illustrated by the article, khyâl attacks constitute a key aspect of trauma ontology in this group, a culturally specific experiencing of anxiety and trauma-related disorder. The article also contributes to the study of trauma somatics, that is, to the study of how trauma results in specific symptoms in a specific cultural context, showing that a key part of the trauma-somatic reticulum is often a cultural syndrome.
authors.affiliation: Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, WACC 812, Boston, MA 02114, USA. devon_hinton@hms.harvard.edu
authors.forename: Devon E
authors.initials: DE
authors.lastname: Hinton
authors.forename: Vuth
authors.initials: V
authors.lastname: Pich
authors.forename: Luana
authors.initials: L
authors.lastname: Marques
authors.forename: Angela
authors.initials: A
authors.lastname: Nickerson
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
mesh_terms: D000328:Adult; D001007:Anxiety / Q000208:ethnology / Q000523:psychology / Q000628:therapy; D001293:Attitude to Death; D002160:Cambodia / Q000208:ethnology; D003431:Cross-Cultural Comparison; D003937:Diagnosis, Differential; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D016584:Panic Disorder / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D012036:Refugees / Q000523:psychology*; D012660:Semantics; D013001:Somatoform Disorders / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D014481:United States
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