Khyâl attacks: a key idiom of distress among traumatized cambodia refugees.
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.
Hinton
Devon E
DE
Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, WACC 812, Boston, MA 02114, USA. devon_hinton@hms.harvard.edu
Pich
Vuth
V
Marques
Luana
L
Nickerson
Angela
A
Pollack
Mark H
MH
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
Cult Med Psychiatry. 1979 Sep;3(3):267-300
520020
Transcult Psychiatry. 2004 Jun;41(2):155-99
15446720
Transcult Psychiatry. 2002 Sep;39(3):323-344
20814562
Cogn Behav Ther. 2008;37(2):101-16
18470741
Depress Anxiety. 2011 Sep;28(9):783-801
21910185
Anthropol Med. 2012 Apr;19(1):129-31
22612498
Cult Med Psychiatry. 1991 Sep;15(3):275-301
1935180
Behav Res Ther. 2009 Jun;47(6):487-93
19321162
Transcult Psychiatry. 2001 Dec;38(4):433-460
20808711
Transcult Psychiatry. 2003 Sep;40(3):342-76
14649850
Transcult Psychiatry. 2001 Dec;38(4):403-432
20852723
J Trauma Stress. 2009 Jun;22(3):218-26
19475656
Psychosom Med. 1998 Jul-Aug;60(4):439-47
9710289
Transcult Psychiatry. 2008 Jun;45(2):142-62
18562491
J Anxiety Disord. 2007;21(1):42-58
16650726
Behav Res Ther. 2005 Dec;43(12):1631-43
16239155
CNS Neurosci Ther. 2009 Fall;15(3):255-63
19691545
Psychosom Med. 2007 Dec;69(9):832-40
18040090
Depress Anxiety. 2008;25(6):489-95
17570492
JAMA. 2007 Feb 28;297(8):820-30
17327524
J Nerv Ment Dis. 2005 Oct;193(10):697-9
16208168
CNS Neurosci Ther. 2009 Fall;15(3):264-75
19691546
Behav Res Ther. 2001 Aug;39(8):977-86
11480838