Psychological Burden in Female, Iraqi Refugees Who Suffered Extreme Violence by the "Islamic State": The Perspective of Care Providers

Caroline Rometsch-Ogioun El Sount; Jana Katharina Denkinger; Petra Windthorst; Christoph Nikendei; David Kindermann; Viola Renner; Johanna Ringwald; Sara Brucker; Virginia M Tran; Stephan Zipfel; Florian Junne

doi:10.3389/fpsyt.2018.00562

Psychological Burden in Female, Iraqi Refugees Who Suffered Extreme Violence by the "Islamic State": The Perspective of Care Providers

Front Psychiatry. 2018 Nov 8:9:562. doi: 10.3389/fpsyt.2018.00562. eCollection 2018.

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
² Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
³ Department of Psychiatry, Psychosomatic Medicine and Psychotherapy for children and Youth, University Hospital Tübingen, Tübingen, Germany.
⁴ Department of Gynecology, University Hospital Tübingen, Tubingen, Germany.
⁵ Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, United States.
⁶ Harvard Medical School, Harvard University, Boston, MA, United States.

Abstract

Introduction: A large number of refugees suffer from mental disorders such as post-traumatic stress disorder (PTSD). In the context of a special quota project, 1100 Yazidi women from Northern Iraq who had suffered extreme violence by the so-called Islamic State (IS) were brought to Germany to receive specialized treatment. This study aims to investigate the psychological burden and trauma-related symptoms of these female IS-victims from the perspectives of their care providers. Material and methods: Care providers with various professional backgrounds (N = 96) were asked to complete a self-developed questionnaire on a Likert-type scale ranging from 1 (very low) to 7 (very high) analyzing the psychological burden and trauma-related symptoms of the IS-traumatized women since their arrival in Germany. We controlled for potential confounders, namely the care providers' personal experiences of trauma and flight, by using chi-square tests. Results: The mean psychological burden for the whole period in Germany as perceived by care providers was M = 5.51 (SD = 0.94). As the main factors of distress the care providers reported: worries about family members in Iraq (M = 6.69; SD = 0.69), worries about relatives' possibilities to be granted asylum in Germany (M = 6.62; SD = 0.68), and uncertainties regarding their future (M = 5.89; SD = 1.02). The most prominent trauma-related psychological symptoms were nightmares (M = 6.43; SD = 0.54). The care providers reported that somatic complaints have been present among the refugees in the following manifestation: pain (M = 6.24; SD = 1.08), gastrointestinal complaints (M = 4.62; SD = 1.62), and dizziness (M = 4.40; SD = 1.59). The care providers' personal experiences of trauma and flight had no significant influence on their response behavior. Discussion: Care providers working with IS-traumatized female refugees evaluate the psychological burden and trauma-related somatic and psychological symptom loads of their clients as very high. The results of this study provide important information about the perceptions of care providers working in a refugee-services context and may provide insights for the progression of specialized treatment programs and interventions for highly traumatized refugees and culture-sensitive training programs for their care providers.

Keywords: PTSD; Yazidi; care providers; pain; psychological burden; refugees; somatic symptoms; trauma.