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9 - Key Idioms of Distress and PTSD among Rural Cambodians

The Results of a Needs Assessment Survey

Published online by Cambridge University Press:  05 November 2014

By
Devon E. Hinton ,
Alexander L. Hinton  and
Kok-Thay Eng
Edited by
Devon E. Hinton  and
Alexander L. Hinton
Devon E. Hinton
Affiliation:
Harvard University
Alexander L. Hinton
Affiliation:
Rutgers University
Kok-Thay Eng
Affiliation:
Documentation Center of Cambodia
Devon E. Hinton
Affiliation:
Harvard University, Massachusetts
Alexander L. Hinton
Affiliation:
Rutgers University, New Jersey
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Summary

Introduction

This chapter describes key idioms of distress among Cambodian refugees and their manner of generation, and it reports on the results of a needs assessment survey of rural Cambodians that was undertaken by the Documentation Center of Cambodia (DC-CAM) as part of their Victims of Torture (VoT) project. The VoT project was conceived by the director of DC-Cam (Youk Chang) and implemented by a VoT project team leader (Kok-Thay Eng). The purpose of this project was to document experiences under the Khmer Rouge, to identify rural villagers who had significant distress, and to provide services to those suffering from PTSD. Members of DC-CAM went to rural villages in Kampot, Takeo, and Kandal Provinces and asked local officials (e.g., the commune or village chief) and villagers to identify individuals who had psychological problems owing to the Pol Pot period. After being interviewed, all participants were given basic mental health information, including instruction about the use of relaxation and breathing techniques to reduce stress, and those individuals who were found to have significant mental health concerns were provided with psychological services, including referral and modest funds to visit the closest mental health clinic and to pay for any prescribed medications.

To date, what little formal knowledge we have about mental health in Cambodia has been derived from a handful of instruments, such as the Harvard Trauma Questionnaire and the Hopkins Checklist. During a pilot version of the Victims of Torture project, DC-Cam team members noted that the instruments were not culturally sensitive in that they did not assess many symptoms of concern among those surveyed such as dizziness. After discussing these issues, the DC-CAM staff asked to include the Cambodian Symptom and Syndrome Inventory (C-SSI), an instrument devised by the first author based on work with Cambodian Americans in a Massachusetts clinic, as an addendum to the existing assessment survey in order to seek a more culturally sensitive means of assessing psychological distress in Cambodia. The C-SSI is an addendum of symptoms and syndromes (see Table 9.1) that are a key aspect of the presentation of trauma-type distress among Cambodian refugees but are not among the seventeen symptoms listed in the PTSD criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR; American Psychiatric Association, 2000) or among the updated list of twenty symptoms in the PTSD criteria of the DSM-5 (American Psychiatric Association, 2013).

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Chapter
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Genocide and Mass Violence
Memory, Symptom, and Recovery
 , pp. 212 - 241
Publisher: Cambridge University Press
Print publication year: 2014

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