Principles and Practice of Structural Equation Modeling (2nd ed.)

Handbook of attachment: Theory, research, and clinical applications

For young people with refugee backgrounds, establishing a sense of belonging to their family and community, and to their country of resettlement is essential for wellbeing. This paper describes the psychosocial factors associated with subjective health and wellbeing outcomes among a cohort of 97 refugee youth (aged 11-19) during their first three years in Melbourne, Australia. The findings reported here are drawn from the Good Starts Study, a longitudinal investigation of settlement and wellbeing among refugee youth conducted between 2004 and 2008. The overall aim of Good Starts was to identify the psychosocial factors that assist youth with refugee backgrounds in making a good start in their new country. A particular focus was on key transitions: from pre-arrival to Australia, from the language school to mainstream school, and from mainstream school to higher education or to the workforce. Good Starts used a mix of both method and theory from anthropology and social epidemiology. Using standardized measures of wellbeing and generalised estimating equations to model the predictors of wellbeing over time, this paper reports that key factors strongly associated with wellbeing outcomes are those that can be described as indicators of belonging e the most important being subjective social status in the broader Australian community, perceived discrimination and bullying. We argue that settlement specific policies and programs can ultimately be effective if embedded within a broader socially inclusive society - one that offers real opportunities for youth with refugee backgrounds to flourish.

Longing to belong : social inclusion and wellbeing among youth with refugee backgrounds in the first three years in Melbourne, Australia

Repeated Measures Analysis

Seeking Safety: A Treatment Manual for PTSD and Substance Abuse

The current research and clinical focus on single traumas fails to assess numerous important trauma dynamics including trauma proliferation. In this study, 2 trauma proliferation pathways were identified that utilize a developmentally based trauma framework (DBTF). Data previously collected from 6 different cultural groups (N = 2279; 2 mental health clinics in Egypt and the United States, Native Americans, Palestinian adults in Gaza, and college students in Poland and Egypt) were reanalyzed. The 6 studies utilized DBTF-based measures of cumulative trauma and trauma types. Path analysis was used to test the trauma proliferation model and PROCESS software was used to identify mediators and their effect sizes. Results of the analyses indicated that attachment trauma and collective identity trauma independently predicted (directly and through mediators) personal identity trauma, role identity trauma, secondary trauma, and survival trauma. The pattern of proliferation was configurally invariant across the 6 groups and strictly invariant across genders. Implications for the consideration of trauma global dynamics, such as trauma proliferation, are discussed. (PsycINFO Database Record

Trauma proliferation and stress generation (TPSG) dynamics and their implications for clinical science.

Traumatology perspective on gender discrimination GD, views it as type III identity continuous trauma that has continuous and stable negative mental health effects. Current work evaluated the salience of GD’s negative effects across different cultures and outcome measures and tested the differential impact of GD within the household (GD-P), and GD within social institutions (GD-S). Data from four previous studies on American Indians, Palestinians, and clients of mental health clinics in Egypt and torture survivors in the US were re-analyzed. All the four studies used the same measure of GD, and trauma types, with similar and different outcome measures which allowed measuring the stability of the effects across different cultures and different outcome measures. Partial correlation and path analysis were conducted. GD predicted increased PTSD, cumulative trauma disorders, general anxiety, annihilation anxiety, and decreased in self-esteem, general assessed functioning. Results suggested that linear and non-linear effects of GD supported its cumulative dynamics. GD-S was associated with more negative outcomes than GD-P. Further, internalizing and appraising GD as positive mediated by resulted decrease in self-esteem, predicted negative mental health outcomes, while negative appraisal did not predict any negative change. Positive appraisal of GD may be a negative coping strategy. The implications of results for trauma

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Are the Negative Mental Health Effects of Gender Discrimination (GD) Salient across Cultures? Does Self-Esteem Mediate These Effects: GD as a Continuous Traumatic Stress and the Pathways to Its Negative Dynamics?

Children of refugee torture survivors present a compelling case of cumulative and continuous chronic past and current traumas and complex post-cumulative trauma symptoms. Traditional models of interventions with victims of single past traumas may not be effective with such victims. The goal is to develop and initially test a new open multi-systemic, multi-component and multi-modal intervention model (MMMM) as applied in the context of Summer Day Treatment and After School (SDTAS) program, and to determine its potential effectiveness as well as the feasibility of a larger study with more rigorous experimental design. A total of 27 secondary torture survivor Iraqi refugee children (13 males and 14 females, age between 11-16), living in the US, who suffered from serious symptoms and were non-responsive to treatment as usual for at least the previous six months, completed the planned interventions and three times follow-up assessments of five domains: PTSD, complex PTSD, anxiety, depression, and global level of functioning (GAF). Repeated measure analysis of variance was used to analyze changes over the three time points. Results indicated significant decrease in symptoms, and increased GAF with high effect sized (Partial Eta Squared ranged between 0.85 - 0.93). The amount of change displayed by the treated individuals was large enough to be clinically meaningful. Current study provides evidence of potential effectiveness of this novel intervention and of the feasibility of more rigorous and larger future controlled clinical trials to help develop evidence-based treatments for the multiply traumatized children who suffer past and present ongoing adversities. We suggest that the model is cost effective, and can be conducted with children of torture survivors and refugees in different settings world-wide by professionals or by trained supervised para-professionals.

/pdf/development-and-piloting-the-mmmm-ecological-interactive-2v526vsev1.pdf

Andrea Z. Omidy

Papers

Trauma proliferation and stress generation (TPSG) dynamics and their implications for clinical science.

Are the Negative Mental Health Effects of Gender Discrimination (GD) Salient across Cultures? Does Self-Esteem Mediate These Effects: GD as a Continuous Traumatic Stress and the Pathways to Its Negative Dynamics?

Development and Piloting the MMMM Ecological Interactive Open Systems Model: A Prospective One-Year Treatment Outcome of Children of Tortured Refugees