Measuring the whole or the parts?: Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity

Explaining high rates of depression in chronic pain: A diathesis-stress framework.

Objective: This paper explores the impact of pre-migration trauma, post-migration living difficulties and social support on the current mental health of 63 resettled Sudanese refugees.Method: A sem...

Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees.

BACKGROUND Research into the mental health of refugees has burgeoned in recent times, but there is a dearth of studies focusing specifically on the factors associated with psychiatric distress in asylum-seekers who have not been accorded residency status.

METHOD Forty consecutive asylum-seekers attending a community resource centre in Sydney, Australia, were interviewed using structured instruments and questionnaires.

RESULTS Anxiety scores were associated with female gender, poverty, and conflict with immigration officials, while loneliness and boredom were linked with both anxiety and depression. Thirty subjects (79%) had experienced a traumatic event such as witnessing killings, being assaulted, or suffering torture and captivity, and 14 subjects (37%) met full criteria for PTSD. A diagnosis of PTSD was associated with greater exposure to pre-migration trauma, delays in processing refugee applications, difficulties in dealing with immigration officials, obstacles to employment, racial discrimination, and loneliness and boredom.

CONCLUSIONS Although based on correlational data derived from'a convenient' sample, our findings raise the possibility that current procedures for dealing with asylum-seekers may contribute to high levels of stress and psychiatric symptoms in those who have been previously traumatised.

Anxiety, depression and PTSD in asylum-seekers: assocations with pre-migration trauma and post-migration stressors.

Context. —Preventive health programs may mitigate against the health risks of older adulthood. Objective. —To evaluate the effectiveness of preventive occupational therapy (OT) services specifically tailored for multiethnic, independent-living older adults. Design. —A randomized controlled trial. Setting. —Two government subsidized apartment complexes for independentliving older adults. Subjects. —A total of 361 culturally diverse volunteers aged 60 years or older. Intervention. —An OT group, a social activity control group, and a nontreatment control group. The period of treatment was 9 months. Main Outcome Measures. —A battery of self-administered questionnaires designed to measure physical and social function, self-rated health, life satisfaction, and depressive symptoms. Results. —Benefit attributable to OT treatment was found for the quality of interaction scale on the Functional Status Questionnaire (P=.03), Life Satisfaction Index-Z (P=.03), Medical Outcomes Study Health Perception Survey (P=.05), and for 7 of 8 scales on the RAND 36-Item Health Status Survey, Short Form: bodily pain (P=.03), physical functioning (P=.008), role limitations attributable to health problems (P=.02), vitality (P=.004), social functioning (P=.05), role limitations attributable to emotional problems (P=.05), and general mental health (P=.02). Conclusions. —Significant benefits for the OT preventive treatment group were found across various health, function, and quality-of-life domains. Because the control groups tended to decline over the study interval, our results suggest that preventive health programs based on OT may mitigate against the health risks of older adulthood.

Occupational therapy for independent-living older adults. A randomized controlled trial

Pilgrimage of pain: The illness experiences of women with repetition strain injury and the search for credibility

Growing recognition that the world faces a modern epidemic of torture has stimulated widespread interest amongst mental health professionals in strategies for the treatment of survivors. In this article we outline the distinctive experiences of torture survivors who present for treatment in western countries. These survivors are usually refugees who, in addition to torture, have suffered a sequence of traumatic experiences and face ongoing linguistic, occupational, financial, educational and cultural obstacles in their country of resettlement. Their multiple needs call into question whether "working through" their trauma stories in psychotherapy will on its own ensure successful psychosocial rehabilitation. Drawing on our experience at a recently established service, we propose a broader therapeutic aim.

Psychosocial Needs of Torture Survivors

Many immigrants to Australia are refugees, some of whom have experienced acute stress and trauma, including torture, prior to or during their escape from their home countries. In response to a growing recognition that the health care services may not be meeting the needs of these people the NSW Department of Health funded the establishment of a community-based rehabilitation service for traumatised refugees. This paper provides an overview of the recent history of the service, some of the organisational and staffing issues faced during its first year, some characteristics of the first 200 clients, principles of treatment, clinical, nosological and therapeutic issues and relationships with other agencies.

Janice Reid

Papers

Pilgrimage of pain: The illness experiences of women with repetition strain injury and the search for credibility

Psychosocial Needs of Torture Survivors

The Development of the New South Wales Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (Startts): The First Year:

Public health education in Australia: Nobody's child?☆