THE DOSE-EFFECT RELATIONSHIPS BETWEEN TORTURE AND PSYCHIATRIC-SYMPTOMS IN VIETNAMESE EX-POLITICAL DETAINEES AND A COMPARISON GROUP

The purpose of this study was to determine in Vietnamese ex-political detainees newly arrived into the United States a) the prevalence of to rture and psychiatric symptoms and b) the dose-effect relationships be tween cumulative torture experience and the psychiatric symptoms of po sttraumatic stress disorder (PTSD) and major depression. The study pop ulation included Vietnamese ex-political detainees (N = 51) and a comp arison group (N = 22). All respondents received culturally validated i nstruments with known psychometric properties including Vietnamese ver sions of the Hopkins Symptom Checklist-25 and the Harvard Trauma Quest ionnaire. The ex-political detainees, in contrast to the comparison gr oup, had experienced more torture events (12.2 SD = 4.2 vs. 2.6 SD = 3 .1) and had higher rates of PTSD (90% vs. 79%) and depression (49% vs. 15%). Dose-effect relationships between cumulative torture experience and psychiatric symptoms were positive with the PTSD subcategory of ' 'increased arousal'' revealing the strongest association. These findin gs provide evidence that torture is associated with psychiatric morbid ity in Vietnamese refugees. The demonstration of significant dose-effe ct responses supports the hypothesis that torture is a major risk fact or in the etiology of major depression and PTSD. The generalizability of these results to other torture survivor groups is unknown. The inte raction between torture and other pre- and post-migration risk factors over time in different cultural settings still needs to be examined.