This proposed study will examine the psychiatric status and psychosocial functioning of a previous massively traumatized group of Cambodian children who are now adolescents and compare them to 2 other refugee groups. The proposal has been shaped by extensive clinical experience and an earlier study of 46 Cambodian refugee adolescents who had survived 4 years of the brutal Pol Pot regime (1975-1979). We found that one-half of this non-clinical sample qualified for a DSM III diagnosis of PTSD (Post Traumatic Stress Disorder). Living currently with at least one family member buffered the symptoms of past trauma. Our overall aims now are to (1) Trace the effects of massive childhood trauma on subsequent psychiatric status and social functioning, controlling for the effects of refugee status itself. (2) Trace the symptom course of the PTSD syndrome over time and across a significant developmental transition. The sample will consist of 100 """"""""Pol Pot"""""""" Cambodian adolescents (ages 17-24), 100 non-Pol Pot Cambodian adolescents, and 100 Vietnamese adolescents. They will be studied in a prospective fashion, being seen three times over a 28 month period. They will also complete several self-report forms at 4 month intervals between the interviews. Standardized research instruments will be used to generate psychiatric diagnoses. Self-report measures will trace the course of affective and PTSD symptoms over 2 years. Data will be collected at two sites (Portland and Salt Lake City). As an empirically designed prospective study on a large subject sample, this proposal has particular theoretical, clinical and public health significance.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
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Special Emphasis Panel (SRCM (02))
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Oregon Health and Science University
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United States
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Sack, W H; Seeley, J R; Clarke, G N (1997) Does PTSD transcend cultural barriers? A study from the Khmer Adolescent Refugee Project. J Am Acad Child Adolesc Psychiatry 36:49-54
Sack, W H; Clarke, G N; Seeley, J (1996) Multiple forms of stress in Cambodian adolescent refugees. Child Dev 67:107-16
Sack, W H; Clarke, G N; Seeley, J (1995) Posttraumatic stress disorder across two generations of Cambodian refugees. J Am Acad Child Adolesc Psychiatry 34:1160-6
Sack, W H; McSharry, S; Clarke, G N et al. (1994) The Khmer Adolescent Project. I. Epidemiologic findings in two generations of Cambodian refugees. J Nerv Ment Dis 182:387-95
Sack, W H; Clarke, G; Him, C et al. (1993) A 6-year follow-up study of Cambodian refugee adolescents traumatized as children. J Am Acad Child Adolesc Psychiatry 32:431-7
Clarke, G N; Sack, W H; Ben, R et al. (1993) English language skills in a group of previously traumatized Khmer adolescent refugees. J Nerv Ment Dis 181:454-6
Clarke, G; Sack, W H; Goff, B (1993) Three forms of stress in Cambodian adolescent refugees. J Abnorm Child Psychol 21:65-77