This household survey of Cambodian refugees residing in the United States will constitute the first-ever community based, epidemiologic study concerning the prevalence and mental health correlates of exposure to pre-migration trauma and post-migration community violence. The major purposes of this study are to document the nature and severity of torture, trauma and violence exposure, to more fully understand the link between exposure and its sequelae, and to provide insight into the coping resources that might explain successful adjustment to life in resettlement. Using a two-stage random sampling strategy, 500 adult male and female refugees, ages 35-70, will be recruited for participation from Cambodian residents in Long Beach, California. Study participants will complete a face-to-face interview, conducted by lay interviewers, of approximately 120 minutes duration. A subset of 50 participants will complete a clinician-administered diagnostic instrument for posttraumatic stress disorder (PTSD). The diagnostic re-interview will provide information to assist in interpreting PTSD prevalence rates that emerge from the use of a lay administered PTSD diagnostic interview in the household survey. The broad aims of the proposed research are: 1) To estimate the prevalence of pre-migration torture and related trauma, and post-migration community violence experienced by a community-based sample of Cambodian refugees residing in the United States; 2) To describe the association of pre-existing sociodemographic and family characteristics, pre-migration torture and related trauma exposure, and post-migration life circumstances with current mental health and health-related quality of life outcomes; and 3) To evaluate the association of personal and social coping resources (i.e., dispositional optimism, social support, and temporal orientation) with mental health and health-related quality of life outcomes, after accounting for pre-existing socio-demographic and family characteristics, pre-migration torture and related trauma exposure, and post-migration life circumstances (including contemporaneous life events and both lifetime and recent exposure to community violence in the United States).
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