Intergenerational transmission of traumatic stress and relational disruptions among Cambodian refugee families in the United States.

Cambodian refugees resettled in the United States were severely affected by genocidal trauma and have been trapped in decades of intergenerational transmission of traumatic stress and relational disruptions without much public attention. This manuscript reports on data collected as part of a Cambodian needs assessment that employed methodological principles of critical ethnography and was grounded by a human ecological theoretical model. Eighteen professionals who served Cambodian communities were interviewed. The interviews were transcribed in Khmer or/and English and analyzed using the Developmental Research Sequence resulting in three domains (Pre-Migration, During Migration, and Post Resettlement in the United States) and four categories (i.e. Impact on Self, Couple Relationships, Parent-Child Relationships, and Context) within each domain. The thematic findings emphasize intergenerational transmission of psychopathology, disruptions in parent-child relationships, and a critical need to support parents to promote positive child development within Cambodian communities.

Mental Health and Relational Needs of Cambodian Refugees after Four Decades of Resettlement in the United States: An Ethnographic Needs Assessment.

The United States has a long history of welcoming refugees fleeing persecution, organized violence, and war. However, the welcome often does not come with adequate immigration infrastructure support necessary to rebuild life and promote family well-being. Approximately 157,000 Cambodians were accepted to resettle in the U.S. between 1975 and 1994 due to the countrywide genocide. Upon resettlement, Cambodians were placed in impoverished neighborhoods with little resources to heal and rebuild. The purpose of this study, grounded in a Human Ecological Model and guided by Critical Ethnography principles, was to conduct a formal needs assessment of Cambodian refugee families across the United States. Eighteen professionals were interviewed virtually in Khmer and/or English. The data were analyzed using the Developmental Research Sequence. The results emphasized a critical need to address mental health complications resulting from untreated mental health disorders such as posttraumatic stress, depression, anxiety-related disorders, and complicated grief, across generations. Severe disruptions in family relationships (i.e., parent-child and couple relationships) were also reported along with substance abuse in the absence of access to culturally responsive mental health treatments. Findings suggest the need for culturally tailored multilevel interventions to effectively address mental health and relational challenges of multigenerational Cambodian families.

A Systematic Review of Evidence-Based Family Interventions for Trauma-Affected Refugees.

Family connections are crucial for trauma-affected refugees from collectivistic cultures. Evidence-based family interventions are consistently promoted to support a host of mental and relational health needs of families exposed to traumatic stressors; however, there is still limited research focused on cultural adaptation and the testing of the effectiveness of these interventions on some of the most disenfranchised populations in the aftermath of forced displacement. This systematic review was conducted to examine the reach of existing evidence-based family interventions implemented with newly resettled refugees globally. Studies included in this review include those testing the effectiveness of a systemic treatment with pre and post intervention evaluation, studies with or without control groups, and studies that include at least one family member in addition to the target participants. Twelve studies met the inclusion criteria. Barriers to conducting randomized control trials with displaced refugee populations are discussed. Recommendations are made for future studies to include a focus on scientifically rigorous multi-method designs, specific cultural adaptation frameworks, and the integration of relational aspects rather than focusing only on individual adjustment. Global displacement continues to rise; therefore, it is imperative that the mental health and wellbeing of displaced populations be treated with a comprehensive, multi-level framework.

Intergenerational Transmission of Traumatic Stress and Resilience Among Cambodian Immigrant Families Along Coastal Alabama: Family Narratives.

Purpose: Intergenerational transmission of psychological trauma is an ongoing global public health concern. Cambodia experienced ∼4 years of genocide, causing about 2 million deaths. Many survivors fled and resettled in the United States where they continued to face the psychological and relational consequences of forced displacement, with limited access to mental health treatment. This study employed an ecological social determinants of health framework to explore how resettled families discussed traumatic experiences and resilience transmitted across three generations. Methods: Narrative inquiry-guided, in-depth semistructured interviews were conducted with intergenerational families: five grandparents, six parents, and nine adult children. The interview protocol included developing detailed family genograms that facilitated the sharing of experiences of living through the Cambodian genocide (1975-1979) and resettlement to the United States in the 1980s. A thematic data analysis was conducted across individual and family experiences before, during, and after the genocide and resettlement. Results: The findings highlight parent-child relationships as the primary mechanism of intergenerational transmission of traumatic stress and resilience among Cambodian immigrant families. Specifically, high parental expectations, authoritarian parenting, corporal punishment, and submissive communication styles were reported. On the other hand, strong bonds and less hierarchy between parents and children were found to be resilience factors among this population. Conclusions: The results of this qualitative study underscore the need for a systemic mental health conceptualization for practitioners working with resettled Cambodian families to overcome the cycle of intergenerational transmission of traumatic stress and promote resilience postresettlement.