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Southeast Asian Refugees: Gender Difference in Levels and Predictors of Psychological Distress

Southeast Asian Refugees: Gender Difference in Levels and Predictors of Psychological Distress

It is well-documented that for the general U.S. population, women are more likely to experience depression than men (Kessler, 1995; Leaf et al., 1986). Among the specialized refugee population in the United States, there is little research on the gender differences in psychological distress, which is considerable.

Since 1975, more than 1.5 million Southeast Asian refugees have come to the United States. Studies have found that many refugees suffer from major psychiatric disorders, such as posttraumatic stress disorder (PTSD), as a result of trauma experienced during the Vietnam War (Kinzie et al., 1990). These traumatic experiences included torture, threat of mass genocide, family loss, persecution, rape, starvation, death, hazardous escape from their home country and hardships in resettlement camps.

Refugee Women at Greater Risk

Southeast Asian refugee women have been identified as an at-risk group for developing serious psychiatric disorders primarily due to their premigration experiences. Many in this population suffered sexual abuse and multiple rapes and beatings, as well as death and separation from family members, poor nutrition and health, and extreme hardships in caring for their children (Mollica and Jalbert, 1989). In response to the severity of their premigration trauma, some older Cambodian women have developed nonorganic or psychosomatic blindness: They literally can no longer stand to "see" the painful memories of their distress (Rozee and Van Boemel, 1989).

A recent study by Chung et al. (1998), using a community sample of 2,180 Southeast Asian refugees, found that Vietnamese, Cambodian and Lao refugee women reported significantly higher levels of psychological distress than did their male counterparts. Gender differences in distress for this population have been previously attributed to variations in premigration traumatic experiences. However, the study found that multiple traumatic events were a significant predictor of distress for both refugee men and women. Therefore, gender differences in psychological distress may not be solely attributed to premigration traumatic experiences, but to other factors such as coping skills, social support and postmigration adjustment.

For Southeast Asian refugees, their own ethnic community is the primary social support system as it not only provides a sense of identity and belonging, but also acts as a buffer to stressful events, and has a beneficial effect on mental health. The family is another supportive resource, with people in intact marriages at lower risk for psychological distress compared to those who are single, widowed or divorced (Beiser et al., 1989; Lin et al., 1982).

Refugee women who reported the death or loss of a spouse may not receive the same family and emotional support as do refugee men. This is best illustrated in the Cambodian community where it has been reported that women who are widowed are often seen as a threat in their community, and are avoided by married Cambodian women who fear losing their husbands (Mollica et al., 1985).

Furthermore, refugee women who reported loss of their spouses and/or close family members must not only cope with the bereavement over the loss of their spouse or family member, but also with the added stress of assuming a new role as head of the household.
This may be particularly difficult given the context of a new and unknown culture, lack of familiar social support networks such as family, and lack of knowledge in accessing resources for economic self-sufficiency. It is not surprising to find also that significantly more women are welfare dependent than men. This puts refugee women at higher risk for cultural isolation and alienation, which leads to higher distress levels.

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