From Persecution to Prison - Bellevue/NYU Program for Survivors of ...

high reliability in numerous languages. 140 A recent literature review concludedthat, among the numerous psychosocial instruments used inresearch with refugee populations, the HSCL-25 and HTQ are among themost widely accepted and well-validated. 141In addition to English, versions of the HSCL-25 and HTQ which hadpreviously been translated and back translated in French, Arabic andSpanish were used. For participants speaking other languages, scales weretranslated by the interpreter.InterviewsSubjects were interviewed by Bellevue/NYU-PHR study team physicians 142about their experiences before and during detention, as well as their physicaland mental health. All of the interviewers were primary care internalmedicine physicians with experience in evaluating and caring for refugeesand asylum seekers. Interviews were conducted in private rooms in thedetention centers, with only the interviewer and the subject present. Whennecessary, these evaluations were conducted with the assistance of anexperienced translator. Interviews typically lasted approximately 2 hoursand were conducted in a single session.Bellevue/NYU-PHR physicians administered the survey questionnaire,which was comprised of a structured interview in which subjects wereasked specific questions, most of which elicited responses using a Likerttypeformat (e.g., “not at all”, “a little bit”, “quite a bit”, “extremely”).When appropriate, participants were asked to provide additional narrativeinformation for positive responses (e.g., to describe incidents they perceivedas unpleasant), which was recorded by the interviewer. A semi-structuredinterview format was used to elicit additional information concerningthe detainee’s health experiences and treatment while in detention.The Bellevue/NYU-PHR researchers also reviewed the asylum applicationsfor each participant, with his/her permission, in order to obtaininformation on the detainees’ demographic characteristics and traumaticexperiences in their countries of origin. This method was used to minimizerisk of re-traumatizing the participants by eliciting their trauma historythrough an interview with study personnel. Prior traumatic experiences140Kleijn WC, Hovens JE, Rodenburg JJ. Posttraumatic stress symptoms in refugees: assessmentswith the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25 indifferent languages. Psychol Rep. 2001;88:527-532.141Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kesler J, Stevenson J,Westermeyer J. Measuring Trauma and Health Status in Refugees: A CriticalReview. Journal of American Medical Association. 2002; 288:611-621.142Interviews were conducted by Allen Keller, M.D., Chris Meserve, M.D., Jonathan Leviss,M.D. Elizabeth Singer, M.D., Melanie Jay, M.D., Alyssa Finlay, M.D., Amina Chaudry,M.D., and Joshua Lee, M.D.46 FROM PERSECUTION TO PRISON