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Mental Health Among Bosnian Refugees
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To the Editor: Dr Mollica and colleagues1 concluded that their survey of Bosnian refugees supports the "ubiquitousness of comorbid psychiatric illness in traumatized refugees," and they attribute substantial disability to these psychiatric conditions.
These conclusions are premature. The authors' assumption that refugee status is inherently traumatic is unwarranted. While flight from one's home is undoubtedly distressing, it is not possible to assume that all respondents experienced or witnessed events that threatened their physical integrity. Given the thin descriptions on the checklist, many of the specific ostensibly traumatic events that were endorsed by respondents might not have been judged traumatic in an interview in which respondents' accounts of the events could be elaborated.
Self-report measures have low specificity as measures of psychiatric disorder, even when administered under the best of circumstances and tailored to diagnostic criteria.2-3 Indeed, such measures are likely to be sensitive to the understandable discomfort and disruption of . . . [Full Text of this Article]
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