Psychodiagnostic assessment with refugees: Studies on the Cultural Formulation Interview and Somatization

Abstract

Refugees in the Western world are a very diverse group of people. In the Netherlands they originate from over more than a hundred different countries. Most refugees suffer from mental disorders, most notably PTSD and depression. Four general rubrics of stressors and supports have been distinguished: migration and loss, acculturation, traumatization and social marginalization. When refugees are referred to mental health care, the challenge will be to have a consensus about the goals of and expectations from the treatment. Furthermore, a proper diagnosis has to be made, in order to start treatment. In the present study, we have assessed the content, the development, and the experience of a cultural interview in the first meeting with a refugee. This cultural interview is an operationalization of the Outline for a Cultural Formulation (OCF), which was published in the Diagnostic and Statistical manual of Mental Disorders, fourth edition (DSM-IV). For DSM-5, we constructed a new interview, the so-called Cultural Formulation Interview (CFI), and collaborated in an international field trial. Psychodiagnostic assessment with refugees is about the construction of the cultural interviews, and about the evaluation of the latest interview. In addition, the challenge of building a good patient-clinician relationship is described here. Another important issue is the syndrome of somatization. It is a complex construct, and in refugees it has a connection with traumatization. Of traumatic experiences, being tortured is studied here. Suggestions on how to cope with somatization are mentioned.