Transcript Slide 1

Psychological evidence
and refugee protection
Dr Jane Herlihy
Clinical and Research Psychologist
Director, Centre for the Study of Emotion and Law
© Centre for the Study of Emotion and Law 2012
Centre for the Study
of Emotion and Law
 Independent research centre
 Hypothesis testing
 Statistical; ‘averages’ (cf. finding one)
 Conducting primary (data collection) and
secondary (reviews) empirical research
 Providing information to all actors
 Aim = “a better informed asylum process”
A Judicial comment…
 “In the case of country evidence, expert
evidence can be evaluated against other
material”
 “In contrast, there will be no similar breadth of
evidence to assist in the evaluation of expert
medical evidence”
Barnes (2004)
Study : Memory
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27 Kosovan and 16 Bosnians
programme refugees
interviewed on two occasions.
asked to recall a traumatic and a non
traumatic event from their past.
 On both occasions, they were asked a series
of standard questions about these events.
 Would they give the same answers each
time?
 (No obvious motivation for deception...)
Herlihy, Scragg & Turner (2002)
Repeated Memory Task
 First interview
 free
recall
 15 questions
 central/peripheral rating
 Second interview
 prompt
 same
15 questions
Herlihy, Scragg & Turner (2002)
Detail questions (examples)
 who was with you?
 what were you wearing?
 what day of the week was it?
Herlihy, Scragg & Turner (2002)
Discrepant Memories I
0.45
0.4
0.35
0.3
0.25
Peripheral
Central
0.2
0.15
0.1
0.05
0
Non-Traumatic
Traumatic
Herlihy, Scragg & Turner (2002)
Discrepant Memories II
0.5
0.45
0.4
0.35
0.3
0.25
0.2
0.15
0.1
0.05
0
High PTSD
Low PTSD
Short Delay
Long Delay
Herlihy, Scragg & Turner (2002)
A refugee has a well-founded fear
of persecution …
 Being a refugee is not a diagnosis
 increased risk of emotional disturbance
Common problems
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PTSD
9% of 6743 refugees in western countries
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Depression – very co-morbid
4-6%
(Fazel, Wheeler, & Danesh, 2005)
“Refugees based in western countries could be
about ten times more likely than the agematched general American population to
have posttraumatic stress disorder.”
(Fazel, Wheeler, & Danesh, 2005)
Diagnosis and Trauma
 Absence of a diagnosis does not disprove
trauma history.
 Presence of a diagnosis does not prove any
particular trauma.
PTSD
 A : Exposure to a trauma (tightly defined)
 B : Persistent reexperiencing
 C : Persistent avoidance and numbing
 D : Persistent increased arousal
 E : Duration over 1 month
 F : Clinically significant distress or impairment
Persistent re-experiencing
 Recurrent and distressing recollections, including
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images, thoughts or perceptions
Recurrent distressing dreams of the event
Acting or feeling as if the traumatic event were
recurring
Intense psychological distress at exposure to internal
or external cues that symbolise or resemble an
aspect of the trauma
Physiological reactivity on exposure to internal or
external cues that symbolise or resemble an aspect
of the trauma
Avoidance and Numbing
 Efforts to avoid thoughts, feelings or conversations
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associated with the trauma
Efforts to avoid activities, places or people that
arouse recollections of the trauma
Inability to recall an important aspect of the trauma
Markedly diminished interest or participation in
significant activities
Feeling of detachment or estrangement from others
Restricted range of affect (eg unable to have loving
feelings)
Sense of a foreshortened future (eg does not expect
to have a career, marriage, children, or a normal life
span)
Hyperarousal Symptoms
 Difficulty falling or staying asleep
 Irritability or outbursts of anger
 Difficulty concentrating
 Hypervigilance
 Exaggerated startle response
Dissociation
 “disruption in the usually integrated functions
of consciousness, identity, memory or
perception” (DSM-IV)
 often related to a history of extreme
interpersonal trauma (abuse/torture)
1. Peri-traumatic (implications for memory)
2. Dissociative flashbacks
3. Protective ‘spacing out’
 NOT under the individual’s control
Correlations
 Difficulty in disclosure positively associated
with higher levels of:
 PTSD
overall severity
 PTSD avoidance
 Shame
 Depression
 Dissociation
n=27; (Bogner, Herlihy & Brewin, 2007)
Dissociation
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“I tried to talk, but my mind kept
wandering off and I kept thinking about the
trauma
and
my
family
that
I
lost.
Everything seemed unreal to me, I felt like I
was dreaming. I found it hard to focus on
the interview and answer questions”
Lawyers ‘clinical’ decisions
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when do legal reps consider a MLR?
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knowledge of PTSD from training, experience
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own comfort levels
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categories assuming vulnerability e.g. rape
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‘anxious’ presentation of PTSD
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not depression
(Wilson-Shaw, Pistrang & Herlihy, 2012)
Depression
 Depressed mood most of the day, nearly every day
 Markedly diminished interest or pleasure in all or almost all
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activities
Significant weight or appetite change
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive/inappropriate guilt
Diminished ability to think or concentrate
Recurrent thoughts of death (not just suicide)
A Judicial comment…
 “In the case of country evidence, expert
evidence can be evaluated against other
material”
 “In contrast, there will be no similar breadth of
evidence to assist in the evaluation of expert
medical evidence”
Barnes (2004)
References
See
www.csel.org.uk/csel_publications
for links to the latest research from CSEL &
other relevant publications.