dr jane herlihy clinical and research psychologist director, centre for the study of emotion and law...

Dr Jane Herlihy Clinical and Research Psychologist

Director, Centre for the Study of Emotion and Law

Psychological evidence and refugee protection

© Centre for the Study of Emotion and Law 2012

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”

Centre for the Study of Emotion and Law

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

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 interviewfree recall 15 questionscentral/peripheral rating

Second interviewpromptsame 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

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

0.45

Non-Traumatic Traumatic

Peripheral

Central

Herlihy, Scragg & Turner (2002)

Discrepant Memories II

00.050.1

0.150.2

0.250.3

0.350.4

0.450.5

Short Delay Long Delay

High PTSD

Low PTSD

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

PTSD9% of 6743 refugees in western countries

Depression – very co-morbid4-6%

(Fazel, Wheeler, & Danesh, 2005)

“Refugees based in western countries could be about ten times more likely than the age-matched 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 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 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

“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

when do legal reps consider a MLR?

knowledge of PTSD from training, experience

own comfort levels

categories assuming vulnerability e.g. rape

‘anxious’ presentation of PTSD

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

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)

See

www.csel.org.uk/csel_publications

for links to the latest research from CSEL & other relevant publications.

References