Citation

Hinton DE, Pich V, Marques L, Nickerson A, Pollack MH. Cult. Med. Psychiatry 2010; 34(2): 244-278.

Affiliation

Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, WACC 812, Boston, MA, 02114, USA, devon_hinton@hms.harvard.edu.

Copyright

(Copyright © 2010, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s11013-010-9174-y

PMID

20407813

Abstract

Traumatized Cambodian refugees with PTSD often complain of khyal attacks. The current study investigates khyâl attacks from multiple perspectives and examines the validity of a model of how khyâl attacks are generated. The study found that khyal attacks had commonly been experienced in the previous 4 weeks and that their severity was strongly correlated with the severity of PTSD (PTSD Checklist). It was found that khyâl attacks were triggered by various processes-such as worry, trauma recall, standing up, going to a mall-and that khyâl attacks almost always met panic attack criteria. It was also found that during a khyal attack there was great fear that death might occur from bodily dysfunction. It was likewise found that a complex nosology of khyal attacks exists that rates the attacks on a scale of severity, that the severity determines how the khyâl attacks should be treated and that those treatments are often complex. As illustrated by the article, khyal attacks constitute a key aspect of trauma ontology in this group, a culturally specific experiencing of anxiety and trauma-related disorder. The article also contributes to the study of trauma somatics, that is, to the study of how trauma results in specific symptoms in a specific cultural context, showing that a key part of the trauma-somatic reticulum is often a cultural syndrome.

Language: en