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Internally Displaced “Victims of Armed Conflict” in Colombia: The Trajectory and Trauma Signature of Forced Migration |
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| Authors: | James M Shultz Dana Rose Garfin Zelde Espinel Ricardo Araya Maria A Oquendo Milton L Wainberg Roberto Chaskel Silvia L Gaviria Anna E Ordóñez Maria Espinola Fiona E Wilson Natalia Muñoz García Ángela Milena Gómez Ceballos Yanira Garcia-Barcena Helen Verdeli Yuval Neria |
| Institution: | 1. Center for Disaster & Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine, Miami, FL, 33136, USA 17. 251 174 St. #2319, Sunny Isles Beach, FL, USA 2. Department of Psychology and Social Behavior, University of California, Irvine, Irvine, CA, USA 3. Department of Psychiatry and Behavioral Health, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, FL, 33136, USA 4. Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK 5. Department of Psychiatry, Columbia University & The New York State Psychiatric Institute, New York, NY, USA 6. Global Mental Health T32 Research Fellowship, Department of Psychiatry, Columbia University & The New York State Psychiatric Institute, New York, NY, USA 7. Child and Adolescent Psychiatry, Fundación Santa Fe de Bogotá, Hospital Militar Central, Universidad El Bosque, Universidad de Los Andes, Bogota, Colombia 8. Department of Psychiatry, Universidad CES, Medellín, Colombia 9. Child Psychiatry Branch, National Institute of Mental Health (NIMH)/National Institutes of Health (NIH), Bethesda, MD, USA 10. McLean Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA 11. Department of Clinical & Health Psychology, University of Edinburgh, Edinburgh, Scotland, UK 12. Program in Clinical and Health Psychology, School of Social Sciences, Universidad de Los Andes, Bogota, Colombia 13. Program in Public Health, Schools of Medicine and Government, Universidad de Los Andes, Bogota, Colombia 14. Department of Health Informatics, Leonard M. Miller School of Medicine, Louis Calder Memorial Library, Miami, FL, USA 15. Teachers College and Department of Psychiatry, Columbia University & The New York State Psychiatric Institute, New York, NY, USA 16. Department of Psychiatry & Department of Epidemiology, Columbia University & The New York State Psychiatric Institute, New York, NY, USA |
| Abstract: | While conflict-induced forced migration is a global phenomenon, the situation in Colombia, South America, is distinctive. Colombia has ranked either first or second in the number of internally displaced persons for 10 years, a consequence of decades of armed conflict compounded by high prevalence of drug trafficking. The displacement trajectory for displaced persons in Colombia proceeds through a sequence of stages: (1) pre-expulsion threats and vulnerability, (2) expulsion, (3) migration, (4) initial adaptation to relocation, (5) protracted resettlement (the end point for most forced migrants), and, rarely, (6) return to the community of origin. Trauma signature analysis, an evidence-based method that elucidates the physical and psychological consequences associated with exposures to harm and loss during disasters and complex emergencies, was used to identify the psychological risk factors and potentially traumatic events experienced by conflict-displaced persons in Colombia, stratified across the phases of displacement. Trauma and loss are experienced differentially throughout the pathway of displacement. |
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