PUB - Publikationen an der Universität Bielefeld

Studies of immigrant populations have shown that the stresses associated with the process of immigration and acculturation could lead to significant psychological, psychiatric or somatic symptoms. In the current presentation, we review four cases of patients who developed Dissociative Disorders (Dissociative Amnesia and Ganser Syndrome, respectively) on a background of stresses related to immigration. The patients were investigated psychiatrically, medically, neurologically and by neuropsychological methods. All four patients developed severe psychiatric dissociative symptoms after objectively minor stresses that involved accidents (physical injuries) of mild severity, which occurred several years after the patients had immigrated to the new country of residence. The neuropsychological profile of these patients revealed certain similar characteristics, such as executive functioning deficits (such as limited cognitive flexibility) and impairments of emotional processing. Although no firm conclusions can be drawn based on the limited number of case reports, we propose that chronic psycho-social stresses related to immigration and acculturation could lead to Dissociative Disorders in certain immigrant populations via a dysregulation of the hormonal stress responses ("allostatic load"), which is mediated by factors related to pre-migration experiences, cultural affiliations and individual characteristics, such as cognitive flexibility, emotional processing abilities, language skills and competence and explanatory model of illness.