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Transcultural Psychiatry
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The `Multiplex Model' of Somatic Symptoms: Application to Tinnitus among Traumatized Cambodian Refugees

Devon E. Hinton

Harvard Medical School, devon_hinton{at}hms.harvard.edu

Susan D. Hinton

Harvard Medical School

Reattidara J.-R. Loeum

Arbour Counseling, Lowell

Vuth Pich

Arbour Counseling, Lowell

Mark H. Pollack

Harvard Medical School

Somatic symptoms are a common clinical presentation of distress among ethnic populations in the USA, particularly traumatized refugees. In this article, we apply a `multiplex model' of bodily experience to explain how a somatic symptom is evoked, amplified, and generates distress, particularly distress related to post-traumatic stress disorder. We illustrate the multiplex model's applicability to acute episodes of tinnitus (i.e., a buzzing-like sound in the ear) among Cambodian refugees, a common symptom in that group. The article demonstrates the importance of carefully examining somatic symptoms and associated meanings in distressed ethnic populations, especially traumatized refugees, and aims to contribute to a medical anthropology of somatic symptoms.

Key Words: anxiety • Cambodian refugees • catastrophic cognitions • posttraumatic stress disorder • somatization • tinnitus

Transcultural Psychiatry, Vol. 45, No. 2, 287-317 (2008)
DOI: 10.1177/1363461508089768
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[Abstract] [PDF]