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'The ghost pushes you down': sleep paralysis-type panic attacks in a Khmer refugee population.

Devon E Hinton, Vuth Pich, Dara Chhean, Mark H Pollack

Transcultural Psychiatry March 1, 2005 DOI: 10.1177/1363461505050710 (opens in new tab)

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AI-extracted from the abstract
Characteristics Observational cross-sectional study Peer reviewed
Sample size 100
Population Cambodian refugees receiving psychiatric care
Topics Anxiety
Keywords Humans Sleep paralysis Spiritualism Middle aged Refugees Cambodia Female Surveys and questionnaires
Key findings Sleep paralysis was reported by 42% of Cambodian refugees in psychiatric care and was strongly associated with PTSD (67% of those with PTSD versus 22.4% of those without). All who experienced sleep paralysis also had panic attacks, and 91% saw an approaching being. The authors propose that cultural beliefs and trauma associations heighten the panic response and argue that sleep paralysis is a core aspect of this population's trauma response.

Abstract

Among a psychiatric population of Cambodian refugees (N = 100), 42% had current--i.e. at least once in the last year--sleep paralysis (SP). Of those experiencing SP, 91% (38/42) had visual hallucinations of an approaching being, and 100% (42/42) had panic attacks. Among patients with post-traumatic stress disorder (PTSD; n = 45), 67% (30/45) had SP, whereas among those without PTSD, only 22.4% (11/45) had SP (chi2 = 20.4, p < .001). Of the patients with PTSD, 60% (27/45) had monthly episodes of SP. The Cambodian panic response to SP seems to be greatly heightened by elaborate cultural ideas--with SP generating concerns about physical status, 'good luck' status, 'bad luck' status, sorcery assault, and ghost assault--and by trauma associations to the figure seen in SP. Case vignettes illustrate cultural beliefs about, and trauma resonances of, SP. A model to explain the high rate of SP in this population is presented. SP is a core aspect of the Cambodian refugees response to trauma; when assessing Cambodian refugees, and traumatized refugees in general, clinicians should assess for its presence.

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