Preliminary studies of trauma and psychiatric sequelae among West African refugees have revealed the need to develop West African-sensitive assessment instruments. This article addresses the results of the first stage of such a process which involved two focus group discussions with nine traditional Mandinka practitioners. Various dimensions of the diagnoses required to adequately reflect the range of refugee experience are presented. Such dimensions include diagnostic labels, idioms of distress, causes, source, and seriousness. The findings of this pilot study suggest that the impact of trauma such as experienced by refugees is so complex that a unitary diagnostic label is insufficient.
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