Prevalence of complex post-traumatic stress disorder in survivors of human trafficking and modern slavery: a systematic review

Author: Evans, Harriet; Sadhwani, Sahnu; Singh, Neil; Robjant, Katy & Katona, Cornelius

Abstract: The human rights violation of human trafficking and modern slavery could be described as multiple and prolonged traumatisation. This corresponds to the type of trauma identified as most likely to be associated with ‘complex post-traumatic stress disorder’ (CPTSD) as identified in the new 11th edition of the International Classification of Diseases (ICD-11). This review aims to collate the evidence of complex post-traumatic stress disorder in populations that have been trafficked, with the intention to highlight important considerations to be made in terms of managing survivor's health care needs and minimising further traumatisation. Five databases were searched using key terms related to human trafficking, modern slavery, and complex post-traumatic stress disorder. Five studies reporting on a total of 342 participants were included in the review. These studies indicated that an average of 41% of survivors of modern slavery and human trafficking had CPTSD. This was higher than the 14% diagnosed with PTSD. Post-trafficking stress, endured whilst living in refugee camps, was higher in individuals with CPTSD than in those living with PTSD. Healthcare was more difficult to access by populations with PTSD and CPTSD compared to those with no diagnosis. There is a high prevalence of CPTSD in modern slavery and trafficking survivors therefore a need for identification and specialised treatment. Consideration should be given to consequent biopsychosocial needs, particularly access to healthcare and minimisation of post-trafficking stress.

Keywords: complex post-traumatic stress disorder, human trafficking, modern slavery, prevalence