Abstract
BackgroundRefugees and asylum seekers are frequently exposed to violence, human rights violations and unstable living conditions before, during, and after their displacement. Elevated prevalence rates of psychiatric disorders in forcibly displaced persons are well documented. However, less is known about other problems related to common refugee experiences, such as embitterment, moral injury, and diminished self-efficacy, and how they are related to trauma exposure and post-migration living difficulties.MethodsA cross-sectional sample of 71 refugees and asylum seekers in treatment were examined regarding exposure to potentially traumatic events, post-migration living difficulties, moral injury appraisals, self-efficacy, and embitterment.ResultsElevated levels of embitterment were reported by 68% of participants. The regression analysis revealed that greater moral injury appraisals and low levels of self-efficacy were significantly associated with higher levels of embitterment.ConclusionThe results provide first insights into embitterment and associated factors in refugee populations. Furthermore, they highlight the significance of moral transgressions and low levels of self-efficacy emerging from displacement and traumatic experiences for the development of mental health problems in a clinical sample of refugees. The findings have implications for future research, policy development and clinical practice.
Highlights
Refugees and asylum seekers are frequently exposed to violence, human rights violations and unstable living conditions before, during, and after their displacement
The analysis revealed that moral injury appraisals, as well as general self-efficacy levels were significant predictors of embitterment (F(4,70) = 9.40, p < 0.01)
The model proved to be significant and accounted for 32.4% of the variance. This exploratory cross-sectional study examined the role of embitterment and its association with trauma exposure, post-migration living difficulties, moral injury, and self-efficacy in a clinical sample of traumatized refugees and asylum seekers
Summary
Refugees and asylum seekers are frequently exposed to violence, human rights violations and unstable living conditions before, during, and after their displacement. Less is known about other problems related to common refugee experiences, such as embitterment, moral injury, and diminished self-efficacy, and how they are related to trauma exposure and post-migration living difficulties. Preliminary evidence shows that, among others, moral injury, loss of control, self-efficacy, pain, attachment problems, and prolonged grief are associated with psychological impairment in refugees [19,20,21,22,23,24,25,26]. Despite this evidence, the interrelation of these aspects and their therapeutic value is poorly understood
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