Abstract
Background: Refugee mental health is affected by traumatic stressors as well as post-migration living difficulties (PMLD). However, their interaction and causal pathways are unclear, and so far, no distinct treatment recommendations regarding exile-related stressors exist.Methods: In a 3-year follow-up study, PMLD and symptoms of post-traumatic stress (PTS), depression and anxiety were examined in a clinical sample of severely traumatized refugees and asylum seekers (N = 71).Results: In regression analysis, reduction in PMLD predicted changes over time in depression/anxiety, but not in PTS. The opposite models with PMLD changes as outcome variable proved not significant for PTS, and significant, though less predictive, for depression/anxiety.Conclusions: In addition to well-established trauma-focused interventions for the treatment of PTS, psychosocial interventions focusing on PMLD might contribute to a favorable treatment response in traumatized refugees, particularly with regard to depression and anxiety.
Highlights
There are currently over 65 million people displaced worldwide due to conflict, violence, and persecution [1]
This study investigated the association between change in posttraumatic stress disorder (PTSD), depression and anxiety symptoms and change in postmigration stressors in a sample of refugees receiving treatment at a torture survivors’ outpatient clinic
In order to examine directionality of findings, we analyzed the opposite models with PMLD changes as outcome variable, and change in PTSD and depression/anxiety as the predictor variables, which proved not to be significant [F(5, 64) = 1.300, p = 0.275] for PTSD, but significant for depression/anxiety [F(5, 64) = 3.086, p = 0.015], respectively, explaining 13.1% of the variance. This 3-year longitudinal study investigated the association between changes in symptoms of PTSD, depression/anxiety and changes in post-migration living difficulties (PMLD) in a sample of severely traumatized refugees receiving treatment and social counseling in a specialized outpatient center
Summary
There are currently over 65 million people displaced worldwide due to conflict, violence, and persecution [1]. Asylum-seekers and other forcibly displaced populations typically report exposure to a high number of potentially traumatic events in their countries of origin and during displacement These experiences are often prolonged, repeated, and interpersonal in nature and have a pervasive negative impact on mental health [2, 3]. Refugees usually face numerous daily challenges related to the post-migration environment, including those relating to lack of resources, family separation, social isolation, acculturation and discrimination, socioeconomic factors, and immigration and refugee policies These displacement-related stressors have been shown to Living Difficulties Predict Treatment Outcome negatively impact on mental health over and above the effects of traumatic experiences [5, 7,8,9]. Their interaction and causal pathways are unclear, and so far, no distinct treatment recommendations regarding exile-related stressors exist
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