Family conflict mediates the relationship between past violence and wellbeing among female refugees

Abstract

Abstract Background Past exposure to violence has been suggested to have a lasting effect on subjective well being (SWB). Similarly, family conflict is another known predictor of SWB. Research shows that refugee women exposed to gender based violence (GBV) before resettlement may also face post-resettlement family conflicts due to socio-cultural factors, changes in social network and migration-based shifting gender roles. This study examines the role of family conflict as a likely mediator between past exposure to violence and SWB among Syrian refugee women in Sweden. Methods A total of 452 women out of a random sample of 1215 Syrian refugee women in Sweden responded to a questionnaire survey in Arabic. Variables include Past violence i.e. exposure to any of torture, physical or sexual violence preflight or during flight before arriving Sweden; Post-resettlement distressing family conflicts i.e. feeling disrespected or unimportant in the family or distressing conflicts; SWB was measured by WHO-5 wellbeing index. Maximum likelihood estimation with Robust standard errors and bias corrected bootstrapped 95% confidence intervals for all estimates. Results Total effect of past violence on SWB was significant (Estimate = -6.63; CI= -12.73 - -0.46). Similarly, family conflicts were associated with decreased SWB (Estimate = -3.80; CI= -5.17 - -2.40), and past violence exposure increased family conflicts (Estimate = 0.57; 0.13 - 1.08). The total effect of violence exposure on decreased SWB was decomposed into a direct and an indirect effect (mediated via family conflicts). The indirect effect via family conflicts was significant (M= -2.19; C1= -4.30 - 0.59), while decomposing rendered the direct effect non-significant (Estimate= -4.44, CI= -10.51 - 1.52). Conclusions Post-resettlement distressing family conflicts mediate the effect of prior exposure to violence on reduced SWB among refugee women. Key messages Past violence exposure reduces refugee women’s SWB via aggravated family conflicts implying the need for family targeted interventions to improve SWB of female refugees previously exposed to violence. Strategies to improve subjective wellbeing among female refugees should include screening for and addressing all forms of previous and ongoing GBV.