Abstract
BackgroundResettled refugees exposed to trauma and loss are at risk to develop mental disorders such as posttraumatic stress disorder (PTSD) and persistent complex bereavement disorder (PCBD). Post-migration stressors have been linked to poor mental health and smaller treatment effects.AimOur aim was to evaluate reductions in PTSD and PCBD symptoms and to explore the presence of post-migration stressors and their associations with symptom change and non-completion in a traumatic grief focused treatment in a cohort of refugees.MethodsPaired sample t-tests were used to test the significance of the symptom reductions in PTSD and PCBD symptoms during treatment. The presence of post-migration stressors was derived from a qualitative analysis of the patient files. Associations between post-migration stressors and symptom reductions as well as non-completion were calculated.ResultsIn this uncontrolled study, 81 files of consecutive patients were included. Significant reductions in both PCBD and PTSD symptomatology with medium effect sizes were found. Patients experienced a mean of three different post-migration stressors during the treatment. Undocumented asylum seekers were more likely to be non-completers. Ongoing conflict in the country of origin was associated with smaller PTSD symptom reductions and the total number of post-migration stressors was associated with smaller PCBD symptom reductions.ConclusionsTreatment for resettled refugees for traumatic grief coincides with alleviations in both PCBD and PTSD symptomatology. Specific post-migration stressors were associated with reduced treatment effects and increased non-completion. This is a first step towards well-informed improvements of mental health interventions for resettled refugees.
Highlights
Resettled refugees in Western countries commonly have been exposed to traumatic and loss events due to armed conflicts, persecution and/or natural disasters in their countries of origin [1, 2]
Ongoing conflict in the country of origin was associated with smaller posttraumatic stress disorder (PTSD) symptom reductions and the total number of post-migration stressors was associated with smaller persistent complex bereavement disorder (PCBD) symptom reductions
We evaluated reductions in PCBD and PTSD symptoms during a traumatic grief focused treatment in a treatment seeking clinical refugee sample
Summary
Resettled refugees in Western countries commonly have been exposed to traumatic and loss events due to armed conflicts, persecution and/or natural disasters in their countries of origin [1, 2]. In a first study with a naturalistic design among 16 consecutive patients, a treatment program for traumatic grief for refugees was found feasible and coincided with significant declines in PTSD symptoms [18]. While these results are promising, evaluation of the treatment in a larger cohort of patients, focusing on changes in both PTSD and PCBD symptoms, is needed. Resettled refugees exposed to trauma and loss are at risk to develop mental disorders such as posttraumatic stress disorder (PTSD) and persistent complex bereavement disorder (PCBD). Post-migration stressors have been linked to poor mental health and smaller treatment effects
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