Abstract
Refugees and asylum-seekers are typically exposed to multiple potentially traumatic events (PTEs) in the context of war, persecution and displacement, which confer elevated risk for psychopathology. There are significant limitations, however, in extant approaches to measuring these experiences in refugees. The current study aimed to identify profiles of PTE exposure, and the associations between these profiles and key demographics, contextual factors (including ongoing stressors, method of travel to Australia and separation from family), mental health and social outcomes, in a large sample of refugees resettled in Australia. Participants were 1085 from Arabic, Farsi, Tamil and English-speaking refugee backgrounds who completed an online or pen-and-paper survey in their own language. Constructs measured included PTE exposure, demographics, pre-displacement factors, ongoing stressors, post-traumatic stress disorder symptoms, depression symptoms, anger reactions, plans of suicide and social engagement. Latent class analysis identified four profiles of PTE exposure, including the torture and pervasive trauma class, the violence exposure class, the deprivation exposure class and the low exposure class. Compared to the low exposure class, participants in the trauma-exposed classes were more likely to be male, highly educated, from Farsi and Tamil-speaking backgrounds, have travelled to Australia by boat, experience more ongoing stressors and report both greater psychological symptoms and social engagement. This study found evidence for four distinct profiles of PTE exposure in a large sample of resettled refugees, and that these were associated with different demographic, psychological and social characteristics. These findings suggest that person-centred approaches represent an important potential avenue for investigation of PTE exposure in refugees, particularly with respect to identifying subgroups of refugees who may benefit from different types or levels of intervention according to their pre-migration PTE experiences.
Highlights
Findings indicated that qualitatively different classes of potentially traumatic events (PTEs) exposure emerged from the data, and that these classes were associated with distinctive characteristics, experiences and mental health outcomes
A key finding from this study is that PTE profiles were strongly tied to personal characteristics and contextual factors, suggesting that there are particular groups who are especially vulnerable to polytrauma exposure
Australian immigration policy dictated that all refugees who travelled by boat to Australia without a valid visa during the data collection phase of the study were subsequently held in immigration detention or offshore processing centres (Parliament of Australia, 2013–2014), with this experience being associated with exposure to adverse events such as witnessing selfharm and physical assault, discrimination and lack of access to medical care (Steel et al, 2006)
Summary
Participants were 1085 individuals living in Australia who (a) were 18+ years, (b) were literate in Arabic, Farsi, Tamil or English (representing >50% of individuals granted refugee status in Australia between 2012 and 2015 (DIBP, 2014)), (c) arrived in Australia since January 2011 and (d) were from a refugee or asylum-seeking background. The second pathway involved arriving in Australia without a valid visa (often via boat), or holding a non-refugee visa and subsequently applying for refugee status (n = 260, 23.9%) These individuals often face lengthy processing periods and may only be granted temporary visas, which afford restricted access to services and support. Depression symptoms were measured using the 9-item Patient Health Questionnaire (Kroenke et al, 2001) Participants indicated on a 4-point scale (0 = not at all, 3 = nearly every day) how often they had been bothered by symptoms in the past 2 weeks. Social engagement was measured using the 10-item Short Social Capital Assessment Tool (SASCAT) (Harpham et al, 2002; De Silva et al, 2007) This scale measures the number of types of (1) group participants were active members of, (2) groups from which participants received emotional or economic assistance and (3) individuals from which participants received emotional or economic assistance in the past 12 months. A total count of the number of groups or individuals participants engaged within the past 12 months was created, ranging from 0 to 33
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