Abstract
BackgroundThe aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and PTSD; (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender.MethodsData from a cross-sectional and population-based study of a random sample of Syrian refugees (n = 1215) resettled in Sweden 2011˗2013 was analyzed within a Structural Equation Modeling (SEM) framework.ResultsOur results indicate adequate fit and gender invariance for a unidimensional model of ESSI. Exposure to torture was associated with lower social support (B = ˗0.22, p < 0.01) and with higher odds ratio (OR) for PTSD (OR 2.52, 95% Confidence interval (CI) 1.83˗3.40). Furthermore, higher social support was associated with less likelihood for PTSD (B = ˗0.56, p < 0.001). Social support partially mediated the effect of torture exposure on PTSD (OR 1.13, 95% bias corrected bootstrap CI 1.06˗1.26). Gender did not moderate this pattern.ConclusionThe results indicate that social support attenuates the link between torture exposure and PTSD, and may function as a protective factor for PTSD among both torture-exposed refugee men and women.
Highlights
The aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and Post-traumatic Stress Disorder (PTSD); (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender
The aim of this study is threefold: 1. To establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden
The main purpose of the present study was to assess whether post-resettlement social support among Syrian refugees acts as a potential mediator in the linkage between torture exposure and PTSD, and to examine the indication for social support as a protective factor that may attenuate the association between such a grave trauma exposure and its mental health consequences
Summary
The aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and PTSD; (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender. Experiences of Gottvall et al BMC International Health and Human Rights (2019) 19:28 torture is a strong predictor of mental ill health, especially symptoms of Post-traumatic Stress Disorder (PTSD) among refugee- and conflict-affected-populations [9]. According to a recent study of Syrian refugees in Sweden, about 30% of the participants reported that they had been exposed to torture. As expected, those who had been exposed to torture were approximately three times more likely to have clinical level symptoms of PTSD [11]. Given the gravity of consequences of torture and the alarming reported prevalence, identifying such protective factors in refugee populations are of immense importance. Increased knowledge about protective factors could contribute to more efficient efforts for providing supportive environments, and to improve treatment strategies for affected refugee populations
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