Testing the pathway from pre-migration sexual violence to suicide-related risk among North Korean refugee women living in South Korea: do social networks matter?

Abstract

To examine the pathways from pre-migration sexual violence to suicide-related risk via the lack of important social networks among North Korean refugee women living in South Korea. As part of a larger study, cross-sectional social network data from 273 North Korean refugee women aged 19 or older (M = 41years; range = 19-69) were collected by self-reported surveys from April to May 2014 in South Korea. Snowball sampling was used for participant recruitment. We analyzed whether lack of network diversity and lack of kin ties mediated the association between pre-migration sexual violence and suicide-related risk in two multivariable mediation analyses. The prevalence of past-year suicide-related risk was 34.4% in our study sample, and 31.1% of the participants reported at least one type of pre-migration sexual violence. Pre-migration sexual violence was associated with increased suicide-related risk. Lack of network diversity (b = 0.03, 95% CI 0.01-0.07) and lack of kin ties (b = 0.03, 95% CI 0.01-0.08) partially mediated this association. Assessment of pre-migration sexual violence victimization needs to begin at an early stage of resettlement. Study findings highlight the urgent need to create suicide prevention programs that incorporate social network interventions, especially for North Korean refugee women who have experienced sexual violence during migration.