ORCID Profile
0000-0001-9171-4209
Current Organisation
University of Maryland at College Park
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Public Health and Health Services | Health and Community Services | Health, Clinical and Counselling Psychology | Psychology | Social and Community Psychology
Ethnicity, Multiculturalism and Migrant Development and Welfare | Specific Population Health (excl. Indigenous Health) not elsewhere classified | Families and Family Services |
Publisher: American Psychological Association (APA)
Date: 02-2023
DOI: 10.1037/TRA0001217
Abstract: Emotion regulation (ER) may be an important psychological mechanism underpinning the development, and management, of posttraumatic stress disorder (PTSD) in refugees. Despite this, little is known about the ER strategies that refugees spontaneously deploy under stress, nor how effective different approaches may be at reducing distress. This was the first study to identify in idual differences in patterns of spontaneous ER among refugees and explore their unique associations with negative affect and PTSD. Spontaneous reappraisal and suppression use was measured among 82 refugees following a 5-min exposure to trauma-salient images. Negative affect was indexed before and after the exposure task. Latent profile analysis (LPA) was conducted to identify distinct profiles of participants based on differing levels of ER use. LPA revealed two distinct profiles: a high ER variability profile (37% high suppression/moderate-high reappraisal) and a low ER variability profile (63% low suppression/moderate reappraisal). The low ER variability profile was associated with increased negative affect during the experimental paradigm, greater PTSD avoidance symptoms, and greater likelihood of insecure visa status compared with the high ER variability profile. Our findings suggest that a more variable ER approach in response to trauma-salient stressors results in lower distress and is associated with less severe PTSD symptoms. Better understanding the links between patterns of ER strategy use and psychopathology has important implications for the development of effective treatments for refugees. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Publisher: Cambridge University Press (CUP)
Date: 2021
DOI: 10.1017/S2045796021000068
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 s le 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 s le 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.
Publisher: Informa UK Limited
Date: 11-09-2019
Publisher: Cambridge University Press (CUP)
Date: 27-09-2016
DOI: 10.1017/S0033291716002361
Abstract: Although perceived social support is thought to be a strong predictor of psychological outcomes following trauma exposure, the temporal relationship between perceived positive and negative social support and post-traumatic stress disorder (PTSD) symptoms has not been empirically established. This study investigated the temporal sequencing of perceived positive social support, perceived negative social support, and PTSD symptoms in the 6 years following trauma exposure among survivors of traumatic injury. Participants were 1132 trauma survivors initially assessed upon admission to one of four Level 1 trauma hospitals in Australia after experiencing a traumatic injury. Participants were followed up at 3 months, 12 months, 24 months, and 6 years after the traumatic event. Latent difference score analyses revealed that greater severity of PTSD symptoms predicted subsequent increases in perceived negative social support at each time-point. Greater severity of PTSD symptoms predicted subsequent decreases in perceived positive social support between 3 and 12 months. High levels of perceived positive or negative social support did not predict subsequent changes in PTSD symptoms at any time-point. Results highlight the impact of PTSD symptoms on subsequent perceived social support, regardless of the type of support provided. The finding that perceived social support does not influence subsequent PTSD symptoms is novel, and indicates that the relationship between PTSD and perceived social support may be unidirectional.
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.JANXDIS.2014.11.004
Abstract: Confirmatory factor analytic studies of the latent structure of DSM-5 PTSD symptoms using self-report data (Elhai et al., 2012 Miller et al., 2013) have found that the four-factor model implied by the DSM-5 diagnostic criteria provided adequate fit to their data. However, the fit of this model is yet to be assessed using data derived from gold standard structured interview measures. This study evaluated the fit of the DSM-5 four-factor model and an alternative four-factor model in 570 injury survivors six years post-injury using the Clinician Administered PTSD Scale (Blake et al., 1990), updated to include items measuring new DSM-5 symptoms. While both four-factor models fitted the data well, very high correlations between the 'Intrusions' and 'Avoidance' factors in both models and between the 'Negative Alterations in Cognitions and Mood' and 'Arousal and Reactivity' factors in the DSM-5 model and the 'Dysphoria' and 'Hyperarousal' factors in the alternative model were evident, suggesting that a more parsimonious two-factor model combining these pairs of factors may adequately represent the latent structure. Such a two-factor model fitted the data less well according to χ(2) difference testing, but demonstrated broadly equivalent fit using other fit indices. Relationships between the factors of each of the four-factor models and the latent factors of Fear and Anxious-Misery/Distress underlying Internalizing disorders (Krueger, 1999) were also explored, with findings providing further support for the close relationship between the Intrusion and Avoidance factors. However, these findings also suggested that there may be some utility to distinguishing Negative Alterations in Cognition and Mood symptoms from Arousal and Reactivity symptoms, and/or Dysphoria symptoms from Hyperarousal symptoms. Further studies are required to assess the potential discriminant validity of the two four-factor models.
Publisher: SAGE Publications
Date: 29-05-2023
DOI: 10.1177/00048674231177950
Abstract: In response to growing numbers of refugees worldwide, host governments are increasingly implementing temporary protection policies however, little is known regarding the mental health impact of these policies. This online longitudinal study investigated whether refugees who transitioned from low visa security (e.g. short-term transient visas) to medium (e.g. temporary protection visas) or high visa (e.g. permanent visas) security showed changes in depression symptoms, social difficulties and immigration-related fears. Participants were 1,201 refugees and asylum-seekers from Arabic, Farsi, Tamil or English-speaking backgrounds. Study variables were measured prior to and after change in visa status (6 months apart). Refugees who transitioned from low to medium security visas showed reduced immigration-related fear ( B = −0.09, 95% confidence interval = −0.29 to −0.06), but no change in depression symptoms or social difficulties compared to those who retained low visa security. Refugees who transitioned from low to high security visas showed reduced depression symptoms ( B = −0.02, 95% confidence interval = −0.04 to −0.01), social difficulties ( B = −0.04, 95% confidence interval = −0.05 to −0.01) and immigration-related fear ( B = −0.03, 95% confidence interval = −0.06 to −0.01) compared to those who retained low visa security. Findings indicate that the increased security afforded by temporary protection policies (vs short-term transient visas) did not translate into improved mental health and social outcomes for refugees. In contrast, permanent protection was associated with significant improvements in psychological and social functioning. These results have important policy implications for countries who have committed to protect and facilitate improved mental health among refugees.
Publisher: Cambridge University Press (CUP)
Date: 30-08-2016
DOI: 10.1017/S2045796016000317
Abstract: Grief symptoms and a sense of injustice may be interrelated responses amongst persons exposed to mass conflict and both reactions may contribute to post-traumatic stress disorder (PTSD) symptoms. As yet, however, there is a dearth of data examining these relationships. Our study examined the contributions of grief and a sense of injustice to a model of PTSD symptoms that included the established determinants of trauma events, ongoing adversity and severe psychological distress. The study involved a large population s le ( n = 2964, response rate: 82.4%) surveyed in post-conflict Timor-Leste. The survey sites included an urban administrative area (suco) in Dili, the capital of Timor-Leste and a rural village located an hour's drive away. Culturally adapted measures were applied to assess conflict related traumatic events (TEs), ongoing adversity, persisting preoccupations with injustice, symptoms of grief, psychological distress (including depressive symptoms) and PTSD symptoms. We tested a series of structural equation models, the final comprehensive model, which included indices of grief symptoms and injustice, producing a good fit. Locating grief symptoms as the endpoint of the model produced a non-converging model. In the final model, strong associations were evident between grief and injustice ( β = 0.34, s.e. = 0.02, p 0.01) and grief and PTSD symptoms ( β = 0.14, s.e. = 0.02, p 0.01). The sense of injustice exerted a considerable effect on PTSD symptoms ( β = 0.13, s.e. = 0.03, p 0.01). In addition, multiple indirect paths were evident, most involving grief and a sense of injustice, attesting to the complex inter-relationship of these factors in contributing to PTSD symptoms. Our findings support an expanded model of PTSD symptoms relevant to post-conflict populations, in which grief symptoms and a sense of injustice play pivotal roles. The model supports the importance of a focus on loss, grief and a sense of injustice in conducting trauma-focused psychotherapies for PTSD amongst populations exposed to mass conflict and violence. Further research is needed to identify the precise mechanisms whereby grief symptoms and the sense of injustice impact on PTSD symptoms.
Publisher: Cambridge University Press (CUP)
Date: 24-05-2017
DOI: 10.1017/S0033291717000472
Abstract: Prolonged separation from parental support is a risk factor for psychopathology. This study assessed the impact of brief separation from parents during childhood trauma on adult attachment tendencies and post-traumatic stress. Children ( n = 806) exposed to a major Australian bushfire disaster in 1983 and matched controls ( n = 725) were assessed in the aftermath of the fires (mean age 7–8 years) via parent reports of trauma exposure and separation from parents during the fires. Participants ( n = 500) were subsequently assessed 28 years after initial assessment on the Experiences in Close Relationships scale to assess attachment security, and post-traumatic stress disorder (PTSD) was assessed using the PTSD checklist. Being separated from parents was significantly related to having an avoidant attachment style as an adult ( B = −3.69, s.e. = 1.48, β = −0.23, p = 0.013). Avoidant attachment was associated with re-experiencing ( B = 0.03, s.e. = 0.01, β = 0.31, p = 0.045), avoidance ( B = 0.03, s.e. = 0.01, β = 0.30, p = 0.001) and numbing ( B = 0.03, s.e. = 0.01, β = 0.30, p 0.001) symptoms. Anxious attachment was associated with re-experiencing ( B = 0.03, s.e. = 0.01, β = 0.18, p = 0.001), numbing ( B = 0.03, β = 0.30, s.e. = 0.01, p 0.001) and arousal ( B = 0.04, s.e. = 0.01, β = 0.43, p 0.001) symptoms. These findings demonstrate that brief separation from attachments during childhood trauma can have long-lasting effects on one's attachment security, and that this can be associated with adult post-traumatic psychopathology.
Publisher: Physicians Postgraduate Press, Inc
Date: 14-04-2015
DOI: 10.4088/JCP.14M09075
Publisher: Royal College of Psychiatrists
Date: 05-2015
DOI: 10.1192/BJP.BP.114.145516
Abstract: Traumatic injuries affect millions of patients each year, and resulting post-traumatic stress disorder (PTSD) significantly contributes to subsequent impairment. To map the distinctive long-term trajectories of PTSD responses over 6 years by using latent growth mixture modelling. Randomly selected injury patients ( n = 1084) admitted to four hospitals around Australia were assessed in hospital, and at 3, 12, 24 and 72 months. Lifetime psychiatric history and current PTSD severity and functioning were assessed. Five trajectories of PTSD response were noted across the 6 years: (a) chronic (4%), (b) recovery (6%), (c) worsening/recovery (8%), (d) worsening (10%) and (e) resilient (73%). A poorer trajectory was predicted by female gender, recent life stressors, presence of mild traumatic brain injury and admission to intensive care unit. These findings demonstrate the long-term PTSD effects that can occur following traumatic injury. The different trajectories highlight that monitoring a subset of patients over time is probably a more accurate means of identifying PTSD rather than relying on factors that can be assessed during hospital admission.
Publisher: Informa UK Limited
Date: 30-04-2023
Publisher: Springer Science and Business Media LLC
Date: 10-05-2016
Publisher: SAGE Publications
Date: 04-05-2018
Abstract: It is unclear which specific symptoms of post-traumatic stress disorder are related to poor perceived quality of life. To investigate the influence of post-traumatic stress disorder symptomatology on quality of life in traumatic injury survivors. Traumatic injury survivors completed questionnaires on post-traumatic stress disorder symptomatology and quality of life at 3 months ( n = 987), 12 months ( n = 862), 24 months ( n = 830) and 6 years ( n = 613) post trauma. Low quality of life was reported by 14.5% of injury survivors at 3 months and 8% at 6 years post event. The post-traumatic stress disorder symptom clusters that contributed most to poor perceived quality of life were numbing and arousal, the in idual symptoms that contributed most were anger, hypervigilance and restricted affect. There was variability in the quality of life of traumatic injury survivors in the 6 years following trauma and a consistent proportion reported low quality of life. Early intervention to reduce anger, hypervigilance and restricted affect symptoms may provide a means to improving the quality of life of traumatic injury survivors.
Publisher: Oxford University Press (OUP)
Date: 03-2018
DOI: 10.1093/IJRL/EEY017
Publisher: Royal College of Psychiatrists
Date: 03-2015
DOI: 10.1192/BJP.BP.114.150078
Abstract: The latent structure of the proposed ICD-11 post-traumatic stress disorder (PTSD) symptoms has not been explored. To investigate the latent structure of the proposed ICD-11 PTSD symptoms. Confirmatory factor analyses using data from structured clinical interviews administered to injury patients ( n = 613) 6 years post-trauma. Measures of disability and psychological quality of life (QoL) were also administered. Although the three-factor model implied by the ICD-11 diagnostic criteria fit the data well, a two-factor model provided equivalent, if not superior, fit. Whereas diagnostic criteria based on this two-factor model resulted in an increase in PTSD point prevalence (5.1% v. 3.4% z = 2.32, P .05), they identified in iduals with similar levels of disability ( P = 0.933) and QoL ( P = 0.591) to those identified by the ICD-11 criteria. Consistent with theorised reciprocal relationships between re-experiencing and avoidance in PTSD, these findings support an alternative diagnostic algorithm requiring at least two of any of the four re-experiencing/avoidance symptoms and at least one of the two hyperarousal symptoms.
Publisher: Elsevier BV
Date: 05-2018
Publisher: Physicians Postgraduate Press, Inc
Date: 27-12-2017
DOI: 10.4088/JCP.16M10729
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.PSYCHRES.2010.12.015
Abstract: Policies of deterrence, including the use of detention and temporary visas, have been widely implemented to dissuade asylum seekers from seeking protection in Western countries. The present study examined the impact of visa status change on the mental health of 97 Mandaean refugees resettled in Australia. At the time of the first survey (2004), 68 (70%) participants held temporary protection visas (TPVs) and 29 (30%) held permanent residency (PR) status, whereas by the second survey (2007), 97 (100%) participants held PR status. We tested a meditational model to determine whether the relationship between change in visa status and change in psychological symptoms was mediated by change in living difficulties associated with the visa categories. The conversion of visa status from TPV to PR status was associated with significant improvements in PTSD and depression symptoms, and increases in mental health-related quality of life (MHR-QOL). The relationship between change in visa status and reduced PTSD and depression symptoms was mediated by reductions in living difficulties. In contrast, the relationship between change in visa status and increased MHR-QOL was not mediated by changes in living difficulties. These results suggest that restriction of rights and access to services related to visa status negatively affect the mental health of refugees. Implications for government policies regarding refugees are discussed.
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.JAD.2013.06.006
Abstract: There is growing research interest in understanding and analyzing explosive forms of anger. General epidemiological studies have focused on the DSM-IV category of Intermittent Explosive Disorder (IED), while refugee and post-conflict research have used culturally-based indices of explosive anger. The aim of this study was to test the convergence of a culturally-sensitive community measure of explosive anger with a structured clinical interview diagnosis of IED in Timor-Leste, a country with a history of significant mass violence and displacement. A double-blind clinical concordance study was conducted amongst a stratified community s le in post-conflict Timor-Leste (n=85) to compare a community measure of anger against the Structured Clinical Interview (SCID) module for IED. Clinical concordance between the two measures was high: the area under the curve (AUC) index was 0.90 (95% CI: 0.83-0.98) sensitivity and specificity were 93.3% and 87.5% respectively. Response rates were modest due to the participant's time commitments. It is possible to achieve convergence between culturally-sensitive measures of explosive anger and the DSM-IV construct of IED, allowing comparison of findings across settings and populations.
Publisher: Wiley
Date: 25-01-2011
DOI: 10.1002/JTS.20608
Abstract: Although the impact of human rights violations on the mental health of refugees has been well documented, little is known about these effects at a family level. In this study the authors examined the relationships among loss, trauma, and mental health at the in idual and family levels in resettled Mandaean refugees (N = 315). Trauma, loss, posttraumatic stress disorder, depression, complicated grief, and mental health-related quality of life were assessed. A multilevel path analysis revealed that loss and trauma significantly impacted on psychological outcomes at both the in idual and family levels. Effect sizes ranged from .21 to .68 at the in idual level, and .38 to .99 at the family level, highlighting the importance of the family when considering the psychological impact of refugee-related trauma.
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.CPR.2010.10.004
Abstract: Despite much research evidence that refugees suffer from elevated rates of posttraumatic stress disorder (PTSD), relatively few studies have examined the effectiveness of psychological treatments for PTSD in refugees. The field of refugee mental health intervention is dominated by two contrasting approaches, namely trauma-focused therapy and multimodal interventions. This article firstly defines these two approaches, then provides a critical review of 19 research studies that have been undertaken to investigate the efficacy of these treatments. Preliminary research evidence suggests that trauma-focused approaches may have some efficacy in treating PTSD in refugees, but limitations in the methodologies of studies caution against drawing definitive inferences. It is clear that research assessing the treatment of PTSD in refugees is lagging behind that available for other traumatized populations. The review examines important considerations in the treatment of refugees. A theoretical framework is offered that outlines contextual issues, maintaining factors, change mechanisms and the distinctive challenges to traditional trauma-focused treatments posed by the needs of refugees with PTSD.
Publisher: SAGE Publications
Date: 28-04-2019
Abstract: The number of refugees worldwide is unprecedented in recent history. Little is known, however, about profiles of psychological symptoms following persecution and displacement. This study reports on a latent class analysis that identified profiles of posttraumatic stress disorder (PTSD), depression and anxiety symptoms in a nationally representative s le of 1625 refugees in Australia. The association between specific symptom profiles, exposure to potentially traumatic events and post-migration stressors, and overall health and help-seeking was examined. Latent class analysis yielded an optimal five-class solution. These classes comprised the Pervasive Symptom class (19.2%), the High PTSD Symptom class (17.1%), the High Depression/Anxiety Symptom class (16.4%), the Moderate PTSD Symptom class (16.2%) and the Low Symptom class (31.1%). Participants in the symptomatic classes were more likely to be female, older and report greater post-migration stressors than those in the Low Symptom class. In addition, in iduals in classes characterized by PTSD symptoms had been exposed to more types of potentially traumatic events. Membership in symptomatic classes was associated with poorer overall heath and greater help-seeking. Qualitatively distinct symptom profiles were observed in a nationally representative s le of refugees. In addition to a group of people who reported high symptoms across psychological disorders and may warrant clinical intervention, we identified two subclinical classes who may be missed by existing diagnostic classification systems. Post-migration stressors play an important role in influencing refugee symptom profiles over and above exposure to potentially traumatic events. Clinicians should consider specific symptom profiles and contextual factors when planning interventions with refugees.
Publisher: Elsevier BV
Date: 05-2014
Publisher: Springer Science and Business Media LLC
Date: 09-04-2014
Publisher: Wiley
Date: 07-08-2009
Publisher: Cambridge University Press (CUP)
Date: 30-08-2018
DOI: 10.1017/S0033291718002246
Abstract: The mental health and social functioning of millions of forcibly displaced in iduals worldwide represents a key public health priority for host governments. This is the first longitudinal study with a representative s le to examine the impact of interpersonal trust and psychological symptoms on community engagement in refugees. Participants were 1894 resettled refugees, assessed within 6 months of receiving a permanent visa in Australia, and again 2–3 years later. Variables measured included post-traumatic stress disorder symptoms, depression/anxiety symptoms, interpersonal trust and engagement with refugees’ own and other communities. A multilevel path analysis was conducted, with the final model evidencing good fit (Comparative Fit Index = 0.97, Tucker–Lewis Index = 0.89, Root Mean Square Error of Approximation = 0.05, Standardized Root-Mean-Square-Residual = 0.05). Findings revealed that high levels of depression symptoms were associated with lower subsequent engagement with refugees’ own communities. In contrast, low levels of interpersonal trust were associated with lower engagement with the host community over the same timeframe. Findings point to differential pathways to social engagement in the medium-term post-resettlement. Results indicate that depression symptoms are linked to reduced engagement with one's own community, while interpersonal trust is implicated in engagement with the broader community in the host country. These findings have potentially important implications for policy and clinical practice, suggesting that clinical and support services should target psychological symptoms and interpersonal processes when fostering positive adaptation in resettled refugees.
Publisher: Wiley
Date: 02-2019
DOI: 10.1002/JTS.22371
Abstract: Refugees who suffer from posttraumatic stress disorder (PTSD) often react with strong emotions when confronted with trauma reminders. In this study, we aimed to investigate the associations between low emotion regulation capacity (as indexed by low heart rate variability [HRV]), probable PTSD diagnosis, and fear and anger reaction and recovery to trauma-related stimuli. Participants were 81 trauma-exposed refugees (probable PTSD, n = 23 trauma-exposed controls, n = 58). The experiment comprised three 5-min phases: a resting phase (baseline) an exposition phase, during which participants were exposed to trauma-related images (stimulus) and another resting phase (recovery). We assessed HRV at baseline, and fear and anger were rated at the end of each phase. Linear mixed model analyses were used to investigate the associations between baseline HRV and probable DSM-5 PTSD diagnosis in influencing anger and fear responses both immediately after viewing trauma-related stimuli and at the end of the recovery phase. Compared to controls, participants with probable PTSD showed a greater increase in fear from baseline to stimulus presentation, d = 0.606. Compared to participants with low emotion regulation capacity, participants with high emotion regulation capacity showed a smaller reduction in anger from stimulus presentation to recovery, d = 0.548. Our findings indicated that following exposure to trauma-related stimuli, probable PTSD diagnosis predicted increased fear reactivity, and low emotion regulation capacity predicted decreased anger recovery. Impaired anger recovery following trauma reminders in the context of low emotion regulation capacity might contribute to the increased levels of anger found in postconflict s les.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2001
DOI: 10.1109/6046.923818
Publisher: Physicians Postgraduate Press, Inc
Date: 10-05-2016
DOI: 10.4088/JCP.15M09854
Publisher: Informa UK Limited
Date: 25-11-2022
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.JAD.2018.07.041
Abstract: Persistent complex bereavement disorder (PCBD) is a disorder of grief included in DSM-5 Section 3. Prolonged Grief Disorder (PGD) is a disorder of grief that will enter the forthcoming ICD-11. This study evaluated the factor structure, prevalence, and validity of disturbed grief as per DSM-5 and ICD-11. With data from a community s le (N =512), we used confirmatory factor analysis (CFA) to evaluate the fit of different factor models for PCBD and PGD, determined diagnostic rates for probable PCBD and PGD, and used sensitivity/specificity analyses to evaluate the performance of in idual items as indicators of PCBD and PGD. We calculated associations of PCBD-caseness and PGD-caseness with concurrently assessed symptoms of posttraumatic stress disorder (PTSD) and depression and, in a subset of 280 participants, with these same symptoms assessed one year later, to examine concurrent and predictive validity of PCBD and PGD. For PCBD-symptoms, a three-factor model with distinct factors of separation distress, reactive distress, and social/identity disruption fit the data well for PGD-symptoms a two-factor model with distinct separation distress symptoms and additional symptom (e.g., guilt, anger, blame) yielded acceptable model fit. Overall, items evidenced strong sensitivity and negative predictive power, and relatively poor specificity and positive predictive power. The prevalence of probable DSM-5 PCBD (6.4%) was significantly lower than the prevalence of ICD-11 PGD (18.0%). Both PCBD and PGD were significantly associated with concurrent overall grief, depression, and PTSD PCBD but not PGD was associated with symptoms one year beyond baseline. Limitations include our reliance on self-reported data and symptoms of PCBD and PGD being derived from two questionnaires. Findings provide preliminary evidence for the validity of both the PCBD and PGD constructs, albeit that prevalence rates of both constructs and predictive validity differ-which needs further scrutiny.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.CPR.2017.08.009
Abstract: Recent research has found that exposure to traumatic events may occur in certain patterns, rather than randomly. Person-centered analyses, and specifically latent class analysis, is becoming increasingly popular in examining patterns, or 'classes' of trauma exposure. This review aimed to identify whether there are consistent homogeneous subgroups of trauma-exposed in iduals, and the relationship between these trauma classes and psychiatric diagnosis. A systematic review of the literature was completed using the databases EMBASE, MEDLINE (PubMed) and PsycINFO. From an initial yield of 189, 17 studies met inclusion criteria. All studies identified a group of in iduals who had a higher likelihood of exposure to a wide range of traumas types, and this group consistently exhibited worse psychiatric outcomes than other groups. Studies differed in the nature of the other groups identified although there was often a class with high levels of sexual interpersonal trauma exposure, and a class with high levels of non-sexual interpersonal trauma. There was some evidence that risk for psychiatric disorder differed across these classes. Person-centered approaches to understanding the relationship between trauma exposure and mental health may offer ways to improve our understanding of the role trauma exposure plays in increasing vulnerability to psychiatric disorder.
Publisher: Elsevier BV
Date: 02-2018
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.JPSYCHIRES.2009.08.006
Abstract: The current study aimed to evaluate the impact of fear for family remaining in the country of origin and under potential threat on the mental health of refugees. Adult Mandaean refugees (N=315) from Iraq, living in Sydney, Australia, were interviewed regarding fear for family in Iraq, fear of genocide, pre-migration trauma, post-migration living difficulties and psychological outcomes. Participants with immediate family in Iraq reported higher levels of symptoms of PTSD and depression, and greater mental health-related disability than those without family in Iraq. Intrusive fears about family independently predicted risk of PTSD, depression and disability after controlling for trauma exposure and current living difficulties. Threat to family members living in a context of ongoing threat predicted psychopathology and disability in Mandaean refugees. The effect of ongoing threat to family still living in conflict-ridden countries on the mental health of refugees should be further considered in the context of healthcare.
Publisher: Informa UK Limited
Date: 2021
Publisher: Hindawi Limited
Date: 10-08-2018
DOI: 10.1002/DA.22787
Abstract: Refugees are often exposed to multiple traumatic experiences, leading to elevated rates of psychological disorders. There is emerging evidence that appraisals of traumatic events as violating deeply held moral beliefs and frameworks (i.e., moral injury) impact negatively on refugee mental health. Despite this, no research has systematically investigated moral injury appraisals in refugees. Participants were 222 refugees from erse backgrounds who had recently resettled in Australia. They completed measures of mental health in Arabic, Farsi, Tamil, or English through an online survey. This study first investigated the factor structure of the Moral Injury Appraisals Scale (MIAS), and then examined the relationship between the moral injury factors and key predictor (age, gender, trauma exposure) and outcome (Posttraumatic stress disorder [PTSD] symptom clusters, anger, and depression) variables. Confirmatory factor analyses of the MIAS supported a two-factor model, comprising a Moral Injury-Other (MI-Other) factor (i.e., interpreting the violation as being enacted by others) and a Moral Injury-Self (MI-Self) factor (i.e., interpreting the violation as being enacted by oneself). Structural equation modeling analyses indicated that both factors were predicted by higher trauma exposure, and both predicted more severe anger and depression. Notably, while MI-Other was associated with more severe PTSD, MI-Self was associated with lower levels of intrusions. These results suggest that there may be subtypes of moral injury appraisals that are associated with different mental health outcomes. These findings have potential implications for designing treatments that address the psychological impact of the refugee experience.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JAD.2018.02.010
Abstract: Although elevated rates of posttraumatic stress disorder (PTSD) have been well-documented in refugees, no study has investigated the heterogeneity of DSM-5 PTSD symptomatology in such populations. This study aimed to determine whether there are unique patterns of DSM-5 defined PTSD symptomatology in refugees, and investigate whether factors characteristic of the refugee experience, including trauma exposure and post-migration stress, predict symptom profiles. Participants were 246 refugees and asylum-seekers from an Arabic-, English-, Farsi-, or Tamil-speaking background who had been resettled in Australia. Participants completed measures of post-migration living difficulties, trauma exposure, PTSD symptoms and functional disability. Latent class analysis was used to identify PTSD symptom profiles, and predictors of class membership were elucidated via multinomial logistic regression. Four classes were identified: a high-PTSD class (21.3%), a high-re-experiencing/avoidance class (15.3%), a moderate-PTSD class (23%), and a no PTSD class (40.3%). Trauma exposure and post-migration stress significantly predicted class membership and classes differed in degree of functional disability. The current study employed a cross-sectional design, which precluded inferences regarding the stability of classes of PTSD symptomatology. This study provides evidence for distinct patterns of PTSD symptomatology in refugees. We identified a novel class, characterized by high-re-experiencing and avoidance symptoms, as well as classes characterized by pervasive, moderate, and no symptomatology. Trauma exposure and post-migration stress differentially contributed to the emergence of these profiles. In iduals with high and moderate probability of PTSD symptoms evidenced substantial disability. These results support conceptualizations of PTSD as a heterogeneous construct, and highlight the importance of considering sub-clinical symptom presentations, as well as the post-migration environment, in clinical contexts.
Publisher: American Psychological Association (APA)
Date: 05-05-2022
DOI: 10.1037/TRA0001275
Abstract: A prior study with people exposed to a traumatic event indicated that posttraumatic anger is a multidimensional construct that consists of five factors comprising anger at (a) the criminal justice system, (b) other people, (c) the self, and (d) a perpetrator and (e) a desire for revenge. Preliminary evidence shows that anger at the self and perpetrators is related to posttraumatic stress disorder (PTSD) symptoms. Expanding the focus from trauma victims to people exposed to a traumatic loss of a significant other, for ex le, due to road traffic accidents, may enhance our knowledge on factors that are amenable to change in the treatment of prolonged grief disorder (PGD) and PTSD. We examined the (a) factor structure of the 20-item Posttraumatic Anger Questionnaire in 209 Dutch people bereaved by road traffic accidents using confirmatory factor analysis and (b) associations between the posttraumatic anger factors and PGD and PTSD using structural equation models. The expected five-factor structure of the Posttraumatic Anger Questionnaire was supported. Anger at the self was related to greater PGD (β = .35) and PTSD (β = .50) symptoms over and above known risk factors of distress. A desire for revenge (β = .20) was uniquely and positively associated with PTSD symptoms. Pending replication of our findings in longitudinal studies, we conclude that anger subtypes relate differently to distress after traumatic loss. Anger toward the self seems the most detrimental type of anger and may therefore be an important target in treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Publisher: Royal College of Psychiatrists
Date: 09-2014
DOI: 10.1192/BJP.BP.113.135285
Abstract: There have been changes to the criteria for diagnosing post-traumatic stress disorder (PTSD) in DSM-5 and changes are proposed for ICD-11. To investigate the impact of the changes to diagnostic criteria for PTSD in DSM-5 and the proposed changes in ICD-11 using a large multisite trauma-exposed s le and structured clinical interviews. Randomly selected injury patients admitted to four hospitals were assessed 72 months post trauma ( n = 510). Structured clinical interviews for PTSD and major depressive episode, as well as self-report measures of disability and quality of life were administered. Current prevalence of PTSD under DSM-5 scoring was not significantly different from DSM-IV (6.7% v. 5.9%, z = 0.53, P = 0.59). However, the ICD-11 prevalence was significantly lower than ICD-10 (3.3% v. 9.0%, z =–3.8, P .001). The PTSD current prevalence was significantly higher for DSM-5 than ICD-11 (6.7% v. 3.3%, z = 2.5, P = 0.01). Using ICD-11 tended to show lower rates of comorbidity with depression and a slightly lower association with disability. The diagnostic systems performed in different ways in terms of current prevalence rates and levels of comorbidity with depression, but on other broad key indicators they were relatively similar. There was overlap between those with PTSD diagnosed by ICD-11 and DSM-5 but a substantial portion met one but not the other set of criteria. This represents a challenge for research because the phenotype that is studied may be markedly different according to the diagnostic system used.
Publisher: American Medical Association (AMA)
Date: 12-2014
DOI: 10.1001/JAMAPSYCHIATRY.2014.1600
Abstract: Prolonged grief disorder (PGD) is a potentially disabling condition that affects approximately 10% of bereaved people. Grief-focused cognitive behavior therapy (CBT) has been shown to be effective in treating PGD. Although treatments for PGD have focused on exposure therapy, much debate remains about whether exposure therapy is optimal for PGD. To determine the relative efficacies of CBT with exposure therapy (CBT/exposure) or CBT alone for PGD. A randomized clinical trial of 80 patients with PGD attending the outpatient University of New South Wales Traumatic Stress Clinic from September 17, 2007, through June 7, 2010. All patients received 10 weekly 2-hour group therapy sessions that consisted of CBT techniques. Patients also received 4 in idual sessions, in which they were randomized to receive exposure therapy for memories of the death or supportive counseling. Measures of PGD by clinical interview and self-reported measures of depression, cognitive appraisals, and functioning at the 6-month follow-up. Intention-to-treat analyses at follow-up indicated a significant quadratic time×treatment condition interaction effect (B [SE], 0.49 [0.16] t120.16=3.08 [95% CI, 0.18-0.81] P=.003), indicating that CBT/exposure led to greater PGD reductions than CBT alone. At follow-up, CBT/exposure led to greater reductions in depression (B [SE], 0.35 [0.12] t112.65=2.83 [95% CI, 0.11-0.60] P=.005), negative appraisals (B [SE], 0.68 [0.25] t109.98=2.66 [95% CI, 0.17-1.18] P=.009), and functional impairment (B [SE], 0.24 [0.08] t111.40=3.01 [95% CI, 0.08-0.40] P=.003) than CBT alone. In terms of treatment completers, fewer patients in the CBT/exposure condition at follow-up (14.8%) met criteria for PGD than those in the CBT condition (37.9%) (odds ratio, 3.51 95% CI, 0.96-12.89 χ2=3.81 P=.04). Including exposure therapy that promotes emotional processing of memories of the death is an important component to achieve optimal reductions in PGD severity. Facilitating emotional responses to the death may promote greater changes in appraisals about the loss, which are associated with symptom reduction. Promotion of emotional processing techniques in therapies to treat patients with PGD is needed. anzctr.org.au Identifier: ACTRN12609000229279.
Publisher: Cambridge University Press (CUP)
Date: 19-08-2019
DOI: 10.1017/S2045796019000386
Abstract: Despite the frequency that refugees suffer bereavement, there is a dearth of research into the prevalence and predictors of problematic grief reactions in refugees. To address this gap, this study reports a nationally representative population-based study of refugees to determine the prevalence of probable prolonged grief disorder (PGD) and its associated problems. This study recruited participants from the Building a New Life in Australia (BNLA) prospective cohort study of refugees admitted to Australia between October 2013 and February 2014. The current data were collected in 2015–2016, and comprised 1767 adults, as well as 411 children of the adult respondents. Adult refugees were assessed for trauma history, post-migration difficulties, probable PGD, post-traumatic stress disorder (PTSD) and mental illness. Children were administered the Strengths and Difficulties Questionnaire. In this cohort, 38.1% of refugees reported bereavement, of whom 15.8% reported probable PGD this represents 6.0% of the entire cohort. Probable PGD was associated with a greater likelihood of mental illness, probable PTSD, severe mental illness, currently unemployed and reported disability. Children of refugees with probable PGD reported more psychological difficulties than those whose parents did not have probable PGD. Probable PGD was also associated with the history of imprisonment, torture and separation from family. Only 56.3% of refugees with probable PGD had received psychological assistance. Bereavement and probable PGD appear highly prevalent in refugees, and PGD seems to be associated with disability in the refugees and psychological problems in their children. The low rate of access to mental health assistance for these refugees highlights that there is a need to address this issue in refugee populations.
Publisher: Informa UK Limited
Date: 15-12-2019
Publisher: Cambridge University Press (CUP)
Date: 02-12-2020
DOI: 10.1017/S0033291720004262
Abstract: Refugees report a erse array of psychological responses following persecution and displacement. Little is known, however, regarding the mechanisms that underlie differential psychological reactions in refugees. This study investigated the longitudinal impact of negative moral appraisals about one's own actions [i.e. moral injury-self (MI-self) appraisals] and others' actions [i.e. moral injury-other (MI-others) appraisals] on a variety of psychological symptoms over a period of 6 months. Participants were 1085 Arabic, Farsi, Tamil, or English-speaking refugees who completed a survey at baseline and 6 months later either on-line or via pen-and-paper. The survey indexed demographic factors, exposure to potentially traumatic events (PTEs), exposure to ongoing stressors, MI-other appraisals, MI-self appraisals, re-experiencing and arousal symptoms, and feelings of sadness, anger and shame. Findings indicated that, after controlling for demographics, PTE exposure and ongoing stressors, MI-other appraisals predicted increased re-experiencing and hyperarousal symptoms, and feelings of sadness and shame. MI-self appraisals predicted decreased feelings of shame, and decreased re-experiencing symptoms. In contrast, psychological symptoms at baseline did not as strongly influence MI appraisals 6 months later. These findings highlight the important role that cognitive appraisals of adverse events play in the longitudinal course of psychological symptoms. These results thus have important implications for the development of tailored psychological interventions to alleviate the mental health burden held by refugees.
Publisher: Informa UK Limited
Date: 11-11-2019
Publisher: SAGE Publications
Date: 05-2017
Abstract: While cognitive reappraisal represents a promising emotion regulation strategy to assist refugees with posttraumatic stress disorder (PTSD) in managing responses to trauma reminders, there has been no experimental research investigating its efficacy in reducing intrusions and negative affect in this group. In this study, 76 refugees and asylum-seekers with varying levels of PTSD received instructions in cognitive reappraisal or emotional suppression before viewing emotional images depicting trauma-related scenes. Findings indicated that cognitive reappraisal led to fewer subsequent image-related intrusions in refugees high in PTSD symptoms. Trait suppression moderated the efficacy of cognitive reappraisal such that participants high in PTSD who had low levels of trait suppression reported significantly lower levels of negative affect when using cognitive reappraisal compared to emotional suppression. These findings highlight the potential utility of cognitive reappraisal when assisting in iduals with PTSD to manage responses trauma reminders and for informing the treatment of the psychological effects of the refugee experience.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.JANXDIS.2017.04.005
Abstract: This study investigated the conceptualization of emotion regulation difficulties in a s le of refugees with varying levels of posttraumatic stress (PTS), and examined whether specific emotion regulation difficulties were associated with PTS severity. Refugees were administered an abbreviated version of the Difficulties in Emotion Regulation Scale, the PTSD Symptom Scale - Interview Version, and the Harvard Trauma Questionnaire. Confirmatory Factor Analysis was used to examine model fit for the 6-factor model originally proposed by the developers of the DERS and the more recently proposed 5-factor model that excludes the awareness subscale. Both models displayed adequate fit. After controlling for age, gender, time in Australia, and trauma exposure, the clarity and strategies subscales were significantly associated with PTS severity. The association between impaired emotional clarity and reduced agency related to accessing regulation strategies and PTS severity in this refugee s le highlights the need for further research to assess interventions that target these disruptions in refugees.
Publisher: SAGE Publications
Date: 23-09-2019
Abstract: Disturbed grief, operationalized as persistent complex bereavement disorder (PCBD), correlates with yet differs from posttraumatic stress disorder (PTSD) and depression symptoms. However, knowledge about temporal associations among these symptoms is limited. We aimed to enhance our understanding of the etiology of loss-related distress by examining temporal associations among PCBD, PTSD, and depression symptom levels. Dutch people ( N = 172) who lost significant other(s) in a plane disaster completed questionnaires for PCBD, PTSD, and depression 11, 22, 31, and 42 months after the disaster. Cross-lagged analyses revealed that changes in PCBD symptom levels have a greater impact on changes in symptom levels of PTSD and depression than vice versa. Our findings contradict the notion that PTSD and depression symptoms should be addressed before grief in treatment. Pending replication of our findings in clinical s les, we tentatively conclude that screening and treatment of grief symptoms has potential value in preventing long-lasting distress.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.JPSYCHIRES.2016.08.011
Abstract: Despite unprecedented numbers of migrants internationally, little is known about the mental health needs of immigrant groups residing in common countries of resettlement. The majority of studies support the 'healthy migrant hypothesis', but few studies have examined: 1) shifts in prevalence patterns across generations 2) how prevalence relates to disability in immigrant groups. Our study examined the prevalence of common mental disorders and disability in first and second generation migrants to Australia. Twelve-month and lifetime prevalence rates of affective, anxiety, and substance use disorders were obtained from the Australian National Survey of Mental Health and Wellbeing (N = 8841). First generation immigrants (born overseas) and second generation immigrants (both parents overseas) from non-English and English speaking backgrounds were compared to an Australian-born cohort. Disability was indexed by days out of role and the WHO Disability Assessment Schedule (WHODAS12). First generation immigrants with non-English speaking (1G-NE) backgrounds evidenced reduced prevalence of common mental disorders relative to the Australian-born population (adjusted odds ratio 0.5 [95% CI 0.38-0.66]). This lower prevalence was not observed in second generation immigrant cohorts. While overall levels of disability were equal between all groups (p > 0.05), mental health-related disability was elevated in the 1G-NE group relative to the Australian-born group (p = 0.012). The findings challenge the overarching notion of the "healthy migrant" and suggest a dissociation between reduced prevalence and elevated mental health-related disability amongst first generation immigrants with non-English speaking backgrounds. These findings highlight the heterogeneous psychiatric needs of first and second generation immigrants.
Publisher: Springer Science and Business Media LLC
Date: 23-05-2018
Publisher: Springer Science and Business Media LLC
Date: 04-09-2018
Publisher: Cambridge University Press (CUP)
Date: 2022
DOI: 10.1017/S2045796022000324
Abstract: Refugees typically spend years in a state of protracted displacement prior to permanent resettlement. Little is known about how various prior displacement contexts influence long-term mental health in resettled refugees. In this study, we aimed to determine whether having lived in refugee c s v. community settings prior to resettlement impacted the course of refugees' psychological distress over the 4 years following arrival in Australia. Participants were 1887 refugees who had taken part in the Building a New Life in Australia study, which comprised of five annual face-to-face or telephone surveys from the year of first arrival in Australia. Latent growth curve modelling revealed that refugees who had lived in c s showed greater initial psychological distress (as indexed by the K6) and faster decreases in psychological distress in the 4 years after resettling in Australia, compared to those who had lived in community settings. Investigation of refugee c characteristics revealed that poorer access to services in c s was associated with greater initial distress after resettlement, and greater ability to meet one's basic needs in c s was associated with faster decreases in psychological distress over time. These findings highlight the importance of the displacement context in influencing the course of post-resettlement mental health. Increasing available services and meeting basic needs in the displacement environment may promote better mental health outcomes in resettled refugees.
Publisher: SAGE Publications
Date: 13-10-2022
DOI: 10.1177/15346501221133315
Abstract: The prevalence of post-traumatic stress disorder (PTSD) in in iduals affected by war and conflict is high, with approximately 1 in 3 refugees and asylum-seekers meeting diagnostic criteria for PTSD. PTSD in refugees and asylum-seekers is associated with significant emotion dysregulation which may arise from chronic trauma exposure and post-migration stressors and lead to impaired day-to-day functioning. There is evidence that treatments that target emotion regulation skills prior to implementing exposure-based therapies lead to improved treatment response and reduced attrition in survivors of interpersonal traumas such as sexual abuse. The current case study details the use of a novel adaptation of one such treatment – Skills Training in Affective and Interpersonal Regulation for refugees and asylum-seekers (STAIR-R). In this case study, we report on the implementation of STAIR-R in combination with Narrative Exposure Therapy (NET) with Sara, a 60-year-old Iraqi woman who presented with high levels of nightmares, avoidance and emotion dysregulation following exposure to war- and conflict-related trauma and post-migration stressors. In this case study, we explore the intersection of emotion regulation skills training (in STAIR-R) and exposure therapy (in NET), and the potential for this combined intervention to improve emotion regulation skills, enhance coping with post-migration stressors and facilitate engagement with exposure-based treatment for PTSD.
Publisher: MDPI AG
Date: 24-07-2019
Abstract: Rates of help-seeking for mental health problems are low amongst refugee communities, despite the high prevalence of PTSD reported amongst these in iduals. Research suggests that the key barriers to seeking help for psychological problems include structural barriers (e.g., unstable housing), cultural barriers (e.g., mental health stigma), and barriers specific to refugees and asylum seekers (e.g., visa status). This study examined the effect of structural, cultural and refugee specific barriers on the relationship between PTSD symptom severity and intentions to seek help from professional, social, and community sources. Data was collected from 103 male refugees and asylum seekers with an Arabic-, Farsi-, or Tamil-speaking background. Participants completed measures indexing demographics, trauma exposure, PTSD symptoms, mental health stigma, and help-seeking intentions. Path analyses indicated that PTSD severity was associated with lower help-seeking intentions indirectly via mental health stigma (self-stigma for seeking help and self-stigma for PTSD) and visa security. PTSD severity was also associated with greater help-seeking intentions from community members indirectly via structural barriers. These findings are important to consider when identifying key barriers to mental health help-seeking and developing interventions designed to increase help-seeking for psychological problems, within this group.
Publisher: Hindawi Limited
Date: 19-10-2018
DOI: 10.1002/DA.22850
Publisher: American Psychological Association (APA)
Date: 11-2014
DOI: 10.1037/A0037920
Abstract: Chronic alcohol abuse is a major public health concern following trauma exposure however, little is known about the temporal association between posttraumatic stress disorder (PTSD) symptoms and problem alcohol use. The current study examined the temporal relationship between PTSD symptom clusters (re-experiencing, effortful avoidance, emotional numbing, and hyperarousal) and problem alcohol use following trauma exposure. This study was a longitudinal survey of randomly selected traumatic injury patients interviewed at baseline, 3 months, 12 months, and 24 months following injury. Participants were 1,139 injury patients recruited upon admission from 4 Level 1 trauma centers across Australia. Participants were assessed using the Clinician Administered PTSD Scale and Alcohol Use Disorders Identification Test. Results indicated that high levels of re-experiencing, effortful avoidance, and hyperarousal symptoms at 12 months were associated with greater increases (or smaller decreases) in problem alcohol use between 12 and 24 months. Findings also suggested that high levels of problem alcohol use at 12 months were associated with greater increases (or smaller decreases) in emotional numbing symptoms between 12 and 24 months. These findings highlight the critical importance of the chronic period following trauma exposure in the relationship between PTSD symptoms and problem alcohol use.
Publisher: Wiley
Date: 21-02-2008
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.PSYCHRES.2016.05.048
Abstract: While clinical reports suggest that torture survivors may try to suppress their emotions during torture, little is known about the use of emotional suppression following torture. In this study, 82 refugees and asylum-seekers (including 33 torture survivors) completed self-report measures of trait suppression, PTSD symptoms and baseline negative affect before being exposed to images depicting scenes of interpersonal trauma. The use of suppression while viewing the images was indexed and negative affect was measured both immediately after viewing the images and following a five minute rest period. Findings indicated that torture survivors did not show higher rates of trait suppression or state emotional suppression during the experimental session compared to non-torture survivors. However, torture survivors who endorsed state suppression higher levels of distress, and this relationship was especially strong for those with more severe PTSD symptoms. In contrast, there was a negative relationship between state suppression and distress for non-torture survivors with high levels of PTSD symptoms. These findings suggest that, while torture exposure does not lead to greater use of suppression, it does influence the impact of suppression on emotional responses to stimuli.
Publisher: Wiley
Date: 21-10-2022
DOI: 10.1002/JTS.22885
Abstract: There is currently an unprecedented number of forcibly displaced people worldwide. Little is known, however, about how external stressors and internal coping strategies intersect to influence mental health in displaced refugees, particularly whether specific types of coping strategies are more or less effective across different levels of external stress. This study aimed to understand whether positive and negative internal coping strategies were differentially associated with mental health across high and low levels of external stressors in displaced refugees. Participants were 1,216 refugees living in Indonesia who completed an online survey indexing demographic characteristics, exposure to ongoing stressors, positive psychological coping strategies (i.e., cognitive flexibility, self‐efficacy, and hope), negative psychological coping strategies (i.e., rumination and intolerance of uncertainty), psychological symptoms (i.e., posttraumatic stress disorder, depression, and anxiety) and mental health‐related quality of life. Participants (27.3% female, M age = 30.52 years) were from Arabic‐, Farsi‐, Tamil‐, Somali‐, Dari‐, and English‐speaking backgrounds. Results of latent moderated structural equation modeling indicated that the association between negative psychological coping strategies and poorer mental health was stronger at higher levels of stress, whereas the association between positive psychological coping strategies and better quality of life was stronger at lower levels of stress. These findings provide evidence in support of tailored approaches that integrate interventions addressing external stressors and internal coping strategies to support positive mental health and enhanced quality of life in displaced refugees.
Publisher: Springer Science and Business Media LLC
Date: 20-07-2016
DOI: 10.1007/S11920-016-0723-0
Abstract: Refugees demonstrate high rates of post-traumatic stress disorder (PTSD) and other psychological disorders. The recent increase in forcible displacement internationally necessitates the understanding of factors associated with refugee mental health. While pre-migration trauma is recognized as a key predictor of mental health outcomes in refugees and asylum seekers, research has increasingly focused on the psychological effects of post-migration stressors in the settlement environment. This article reviews the research evidence linking post-migration factors and mental health outcomes in refugees and asylum seekers. Findings indicate that socioeconomic, social, and interpersonal factors, as well as factors relating to the asylum process and immigration policy affect the psychological functioning of refugees. Limitations of the existing literature and future directions for research are discussed, along with implications for treatment and policy.
Location: United States of America
Start Date: 07-2018
End Date: 12-2023
Amount: $739,083.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2022
End Date: 12-2025
Amount: $837,040.00
Funder: Australian Research Council
View Funded ActivityStart Date: 09-2016
End Date: 09-2019
Amount: $568,000.00
Funder: Australian Research Council
View Funded Activity