Abstract
Background: Longitudinal studies examining mental health trajectories in refugees and asylum seekers are scarce.
Objectives: To investigate trajectories of psychological symptoms and wellbeing in refugees and asylum seekers, and identify factors associated with these trajectories.
Method: 912 asylum seekers and refugees from the control arm of three trials in Europe (n = 229), Turkey (n = 320), and Uganda (n = 363) were included. We described trajectories of psychological symptoms and wellbeing, and used trauma exposure, age, marital status, education, and individual trial as predictors. Then, we assessed the bidirectional interactions between wellbeing and psychological symptoms, and the effect of each predictor on each outcome controlling for baseline values.
Results: Symptom improvement was identified in all trials, and for wellbeing in 64.7% of participants in Europe and Turkey, versus 31.5% in Uganda. In Europe and Turkey domestic violence predicted increased symptoms at post-intervention (ß = 1.36, 95% CI 0.17–2.56), whilst murder of family members at 6-month follow-up (ß = 1.23, 95% CI 0.27–2.19). Lower wellbeing was predicted by murder of family member (ß = −1.69, 95% CI −3.06 to −0.32), having been kidnapped (ß = −1.67, 95% CI −3.19 to −0.15), close to death (ß = −1.38, 95% CI −2.70 to −0.06), and being in the host country ≥2 years (ß = −1.60, 95% CI −3.05 to −0.14). In Uganda at post-intervention, having been kidnapped predicted increased symptoms (ß = 2.11, 95% CI 0.58–3.65), and lack of shelter (ß = −2.51, 95% CI −4.44 to −0.58) and domestic violence predicted lower wellbeing (ß = −1.36, 95% CI −2.67 to −0.05).
Conclusion: Many participants adapt to adversity, but contextual factors play a critical role in determining mental health trajectories.
Objectives: To investigate trajectories of psychological symptoms and wellbeing in refugees and asylum seekers, and identify factors associated with these trajectories.
Method: 912 asylum seekers and refugees from the control arm of three trials in Europe (n = 229), Turkey (n = 320), and Uganda (n = 363) were included. We described trajectories of psychological symptoms and wellbeing, and used trauma exposure, age, marital status, education, and individual trial as predictors. Then, we assessed the bidirectional interactions between wellbeing and psychological symptoms, and the effect of each predictor on each outcome controlling for baseline values.
Results: Symptom improvement was identified in all trials, and for wellbeing in 64.7% of participants in Europe and Turkey, versus 31.5% in Uganda. In Europe and Turkey domestic violence predicted increased symptoms at post-intervention (ß = 1.36, 95% CI 0.17–2.56), whilst murder of family members at 6-month follow-up (ß = 1.23, 95% CI 0.27–2.19). Lower wellbeing was predicted by murder of family member (ß = −1.69, 95% CI −3.06 to −0.32), having been kidnapped (ß = −1.67, 95% CI −3.19 to −0.15), close to death (ß = −1.38, 95% CI −2.70 to −0.06), and being in the host country ≥2 years (ß = −1.60, 95% CI −3.05 to −0.14). In Uganda at post-intervention, having been kidnapped predicted increased symptoms (ß = 2.11, 95% CI 0.58–3.65), and lack of shelter (ß = −2.51, 95% CI −4.44 to −0.58) and domestic violence predicted lower wellbeing (ß = −1.36, 95% CI −2.67 to −0.05).
Conclusion: Many participants adapt to adversity, but contextual factors play a critical role in determining mental health trajectories.
| Original language | English |
|---|---|
| Article number | 2128270 |
| Journal | European Journal of Psychotraumatology |
| Volume | 13 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 07 Oct 2022 |
Bibliographical note
Funding Information:This work was funded by the European Commission (grant agreement No. 779255; ‘RE-DEFINE: Refugee Emergency: DEFining and Implementing Novel Evidence-based psychosocial interventions'). Authors are grateful to the Department of Excellence (Dipartimento di Eccellenza) project, Department of Neuroscience, Biomedicine and Movement Sciences of the University of Verona. MP, CB, WT, and FT designed this study and drafted the protocol with inputs from PC and MS. All the authors contributed to the recruitment of participants, follow-up assessments, and/or commenting on/editing and revising the drafts of this work. FT, MP, WT and CB planned the statistical analyses. FT performed all of the statistical analyses with inputs from MP and CB.
Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Keywords
- asylum seekers
- Individual participant data analysis
- psychological symptoms
- refugees
- wellbeing
ASJC Scopus subject areas
- Psychiatry and Mental health
Access to Document
- Trajectories of psychosocial symptoms and wellbeing in asylum seekers and refugees exposed to traumatic events and resettled in Western Europe Turkey
Copyright 2022 the authors. This is an open access Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction for non-commercial purposes, provided the author and source are cited.