A network analysis of postmigration living difficulties in refugees and asylum seekers

Abstract

Background The prevalence of mental disorders among asylum seekers and refugees is elevated compared to the general population. The importance of post-migration living difficulties (PMLDs), stressors faced after displacement, has recently been recognized due to research demonstrating their moderating role of on mental health outcomes. Traditionally, PMLDs were investigated as count variables or latent variables, disregarding plausible interrelationships among them. Objectives To use network analysis to investigate the associations among PMLDs. Methods Based on a cross-sectional measurement of seventeen PMLDs in a clinical sample of traumatized asylum seekers and refugees ( N = 151), a partial correlation network was estimated, and its characteristics assessed. Results The network consisted of 71 of the 120 possible edges. The strongest edge was found between ‘Communication difficulties’ and ‘Discrimination’. ‘Loneliness, boredom, or isolation’ had highest predictability. Conclusion Our finding of an association between communication difficulties and discrimination has been documented before and is of importance given the known negative impact of discrimination on mental and physical health outcomes. The high predictability of isolation is indicative of multiple associations with other PMLDs and highlights its importance among the investigated population. Our results are limited by the cross-sectional nature of our study and the relatively modest sample size.

The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis

“…These emotions may accompany many interpersonal situations in everyday life or during the asylum process in which language comprehension or the ability to express oneself as well as actively respond to the environment through language is limited. And, as previously reported, might be associated with an increased risk of discrimination [ 32 ]. We hypothesise that these mentioned feelings, combined with a reduced ability to respond actively, and reinforced by affective dysregulation , may trigger re-experiencing.…”

“…While several studies have already examined the complex interplay of the individual symptoms of PTSD [ 28 ] and CPTSD [ 29 – 32 ], and generalisability has been examined in various samples with different characteristics and cultural backgrounds [ 29 , 30 ], there is only one initial study investigating how individual PMLDs are related to each other [ 32 ]. Overall, there is a lack of knowledge on how external variables influence network structure and dynamics in psychopathology [ 23 , 32 , 33 ].…”

Knowledge of legal rights as a factor of refugee and asylum seekers’ health status: a qualitative study

“…Participants received a $60 USD gift card for their time and travel on completion of the interview, as has been done previously in our own studies and in multiple qualitative studies with refugees and asylum seekers in highincome countries. [45][46][47][48][49][50][51][52][53] The audio-recorded interviews were transcribed verbatim. Identifying information was removed from each transcript and then saved on a secure server.…”

“…36 37 39 40 All participants were provided a gift card to remove any monetary barriers to participation related to missing work obligations and incurring expenses while travelling to the interview site. [45][46][47][48][49][50][51][52][53] This compensation mechanism could have introduced participation bias. Thus, the characteristics of participants may differ from those who chose not to participate (e.g., age, employment).…”

Long-term effectiveness of Self-Help Plus in refugees and asylum seekers resettled in Western Europe: 12-month outcomes of a randomised controlled trial

“…Refugees and asylum seekers are exposed to multiple stressors and traumatic events occurring in their country of origin, before migration, and during the migration process (Steel et al ., 2009; Zimmerman et al ., 2011; Giacco, 2019). During the post-migration phase, in the host country of resettlement, additional stressors and traumatic events may also frequently occur (Porter and Haslam, 2005; Jannesari et al ., 2020; Wicki et al ., 2021). Exposure to such stressors and repeated traumatic events may spread over long periods of time, and increases the risk of developing mental disorders (Barbui et al ., 2020; Jannesari et al ., 2020; Nosè et al ., 2020; de Silva et al ., 2021; Jowett et al ., 2021).…”