Loneliness as a mediator of social relationships and health-related quality of life among refugees living in North Rhine-Westphalia, Germany

Belau, Matthias Hans; Becher, Heiko; Kraemer, Alexander

doi:10.1186/s12889-021-12303-5

Cited by 12 publications

(6 citation statements)

References 66 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There might be an interaction between these areas such as that a negative self-concept increases the risk of social withdrawal and in turn a lack of positive relational experiences reinforces the negative self-concept . Overall, refugees have a higher risk of loneliness and low social support, factors that have been repeatedly related to higher levels of mental distress [ 62 ], CPTSD [ 63 ] and lower quality of life [ 64 ]. Additionally, we suggest that numbness due to affective dysregulation and an associated reduced self-awareness or ability to engage in interpersonal relationships might further promote disturbances in relationships and a negative self-concept .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

Background Psychological distress due to the ongoing war, violence, and persecution is particularly common among Afghan asylum seekers and refugees. In addition, individuals face a variety of post-migration living difficulties (PMLDs). Complex posttraumatic stress symptoms are among the most common mental health problems in this population, and were associated with the overall burden of PMLDs. The complex interplay of posttraumatic symptoms has been investigated from a network perspective in previous studies. However, individuals are embedded in and constantly react to the environment, which makes it important to include external factors in network models to better understand the etiology and maintaining factors of posttraumatic mental health problems. PMLDs are a major risk factor for posttraumatic distress and considering their impact in interventions might improve response rates. However, the interaction of these external factors with posttraumatic psychopathological distress is not yet fully understood. Thus, we aimed to illuminate the complex interaction between PMLDs and CPTSD symptom clusters. Objective The main objective is the exploration of the network structure and the complex interplay of ICD-11 CPTSD symptom clusters and distinct forms of PMLDs. Method The symptom clusters of CPTSD and PMLDs were collected within a randomised controlled trial among 93 treatment-seeking Afghan asylum seekers and refugees via a fully structured face-to-face and interpreter assisted interview. Using a network analytical approach, we explored the complex associations and network centrality of the CPTSD symptom clusters and the PMLD factors: discrimination & socio-economical living conditions, language acquisition & barriers, family concerns, and residence insecurity. Results The results suggest direct links within and between the constructs (CPTSD, PMLD). Almost all PMLD factors were interrelated and associated to CPTSD, family concerns was the only isolated variable. The CPTSD symptom cluster re-experiencing and the PMLD factor language acquisition & barriers connected the two constructs. Affective dysregulation had the highest and avoidance the lowest centrality. Conclusions Re-experiencing and affective dysregulation have the strongest ties to PMLDs. Thus, these domains might explain the strong association of posttraumatic psychopathology with PLMDs and, consequently, prioritization of these domains in treatment approaches might both facilitate treatment response and reduce burden caused by PMLDs.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Social support has been identified as one of the most important risk factors for PTSD in non-refugee traumatized groups [90], but more studies in the present review reported its correlation with PGD. In individualistic host societies, refugees often experience loneliness, which has negative effects on health [95,96]. When the deceased was the major source of social support, building new relationships of trust and support may be especially difficult in a post-migration setting.…”

Section: Associated Factorsmentioning

confidence: 99%

Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: a systematic review

Lechner-Meichsner,

Comtesse,

Olk

2024

Confl Health

View full text Add to dashboard Cite

Background The number of refugees worldwide is at an all-time high with many being exposed to potentially traumatic events and the loss of loved ones. The 11th revision of the International Statistical Classification of Diseases and Related Health Problems now includes prolonged grief disorder and complex posttraumatic stress disorder and revised criteria for posttraumatic stress disorder. An overview of these stress-related disorders among people who have become refugees is therefore needed. Consequently, we conducted a systematic review to determine prevalence rates, comorbidities, and associated factors for each of the disorders. Method We systematically searched PubMed, Web of Science, and PsycArticles to identify studies that reported prevalence rates, predictors or associated factors, and/or comorbid mental disorders for either (1) prolonged grief disorder, (2) posttraumatic stress disorder, or (3) complex posttraumatic stress disorder among refugees. The selection process followed the PRISMA guidelines. Results A total of 36 studies met the inclusion criteria. Most of the studies were of high quality. There was substantial variation in prevalence rates by disorder, with prolonged grief ranging from 6 to 54%, posttraumatic stress disorder ranging from 0.4 to 80%, and complex posttraumatic stress disorder ranging from 3 to 74.6%. Pooled prevalence for posttraumatic stress disorder was estimated at 29.8% in treatment seeking samples and 9.92% in population samples. For complex posttraumatic stress disorder, it was estimated at 57.4% in treatment seeking samples and 7.8% in population samples. Posttraumatic stress disorder was among the most frequent comorbidities for prolonged grief disorder while depressive symptoms were the most frequently occurring co-morbidity across all three disorders. Sociodemographic variables, trauma exposure, and loss characteristics were associated with higher symptom severity. Postmigration living difficulties played an important role in prolonged grief and complex posttraumatic stress disorder. Conclusion The review revealed substantial differences in prevalence rates between the three studied disorders but underscored a very high prevalence of ICD-11 stress-related disorders among refugees. The identified associated factors point to subgroups that may be particularly at risk and establishes a foundational basis for targeted interventions and potential policy changes. Future research should incorporate longitudinal investigations and emphasize culturally sensitive assessments.

show abstract

“…Although social support has been identified as one of the most important risk factors for PTSD in non-refugee traumatized samples (79), more studies in the present review reported its correlation with PGD. In individualistic host societies, refugees often experience great loneliness which has negative effects on health (94,95). When the deceased was the major source of social support, building new relationships of trust and support may be especially difficult in a post-migration setting.…”

Section: Associated Factorsmentioning

confidence: 99%

Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: A systematic review

Lechner-Meichsner¹,

Comteße²,

Olk³

2023

Preprint

View full text Add to dashboard Cite

Background: The number of refugees worldwide is at an all-time high. The majority of refugees experience traumatic events and the death of loved ones. The 11th revision of the International Statistical Classification of Diseases and Related Health Problems now includes prolonged grief disorder and complex posttraumatic stress disorder and a revised guideline for posttraumatic stress disorder, and a joint overview of these stress-related disorders in refugees is needed. We therefore conducted a systematic review to determine prevalence rates, comorbidities, and associated factors. Method: We systematically searched PubMed, Web of Science, and PsycArticles to identify studies published in English that reported prevalence rates, predictors or associated factors, and/or comorbid mental disorders of at least one of the disorders in a refugee population. The selection process was based on the PRISMA guidelines, and independent raters assessed selection criteria and study quality. Results: 36 studies that were published between 2008 and 2022 met inclusion criteria. Most of the studies were of high quality. Pooled prevalence for posttraumatic stress disorder was 21.3%, and 36.8% for complex posttraumatic stress disorder. Prevalence rates ranged from 6% to 54% for prolonged grief, 0.4% to 80% for posttraumatic stress disorder, and 3% to 74.6% for complex posttraumatic stress disorder. Posttraumatic stress disorder was among the most frequent comorbidities for prolonged grief disorder and depressive symptoms co-occurred frequently for all three disorders. Sociodemographic variables, trauma exposure, and loss characteristics were associated with higher symptom severity. Postmigration factors played an important role in prolonged grief and complex posttraumatic stress disorder. Conclusion: Despite substantial variations in prevalence rates, the review underscored very high prevalence rates of stress-related disorders included in ICD-11 among refugees. The identified associated factors point to subgroups of refugees that may be particularly at risk and provide implications for specific interventions and policy changes. Future research should perform longitudinal investigations, emphasize culturally sensitive assessment, and study disorder-specific mechanisms.

show abstract

Loneliness as a mediator of social relationships and health-related quality of life among refugees living in North Rhine-Westphalia, Germany

Cited by 12 publications

References 66 publications

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

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

Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: a systematic review

Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: A systematic review

Contact Info

Product

Resources

About