Psychological Distress in Afghan Refugees: A Mixed-Method Systematic Review

Abstract

Mental health problems disproportionately affect Afghan refugees and asylum seekers who continue to seek international protection with prolonged exposure to war. We performed a systematic review aimed at synthesizing peer-reviewed literature pertaining to mental health problems among Afghans resettled in industrialized nations. We used five databases to identify studies published between 1979 and 2013 that provided data on distress levels, and subjective experiences with distress. Seventeen studies met our inclusion criteria consisting of 1 mixed-method, 7 qualitative, and 9 quantitative studies. Themes from our qualitative synthesis described antecedents for distress being rooted in cultural conflicts and loss, and also described unique coping mechanisms. Quantitative findings indicated moderate to high prevalence of depressive and posttraumatic symptomatology. These findings support the need for continued mental health research with Afghans that accounts for: distress among newly resettled groups, professional help-seeking utilization patterns, and also culturally relevant strategies for mitigating distress and engaging Afghans in research.

Gendered Sources of Distress and Resilience among Afghan Refugees in Northern California: A Cross-Sectional Study

“…Previous work on refugees and Afghan refugees has found this same pattern [21,22]. [34], found that for Southeast Asians, 10 years after relocating to Canada, low English ability was associated with depression for women but not men.…”

Transdiagnostic culturally adapted CBT with Farsi-speaking refugees: a pilot study

“…CA CBT has been evaluated for various ethnic groups but not for Afghan refugees (Hinton et al, 2005, 2009; Jalal et al, 2017), and to our knowledge this is the first treatment study with a Farsi-speaking refugee sample outside Afghanistan. Due to specific cultural barriers in the utilization of psychotherapy (Alemi et al, 2016; Yaser et al, 2016) and the high comorbidity of PTSD with other trauma-related disorders (Alemi et al, 2014) in refugees, CA CBT is conceptualized as a low-threshold transdiagnostic treatment programme.…”

Discrimination and Distress among Afghan Refugees in Northern California: The Moderating Role of Pre- and Post-Migration Factors

“…Our measure of discrimination captured the degree of unfair treatment and marginalization that Afghans perceive, which is concerning given that such acts may further hinder opportunities in social and economic spheres, already known to play a significant role in determining the mental health of Afghan refugees [5]. Importantly, perceived discrimination has a stronger mental health impact on individuals with higher pre-resettlement traumatic experiences in our sample (confirming our third hypothesis), an interplay of variables that is largely understudied in previous research, but here, speaking directly for the vulnerability of this population.…”

“…Research on the mental health of Afghans [5], and of many other refugee nationalities has focused on the influences of pre-migration traumas [6] and post-resettlement factors such as ethnic ties, social support, socio-economic and cultural adjustment difficulties, and difficulty with immigration officials [7][8][9].While not a central focus of this line of research, several studies assess the impact of perceived discrimination on refugee health and mental health [10][11].…”