The Impacts of Contextual Factors on Psychosocial Wellbeing of Syrian Refugees: Findings from Turkey and the United States

Yalım, Aslı Cennet

doi:10.1080/01488376.2020.1717717

Cited by 11 publications

(17 citation statements)

References 51 publications

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“…At the community and societal level, we found that each additional postmigration stressor increased the odds of experiencing a mental health condition by 28–46%. This echoes similar findings in existing literature, where a strong association between postmigration stressors and mental health conditions have been highlighted [ 32 , 33 , 43 ]. These findings also highlight how necessary it is for service providers, healthcare agencies, and policy makers to address postmigration stressors when alleviating mental health conditions.…”

Section: Discussionsupporting

confidence: 91%

“…Other studies have found different postmigration stressors to be associated with mental health conditions [ 29 – 31 ], which may suggests an association with context- or country-specific factors. For example, a study of contextual factors and psychosocial wellbeing of Syrian refugees in Turkey and the United States found that the most pressing postmigration stressors to be related to employment and poverty in the Turkey sample, while communication difficulties, isolation, and boredom were found in the United States sample [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Common postmigration stressors associated with mental health conditions include poverty, poor employment opportunities, inadequate housing, language barriers, challenges with asylum-seeking process, loneliness and isolation, as well as discrimination from the host community [ 29 ]. A comparison study of Syrian refugees in Turkey and New York highlight how different postmigration living difficulties impact mental health, and emphasized the importance of context-specific factors [ 32 ]. In Jordan, a qualitative synthesis of humanitarian organization supporting Syrian refugees noted postmigration stressors such as lack of income, insecure housing, employment restrictions, loss of social support to exacerbate psychological distress among Syrian refugees [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Mental health of clinic-attending Syrian refugee women in Jordan: associations between social ecological risks factors and mental health symptoms

et al. 2022

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Background The mental health of refugee women is often affected by multiple risk factors in their social ecology. Assessing these risk factors is foundational in determining potential areas for intervention. We used the social ecological model to examine risk factors associated with self-reported mental health symptoms among clinic-attending Syrian refugee women in Jordan. We hypothesize that individual (older age, unmarried, have more children under 18, difficulty reading/writing with ease), interpersonal (intimate partner violence [IPV]), community and societal level risk factors (greater number of postmigration stressors), will be associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Methods We surveyed 507 women using a cross-sectional clinic-based systematic sampling approach between April and November 2018. We used multivariable regressions to examine associations between different risk factors in the social ecology on depression, anxiety, and PTSD. Additional multivariable regressions explored associations between specific postmigration stressors and mental health conditions. Results We found rates of depression among our sample to be 62.92%; anxiety 57.46%; and PTSD 66.21%. Our hypothesis was partially supported. At the individual level, age was directly associated with anxiety (aOR 1.04, 95% CI [1.02, 1.06]) and PTSD (aOR 1.03, 95% CI [1.01, 1.06]), while marriage decreased odds for depression (aOR 0.41, 95% CI [0.19, 0.92]) and PTSD (aOR 0.36, 95% CI [0.15, 0.87]). IPV was associated with depression (aOR 2.78, 95% CI [1.72, 4.47]); anxiety (aOR 3.30, 95% CI [2.06, 5.27]); and PTSD (aOR 5.49, 95% CI [3.09, 9.76]). Each additional community and societal risk factor (postmigration stressor) increased the odds for depression (aOR 1.32, 95% CI [1.22, 1.42]), anxiety (aOR 1.28, 95% CI [1.19, 1.39]), and PTSD (aOR 1.46, 95% CI [1.33, 1.60]). Conclusion Understanding social ecological risk factors associated with mental health conditions of Syrian refugee women is vital to addressing their mental health needs. IPV and postmigration stressors are consistently impactful with all mental health conditions. IPV resulted in the largest odds increase for all mental health conditions. Multilevel interventions are needed to address mental health risk factors at multiple levels of the social ecology.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mental health of clinic-attending Syrian refugee women in Jordan: associations between social ecological risks factors and mental health symptoms

et al. 2022

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Section: Resultsmentioning

confidence: 99%

“…Eleven papers investigated the effect of employment on anxiety ( Baranik et al, 2018 ; Birman, Simon, Chan, & Tran, 2014 ; Bogic et al, 2012 ; Carlsson et al, 2006 ; Hermansson et al, 2003 ; Hocking et al, 2015 ; Kim, 2016 ; Kim et al, 2011 ; Laban et al, 2005 ; Sonne et al, 2021 ; Yalim, 2020 ). Notably, a significant effect was found in the longitudinal studies ( Carlsson et al, 2006 ; Hermansson et al, 2003 ; Sonne et al, 2021 ), whereas the findings from the cross-sectional studies were mixed ( Baranik et al, 2018 ; Birman et al, 2014 ; Bogic et al, 2012 ; Hocking et al, 2015 ; Kim, 2016 ; Kim et al, 2011 ; Laban et al, 2005 ; Yalim, 2020 ). Anxiety was most frequently reported as part of the Hopkins Symptoms Checklist-25 ( Birman et al, 2014 ; Carlsson et al, 2006 ; Hermansson et al, 2003 ; Hocking et al, 2015 ; Sonne et al, 2021 ; Yalim, 2020 ) and short structured diagnostic interviews such as the Mini-International Neuropsychiatric Interview (MINI) ( Bogic et al, 2012 ), World Mental Health Composite International Diagnostic Interview ( Kim, 2016 ), and Composite International Diagnostic Interview (CIDI) ( Laban et al, 2005 ).…”

Section: Resultsmentioning

confidence: 99%

The relationship between employment and health for people from refugee and asylum-seeking backgrounds: A systematic review of quantitative studies

Lai

Due

Ziersch

2022

SSM - Population Health

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War exposure, post-traumatic stress symptoms and hair cortisol concentrations in Syrian refugee children

et al. 2022

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Altered secretion of cortisol, the primary effector of the hypothalamus–pituitary–adrenal axis, has been proposed as a means by which traumatic experiences compromise later mental health. However, despite the popularity of cortisol as a potential biomarker for stress and adversity, findings are inconsistent, and little is known about the impact of war-related trauma on stress physiology of children and adolescents. Here we aimed to evaluate the relationships between war exposure, current living conditions, hair cortisol concentrations (HCC) and post-traumatic stress disorder (PTSD) symptoms in a large cohort of Syrian refugee children and adolescents (6–18 years) and their caregiver. This longitudinal observational study assessed Syrian refugee children and adolescents in two waves, 1 year apart, within informal tented settlements in Lebanon. The relationships between war exposure, time since leaving Syria, PTSD symptoms and HCC were investigated using linear mixed-model regression utilising both waves of data collected (Y1: N = 1574, Y2: N = 923). Hair cortisol concentration was positively, but weakly associated with the number of war-related events experienced. This was limited to those who were at least 12 years old at the time of war exposure. Conversely, HCC decreased with time since leaving Syria. HCC was also associated with PTSD symptoms but not with the quality of their current living conditions. This study revealed that changes to hypothalamic-pituitary-adrenal axis activity may accompany both earlier war exposure and current PTSD symptoms in children and adolescents. Additionally, early adolescence may be a particularly sensitive time in terms of trauma-related changes to the hypothalamic-pituitary-adrenal axis.

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The Impacts of Contextual Factors on Psychosocial Wellbeing of Syrian Refugees: Findings from Turkey and the United States

Cited by 11 publications

References 51 publications

Mental health of clinic-attending Syrian refugee women in Jordan: associations between social ecological risks factors and mental health symptoms

Mental health of clinic-attending Syrian refugee women in Jordan: associations between social ecological risks factors and mental health symptoms

The relationship between employment and health for people from refugee and asylum-seeking backgrounds: A systematic review of quantitative studies

War exposure, post-traumatic stress symptoms and hair cortisol concentrations in Syrian refugee children

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