Multiple trauma exposure and psychopathology in Syrian refugees living in Turkey: A latent class analysis.

BACKGROUND: After the Syrian civil war, millions of Syrian refugees migrated to neighboring countries, with the majority settling in Turkey. The prevalence of mental disorders is notably higher among refugee populations. However, prior research on Syrian refugees have mostly used variable-centred approaches which have known limitations. Thus, the present study sought to examine the occurrence and co-occurrence of traumatic experiences among Syrian refugees living in Turkey using latent class analysis (LCA). Additionally, this study aimed to identify the associations between latent class membership and trauma-related psychopathology. METHODS: Participants included 593 Syrian refugees living in Turkey. LCA was used to identify latent classes of trauma exposure. Demographic predictors of the latent classes were examined and associations with PTSD, CPTSD, depression and anxiety were also explored. RESULTS: Three latent classes were identified based on trauma exposure; a "multiple traumas" class, "war and human suffering" class, and "low exposure, combat-exposed" class. Odds of PTSD, CPTSD, depression, or anxiety diagnosis did not differ significantly between classes, with the exception of the "multiple traumas" class who were more likely to meet the criteria for anxiety diagnosis compared to the "low exposure" class. LIMITATIONS: Historic psychiatric symptoms or post-migration stressors could not be accounted for in this study, which may explain the lack of significant differences in most mental health outcomes by trauma exposure class. DISCUSSION: The latent classes identified in this study correspond with previous research regarding trauma in Syrian refugees. However, this study largely failed to find significant differences in mental health diagnoses between classes. Future research should consider the effect of post-migration stressors in refugee populations, which may play a crucial role in mental health outcomes.

The moderator roles of depression and anxiety symptoms in the relationship between posttraumatic stress disorder and posttraumatic growth in Syrian refugees.

PURPOSE: Traumatic events not only lead to negative consequences such as posttraumatic stress disorder (PTSD) but are also associated with positive results such as psychological growth and maturity. This paper aimed to examine the moderating effect of depression and anxiety symptoms on the relationship between PTSD and posttraumatic growth (PTG). METHOD: The participants were 630 adult Syrian refugees (Mage = 31.83, SD = 9.71; 218 were male and 412 were female) who migrated to Türkiye after the civil war in Syria. They completed the Posttraumatic Stress Disorder Checklist, the Posttraumatic Growth Inventory, the Patience Health Questionnaire, and the Generalized Anxiety Disorder Questionnaire. A double moderation model was tested to investigate the potential moderation roles of depression and anxiety symptoms in the relationship between PTSD symptoms and PTG. RESULTS: The rates of getting above the cutoff score on PTSD, depression, and anxiety scales were 28.6%, 34.9%, and 29.7%, respectively. Depression and anxiety symptoms moderated the relationship between PTSD and PTG: For individuals scoring higher in depression compared to those scoring lower in depression, high PTSD scores were related to substantially lower PTG scores. A similar effect was observed for anxiety symptoms: high anxiety scores were associated with lower PTG scores, especially when PTSD scores were high. CONCLUSION: These findings highlight the importance of addressing depression and anxiety symptoms in the relationship between PTG and PTSD in refugees. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prenatal Attachment and Mental Well-Being Among Expectant Fathers Amidst COVID-19: A Cross-Sectional Study.

Background The COVID-19 pandemic has posed significant threats to global physical and mental health, notably impacting the psychological management of pregnancy. The mental health of parents plays a critical role in fostering the emotional bond with their unborn child, referred to as prenatal attachment. Despite the significance of this bond, research has primarily concentrated on maternal outcomes, often neglecting the paternal aspect during the pandemic. This study investigates the correlation between coronavirus disease 2019 (COVID-19) risk perception and paternal prenatal attachment, further exploring the mediating role of well-being within this association. Methods A total of 141 expectant fathers attending the gynecology and obstetrics outpatient clinic with their partners were recruited. Participants completed measures including the Paternal Antenatal Attachment Scale (PAAS), the World Health Organization Well-being Index (WHO-5), and the COVID-19 Perceived Risk Scale (CPRS). Results Data analysis revealed a significant negative correlation between COVID-19 risk perception and well-being (ß = -.34, p < .001). There was a positive correlation between well-being and prenatal attachment (ß = .37, p = .002). The prenatal attachment was also positively linked to COVID-19 risk perception (ß = .20, p = .047). Furthermore, well-being mediated the relationship between COVID-19 risk perception and prenatal attachment. Conclusion The findings underscore the potential of the COVID-19 risk perception to disrupt the prenatal attachment process for expectant fathers by interfering with psychological well-being. However, it can also promote prenatal attachment through various mechanisms. Consequently, acknowledging and understanding the experiences of fathers during pregnancy is of paramount importance. Future longitudinal studies are necessitated to examine the parent-child relationship dynamics that have evolved under the influence of the pandemic.

Translation and validation of the Turkish forms of the International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ).

BACKGROUND: The 11th version of the International Classification of Diseases (ICD-11) included revised formulations of single episode depressive disorder (DD) and generalized anxiety disorder (GAD). Consequently, the International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ) have been developed as self-report measures which directly align with the ICD-11 description of DD and GAD, respectively. OBJECTIVE: The current study sought to (1) test the factorial validity of the Turkish translations of the IDQ and IAQ, (2) evaluate their internal reliability, (3) determine how meeting diagnostic requirements for ICD-11 DD and ICD-11 GAD vary across different demographic variables, and (4) determine the convergent validity of the Turkish translations of the IDQ and IAQ. METHODS: Participants were a community sample of 1455 Turkish adults and largely comprised of university students. This study used confirmatory factor analysis (CFA) to test the latent structure of both scales. Prevalence rates of ICD-11 GAD and DD were also estimated, and differences in prevalence rates according to gender and relationship status were examined. RESULTS: The CFA results indicated that both scales were unidimensional. Both scales demonstrated high levels of internal consistency. The prevalence of ICD-11 DD and GAD was 26.6 % and 28.5 %, respectively. Rates of probable ICD-11 DD and GAD were highest for females and single participants. Convergent validity was indicated by strong associations with external measures of depression and anxiety. CONCLUSION: Findings from this study provide support for the validity and reliability of the Turkish versions of the IDQ and IAQ in a large community sample.

Validity and Reliability of the Turkish Version of the Mentalization Scale (MentS). / Zihinsellestirme Ölçegi'nin Türkçe Çevirisinin Geçerlik ve Güvenirlik Çalismasi.

OBJECTIVE: This study, aims to translate the Mentalization Scale (MentS) into Turkish and investigate the reliability and validity of the Turkish version. METHOD: The participants, consisting of 615 (310 female and 305 male) Turkish speaking adults, were asked to complete the MentS and the Emotional Intelligence Feature Scale-Short Form (EIFS) and the Borderline Personality Inventory (BPI). RESULTS: The factor structure of the scale was investigated by exploratory and confirmatory factor analysis. Similar with the original scale, findings demonstrated a three-factor structure, namely, 'the self,' 'others' and 'motivation'. Corrected total score correlations for each item were between 0.28 and 0.52. The MentS score showed positive correlations with the EIFS score (r=0.49; p<0.001); and negative correlations with the BPI score (r=-0.37; p<0.001). Cronbach's alpha internal consistency coefficient was calculated as 0.84 for the total score, 0.78, 0.80, and 0.79 for MentS-S, MentS-O, and MentS-M, respectively. CONCLUSION: The findings show that the 25-item MentS Turkish form has sufficient psychometric properties. Our data supports the use of the Turkish version of MentS in future studies for assessment of mentalization capacity.

The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey.

There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown's stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-01743-2.