Can Circumstances Be Softened? Self-Efficacy, Post-Migratory Stressors, and Mental Health among Refugees.

Post-migratory stressors (PS) are a risk factor for mental health problems among resettled refugees. There is a need to identify factors which can reduce this burden. Self-efficacy (SE) is associated with refugees' mental health. The current study examined whether SE can protect this group from the impact of PS on mental wellbeing. Higher levels of PS were expected to be associated with higher levels of mental health problems. In addition, we expected this linkage to be moderated by lower SE. Questionnaires were administered to a non-clinical refugee sample (N = 114, 46% female, average age 35 SD = 10.42 years) with various backgrounds. The following questionnaires were used: the Self-Reporting Questionnaire-20 (SRQ-20) to assess mental health problems, the General Self-Efficacy Scale (SGES) to measure SE, and an adapted version of the Post-Migration Living Difficulties Checklist (PMLD) to measure PS. Bivariate correlations and multiple linear regression analysis were performed. No significant contribution was found for SE or the interaction of SE and daily stressors, above and beyond the significant contribution of daily stressors to mental health problems. The findings reinforce that PS affects mental health and suggest that SE had a limited impact on mental health in this non-clinical sample of refugees.

Correction to: Feasibility and predictors of change of narrative exposure therapy for displaced populations: a repeated measures design.

[This corrects the article DOI: 10.1186/s40814-020-00613-1.].

Feasibility and predictors of change of narrative exposure therapy for displaced populations: a repeated measures design.

BACKGROUND: Displaced victims of interpersonal violence, such as refugees, asylum seekers, and victims of sexual exploitation, are growing in numbers and are often suffering from a post-traumatic stress disorder (PTSD). At the same time, these victims are known to benefit less from trauma-focused therapy (TFT) and to be less compliant to treatment. The objective of this paper is to describe the rationale and research protocol of an ongoing trial that aims to evaluate different variables that might influence the feasibility of TFT for the study population. Specifically, perceived daily stress, emotion regulation, and mood are investigated as predictors of change in PTSD symptoms during a trauma-focused therapy (narrative exposure therapy (NET)). The feasibility of administering measures tapping these constructs repeatedly during treatment will also be evaluated. METHODS/DESIGN: Using an observational treatment design, 80 displaced victims of interpersonal violence will be measured before, during, and after partaking in NET. Several questionnaires tapping PTSD plus the aforementioned possible predictors of PTSD change will be administered: Post-traumatic Stress Disorder Checklist-5, Perceived Stress Scale, Difficulties in Emotion Regulation Scale-18 (pre-test, post-test, and follow-up),subscale impulsivity of the Difficulties in Emotion Regulation Scale-18, Perceived Stress Scale short version, Primary Care Post-traumatic Stress Disorder and a single Mood item (each session). Multilevel modelling will be used to examine the relation between the possible predictors and treatment outcome. DISCUSSION: The present study is the first to examine the interplay of facilitating and interfering factors possibly impacting treatment feasibility and effectiveness in displaced victims of interpersonal violence with PTSD receiving NET, using repeated measures. The current study can help to improve future treatment based on individual characteristics. TRIAL REGISTRATION: Netherlands Trial Register: NTR7353, retrospectively registered. Date of registration: July 11, 2018.

7ROSES, a transdiagnostic intervention for promoting self-efficacy in traumatized refugees: a first quantitative evaluation.

Objective: Due to traumatic experiences and highly prevalent post-migration stressors, refugees are vulnerable for developing psychopathology. To date, research has mainly evaluated trauma-focused therapies, targeting post traumatic stresss symptoms. Treatments targeting post-migration stressors are relatively understudied. The present cohort study evaluated the potential effectiveness of 7ROSES, a transdiagnostic intervention that aims to increase self-efficacy among treatment-seeking refugees in dealing with post-migration stressors. Because it can be applied by non-specialist health care workers, it can be disseminated on a large scale, thereby increasing options for psychosocial support for refugees. Method: Forty-nine refugees (65% male, average age: 36.02 years, SD = 8.52) with psychopathology were included. Before and after participation in 7ROSES, self-efficacy was measured using the General Self-Efficacy Scale (GSES), and general psychopathology using the Brief Symptom Inventory (BSI). Results: Completers analysis yielded a significant increase in GSES scores (Z = -2.16, p = .03) and significant decrease in BSI scores (Z = -2.05, p = .04) with medium-small effects (both r = -.28). Intent-to-treat analysis, using predictive mean matching imputation, yielded significant results for the GSES (p = .012) but not for the BSI (p = .14) with small effects (GSES r = .14, BSI r = .12). Reliable change indices established negative change in 3%, no change in 70%, and positive change in 27% based on the GSES; percentages were 11.5%, 65.5%, and 23%, respectively, based on the BSI. Conclusion: Findings provide preliminary evidence that 7ROSES could improve self-efficacy and general mental health in refugees with psychopathology.

Objetivo: Debido a las experiencias traumáticas y los estresores post-migración altamente prevalentes, los refugiados son vulnerables al desarrollo de psicopatología. Hasta la fecha, la investigación ha evaluado principalmente las terapias centradas en el trauma, dirigidas a los síntomas de estrés postraumático. Los tratamientos dirigidos a los estresores posteriores a la migración han sido relativamente poco estudiados. El presente estudio de cohorte evaluó la efectividad potencial de 7ROSES, una intervención transdiagnóstica que tiene como objetivo aumentar la autoeficacia entre los refugiados que buscan tratamiento para tratar los factores estresantes posteriores a la migración. Debido a que puede ser aplicada por trabajadores de la salud no especializados, puede ser difundida a gran escala, aumentando así las opciones de apoyo psicosocial para los refugiados.Método: Se incluyeron 49 refugiados (65% hombres, edad promedio: 36.02 años, DE = 8.52) con psicopatología. Antes y después de la participación en 7ROSES, se midió la autoeficacia utilizando la Escala General de Autoeficacia (GSES en su sigla en inglés) y la psicopatología general utilizando el Inventario Breve de Síntomas (BSI en su sigla en inglés).Resultados: El análisis de los refugiados que completaron la intervención arrojó un aumento significativo en las puntuaciones de GSES (Z = −2.16, p = .03) y una disminución significativa en las puntuaciones de BSI (Z = −2.05, p = .04) con efectos medio-pequeños (ambos r = −.28). El análisis por intención de tratar, utilizando la imputación predictiva de correspondencia de medias, arrojó resultados significativos para el GSES (p = .012) pero no para el BSI (p = .14) con efectos pequeños (GSES r = .14, BSI r = .12). Los índices de cambio confiables establecieron un cambio negativo en el 3%, ningún cambio en el 70%, y un cambio positivo en el 27% basado en el GSES; los porcentajes fueron 11.5%, 65.5%, y 23%, respectivamente, basados en el BSI.Conclusión: Los resultados proporcionan evidencia preliminar de que 7ROSES podría mejorar la autoeficacia y la salud mental general en refugiados con psicopatología.