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1.
Sci Rep ; 13(1): 1465, 2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36702839

RESUMO

The paper investigates the psychological factors associated with the unprecedented assistance that Poles have offered refugees from Ukraine since the outset of Russia's invasion of Ukraine. Building on social identity theory, and examining the current social context in Poland, we focus on three social identity dimensions, i.e., a feeling of closeness towards refugees from Ukraine, anticipatory fears (of a Russian invasion), and a community norm of helping. These three dimensions predict collective helping resulting from a sense of a common fate and a feeling of togetherness with Ukrainians. We tested this hypothesis in a study (N = 1066) conducted between 11 and 17 March 2022. Participants were asked about their helping activities during the previous week; they also responded to questions on different measures of social identity processes. The results support our expectations, revealing that closeness, anticipatory fears, and social norms are associated with two forms of help: benevolent and activist. The results of the study contribute to the discussion on social identity processes underlying offers of help to people fleeing from war-zones. Thus, they enhance our understanding of the role of citizens in terms of their contribution to helping refugees, and can be used to improve responses to other humanitarian crises.


Assuntos
Refugiados , Humanos , Refugiados/psicologia , Medo , Identificação Social , Etnicidade , Ucrânia
2.
East Mediterr Health J ; 29(1): 15-23, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36710610

RESUMO

Background: Polymerase chain reaction is a well-known method for testing COVID-19 infection, however, refugee populations often face difficulties in accessing testing. Several structural and cultural challenges have hindered access of Syrian refugees to COVID-19 testing in Lebanon, including financial barriers, stigma, and low perception of vulnerability. Aims: To explore barriers to accessing COVID-19 testing by Syrian refugees in Lebanon. Methods: This qualitative study conducted 10 focus group discussions among Syrian refugees and 21 individual semistructured interviews with healthcare workers. Ethical approval was obtained from the Institutional Review Board of the Lebanese International University, and the study followed the ethical principles of the Declaration of Helsinki. Results: Syrian refugees in Lebanon did not consider COVID-19 testing to be important. Despite the availability of free testing services, psychological, cultural, environmental, and financial barriers hindered them from getting tested. Some of them relied on consultation with pharmacists, who were easy to access and provided symptomatic treatment without the need to test for COVID-19. Fear of stigma, deportation, and isolation were common cultural barriers. Testing was considered unnecessary because of the perception of low disease severity and an attitude of negligence towards preventive practices. The harsh economic and living conditions were of greater concern to the refugees. Conclusion: Findings from this study add to existing literature regarding the social and cultural barriers to COVID-19 testing among Syrian refugees and should be considered when tailoring health promotion campaigns to halt the spread of the COVID-19 pandemic.


Assuntos
COVID-19 , Refugiados , Humanos , Refugiados/psicologia , Líbano , Teste para COVID-19 , Síria , Pandemias , COVID-19/diagnóstico
3.
BMC Psychiatry ; 23(1): 7, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36597066

RESUMO

BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Saúde Mental , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Ansiedade , Transtornos de Ansiedade/diagnóstico
4.
Int J Equity Health ; 22(1): 16, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36681845

RESUMO

BACKGROUND: The re-emerging dominance of the Taliban in Afghanistan in 2021 caused a new wave of Afghan refugees heading Iran and neighboring countries. Iran in the Middle East and Germany in Europe are two major host countries to the largest populations of Afghan refugees. In both countries, several studies have been done to assess the health condition of refugees. OBJECTIVES: To systematically review the existing literature to identify similarities and differences of health conditions of Afghan refugees living in the two countries, and to synthesize evidence on the health status and health care access of these populations. METHODS: Related electronic databases and grey literature of Iran and Germany on the health of Afghan refugees were scanned and searched up for the period 2000-2020. Key terms were formed by combining "Afghan refugees or immigrants or populations or asylum seekers", "Physical or mental health", "Healthcare service or access or use", "Iran or Germany". Empirical studies were considered if they contained samples of Afghan refugees with particular outcomes for Afghans. Results were categorized for both countries in the three main areas of physical health, mental health, and access/use of healthcare services. RESULTS: Nine hundred twenty-two documents were extracted, of which 75 full-texts were finally reviewed. 60 documents belonged to the health condition of Afghan refugees residing in Iran including 43 in physical health, 6 in mental health, 8 in healthcare access and use, and 3 in multiple aspects of health, and 15 belonged to Germany including 7 in physical health, 4 in mental health, 2 in healthcare access and use, and 2 in multiple aspects of health. A less explicit evaluation of the overall health condition of Afghan refugees was observable, particularly for Germany. While matches on the study subject exist for both countries, in comparison to Germany, we extracted more quantitative and qualitative health studies on Afghan refugees of the mentioned areas from Iran. German health studies were rare, less qualitative, and more on the health condition of diverse refugee groups in general. CONCLUSIONS: Wide gaps and unanswered questions related to mental health and overall health status of the Afghan refugee population are observable, especially in Germany. Our systematic review identified the gap in evidence, which we would recommend to bridge using a wider lens to comprehensively assess the overall condition of refugees considering associations between health and socio-economic and cultural determinants instead of a one-dimensional approach. Further, within health studies on refugee populations, we recommend stratification of results by the country of origin to capture the within-group diversity among refugees with different countries of origin.


Assuntos
Refugiados , Humanos , Irã (Geográfico) , Refugiados/psicologia , Europa (Continente) , Nível de Saúde , Afeganistão , Alemanha
5.
Artigo em Inglês | MEDLINE | ID: mdl-36673976

RESUMO

Refugee populations exhibit high rates of PTSD, anxiety, depression, and psychological distress, but are less likely to receive care than the general population. Perceptions among the Kurdish refugee community about causes and consequences of mental illness symptoms and perceived barriers to help-seeking are understudied. This community-engaged research study conducted in-depth interviews with Kurdish refugees from Iraq to explore their beliefs about drivers of mental illness and seeking help for mental health. Iterative thematic analysis of transcripts from ten participants indicated four key themes: (1) social network loss due to resettlement causes poor mental health; (2) socioeconomic status loss due to unrecognized professional qualifications puts strain on mental health; (3) social stigma about mental health and fears about disclosure of mental health issues within community and subsequent negative gossip prevent help-seeking; and (4) social interaction may alleviate mental illness symptoms. Overall, Kurdish refugees perceived social factors as major drivers of mental illness symptoms and barriers to help-seeking in their community. However, while participants believed that the general community attitude was against help-seeking, most participants personally expressed support of anyone in their community needing to see a mental health professional. Future research should assess the extent to which perceived community norms differ from aggregated personal help-seeking attitudes and behaviors among Kurdish refugees from Iraq in the United States.


Assuntos
Saúde Mental , Refugiados , Humanos , Refugiados/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Tennessee , Estigma Social
6.
Artigo em Inglês | MEDLINE | ID: mdl-36674012

RESUMO

As research subjects, refugees have numerous potential vulnerabilities. This study aimed to examine the ethics- and trauma-informed challenges of implementing a mental health research protocol with Syrian refugees living in Portugal. Guided by the integrated meaning-making model, the research project "Journeys in Meaning" employed a mixed-methods cross-sectional design to explore posttraumatic cognitive processing in refugees using two phases of data collection: two focus groups (Phase 1) to test the protocol and 39 in-depth individual interviews (Phase 2) to implement the protocol. Results examine the strategies used to address the following: methodological challenges related to protocol design, participant recruitment, and language; ethics- and trauma-informed challenges aimed at minimizing harm and maximizing benefit to participants that followed social justice principles; and perceived compassion fatigue on the part of the researcher following repeated empathetic exposure to traumatic content. Findings suggest the need for adaptive approaches to research with refugee populations that challenge strict compliance with the traditional principles of "do no harm" and researcher neutrality, and that accommodate individual and community complexities.


Assuntos
Fadiga por Compaixão , Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Refugiados/psicologia , Síria , Estudos Transversais , Grupos Focais , Transtornos de Estresse Pós-Traumáticos/psicologia
7.
BMC Psychiatry ; 23(1): 11, 2023 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-36600233

RESUMO

BACKGROUND: The COVID-19 pandemic has created significant challenges in 2020 in the world and Iran. To help vulnerable groups such as refugees during the response and recovery phases of the COVID-19 pandemic, identifying the quality of life (QOL) and its associated factors is helpful. Considering that research in this field is limited, this study evaluated the effect of social determinants of health on the quality of life among Afghan refugees in Iran during the COVID-19 pandemic. METHODS: We conducted a cross-sectional study on 300 Afghan refugees and migrants in Alborz province, Iran, from February to May 2022 using Convenience sampling. Data were completed using the socioeconomic status scale (SES), World Health Organization's quality of life -BREF (WHOQOL), Depression, Anxiety and Stress Scale-21 Items (DASS-21), and COVID-19 Post-Traumatic Stress Disorder Checklist (COVID-PTSD). In addition, path analysis was applied to evaluate the relationships among the research variables with quality of life. RESULTS: 64.3% of the study participants were male, with a mean of 29.29 ± 9.64 years. The path analysis showed that SES had the most positive relationship (B = .266), and the number of COVID-19 cases had the most negative relationship (B = -.169) with the quality of life from both paths. The self-rated health had the most positive relationship (B = .25), and the DASS score had the most negative relationship (B = -.2) with the quality of life through only one path. Access to medical services was the only variable that indirectly had a positive causal relationship with QOL (B = .044). CONCLUSION: We provided an empirical model that illustrates the relationships between quality of life and social determinants of health among Afghan refugees and migrants during the Covid19 pandemic. The negative emotional states of Depression, Anxiety, and Stress (DAS) as a mediator play an essential role in the quality of life and other variables.


Assuntos
COVID-19 , Refugiados , Humanos , Masculino , Feminino , Qualidade de Vida , Pandemias , Refugiados/psicologia , Irã (Geográfico)/epidemiologia , Estudos Transversais , Determinantes Sociais da Saúde , COVID-19/epidemiologia
8.
Women Health ; 63(1): 51-58, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36529708

RESUMO

Adolescent girls and young women (AGYW) in sub-Saharan Africa face a high risk of unintended pregnancy. This risk is compounded in informal settlements, where resources are scarce and access to sexual and reproductive health services is limited. Being a young mother in informal settlements could exacerbate existing experiences of resource scarcity and poor access to sexual and reproductive health services. To explore this, we analyzed the factors associated with motherhood among refugee AGYW in Kampala, Uganda. Between January and March 2018, peer researchers recruited refugee youth aged 15-24 and living in five informal settlements in Kampala to participate in this study. We used a backwards generalized linear model with a log binomial regression to determine if mental health, resource insecurity and sexual and reproductive health variables were associated with motherhood among study participants. Our analysis included 333 AGYW with a mean age of 19.3 years (standard deviation: 2.6). Nearly one-quarter (23 percent; n = 76) of AGYW had children. Having children was associated with greater likelihood of reporting food insecurity (adjusted prevalence ratio [aPR]: 1.96, 95 percent confidence interval [CI]: 1.07-3.61), depressive symptoms (aPR: 2.03, 95 percent CI: 1.09-3.80), and contraception uptake (aPR: 2.37, 95 percent CI: 1.58-3.56) compared to not having children. Mental health and resource insecurity interventions are required for refugee AGYW with children in informal settlements. Sexual and reproductive health services should be promoted to refugee AGYW regardless of motherhood status to prevent unplanned pregnancy.


Assuntos
Infecções por HIV , Refugiados , Gravidez , Criança , Humanos , Adolescente , Feminino , Adulto Jovem , Adulto , Refugiados/psicologia , Uganda , Comportamento Sexual , Anticoncepção , Gravidez não Planejada , Infecções por HIV/epidemiologia
9.
Torture ; 32(3): 49-64, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36519196

RESUMO

Introduction This research, through the analysis of the case-law of the Inter-American Court of Human Rights (IACtHR), seeks to shed light on the nexus between families of the missing' claims, their agency and State compliance with reparations. The IACtHR has a unique follow-up system in the area of reparations, where victims can directly address the judges during hearings. This paper suggests that victims' participation - before and after the judgment- pervades the legal rigidity of international jurisdictions and contributes to a better understanding of reparations. INTRODUCTION: The number of forcibly displaced immigrants seeking asylum in the United States continues to rapidly increase. Movement from Latin America to the United States was the third-largest migration worldwide in 2017 (Leyva-Flores et al., 2019). As migration patterns change, understanding the background and trauma profile of newly displaced populations is essential to meet their health needs and aid successful resettlement. University-affiliated student-run asylum clinics conduct a growing number of forensic medical evaluations of asylum seekers and provide a vital lens to study changes in this population's profile over time. METHODS: A retrospective review was conducted of the first 102 asylum seekers receiving forensic medical evaluations between 2019 and 2021 at a university-affiliated student- run clinic, reporting demographics; trauma, medical, and mental health histories; referral patterns; and legal outcomes. Bivariate statistics were used to investigate the relationship between past trauma and mental health outcomes. RESULTS: Clients reported an average of 4.4 different types of physical, psychological, and sexual ill-treatment per person. The current mental health burden was extensive with 86.9 percent of clients reporting symptoms of PTSD and/or depression. Clinician-student teams evaluated clients within a clinic structure deploying a continuous improvement model to reduce common barriers to forensic evaluations and promote longitudinal follow- up and referrals. DISCUSSION: This study demonstrates the complexity of trauma exposure reported by asylum seekers, contributes to the evidence on how trauma results in mental health outcomes, and describes trauma-centred clinic adaptations that reduce barriers to forensic evaluations known to improve the rates of legal protection.


Assuntos
Refugiados , Clínica Dirigida por Estudantes , Humanos , Estados Unidos , Refugiados/psicologia , Direitos Humanos , Saúde Mental , Estudantes
10.
Torture ; 32(3): 31-48, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36519195

RESUMO

INTRODUCTION: There are 1.3 million refugee survivors of torture living in the United States today. An existing body of research with refugees has largely examined mental health, but few of these studies focused on resilience. OBJECTIVE: Using a clinical sample of refugee survivors of torture, we tested the resiliencepromoting factors of community engagement, employment, English fluency, and psychological flexibility. We conducted moderation and mediation analyses to investigate how these resilience-promoting factors impact the torture-mental health relationship. RESULTS: Torture severity had significant positive associations with all mental health symptoms including PTSD (post-traumatic stress disorder), depression, and anxiety. Conversely, psychological flexibility had significant negative associations with all mental health symptoms. Additionally, psychological flexibility was a significant mediator of the torture-mental health relationship, highlighting its potential as a causal mechanism between torture and mental health. This evidence suggested that experiencing greater torture severity led to greater mental health problems in part via difficulties in psychological flexibility. Separately, English fluency and employment status were negatively correlated with mental health symptoms. CONCLUSION: The findings from this study identified potentially resilience-promoting factors for refugee survivors of torture and contributed to both research and clinical insights in better serving this vulnerable population.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Tortura , Humanos , Tortura/psicologia , Refugiados/psicologia , Sobreviventes/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Saúde Mental
11.
Sleep Health ; 8(6): 593-600, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36511279

RESUMO

Sleep difficulty is a recognized hallmark symptom of post-traumatic stress disorder (PTSD) yet often remains an enduring and neglected problem post-treatment. Around 4.4%- 88.0% of refugees, asylum seekers, and internally displaced persons report PTSD, of which 39%- 99% report sleep difficulties. These percentages substantially exceed those of the general population. Yet there has been a lack of research examining evidence-based stand-alone and add-on treatments for PTSD and related sleep disturbances among this population. Barriers to treatment encountered by this population often vary by their legal status or location, but generally include lack of access due to insufficient evidence-based treatments or mental health practitioner shortages, lack of psychoeducation on mental health, cultural stigma, language barriers, situational instability, and racial bias. The refugee population has been on the rise over the past 10 years, and the United Nations estimated the recent Ukraine-Russia conflict would lead to an additional 12 million people needing humanitarian assistance inside Ukraine and more than 6.9 million refugees fleeing to neighboring countries in the coming months. Given that refugees, asylum seekers, and internally displaced persons repeatedly encounter barriers to mental health care specific to their predicament, interventions designed to accommodate their situation are imperative for improving their sleep and mental health. We therefore call for there to be more research on integrative programs incorporating evidence-based treatments that allow for scalability, adaptability, and rapid dissemination to maximize impact in this population. Further, we encourage trainings among clinicians and researchers to increase knowledge and confidence in working with this population.


Assuntos
Refugiados , Transtornos do Sono-Vigília , Transtornos de Estresse Pós-Traumáticos , Humanos , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Saúde Mental , Sono
12.
PLoS One ; 17(12): e0279397, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36534679

RESUMO

Structural barriers such as inadequate housing, lack of employment opportunities, and discrimination are known to adversely affect the health of newly settled refugee migrants. However, these barriers remain largely unresolved and unaddressed. Thus, there is a need to better understand how other factors, such as individual-level health resources, may influence health and mitigate ill health in the early post-migration phase. In this study, we aimed to explore the relationship between health outcomes and individual health resources including health literacy, social support, and self-efficacy in newly settled refugee migrants. Survey data was collected from 787 refugee migrants in Sweden. Logistical regression analysis showed that limited health literacy, lack of emotional support, and low self-efficacy were consistently associated with poor health outcomes. Demographic variables such as gender, education, and type of residence permit were not as imperative. Individual-level health resources may play an important role in the general and psychological well-being of newly settled migrants. Promoting health literacy and facilitating the attainment of social support may buffer for structural challenges in the establishment phase and enhance the prospects of later health and social integration.


Assuntos
Letramento em Saúde , Refugiados , Migrantes , Humanos , Estudos Transversais , Suécia , Refugiados/psicologia , Autoeficácia , Apoio Social
13.
Artigo em Inglês | MEDLINE | ID: mdl-36554503

RESUMO

Several high-income countries are currently experiencing an unprecedented and multifaceted housing crisis. The crisis is escalating rapidly, and its negative ramifications are shared disproportionately by migrant and refugee communities. Although housing is often cited as an important social determinant of health, the relationship between housing inequalities and health outcomes in the context of migrant and refugee populations remain under-explored, particularly in high-income countries. This paper presents a protocol for a mixed-methods systematic review which will synthesize the evidence on the key housing and health inequalities faced by migrant and refugee populations in high-income countries. It will inform the identification of pathways linking housing inequalities to health outcomes. The protocol for this systematic review was developed with guidance from the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration, and the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. Quantitative, qualitative and mixed-methods studies reporting the association of housing inequalities with physical and mental health outcomes among refugee and migrant populations in high-income countries will be included. Medline, Web of Science, Embase, PsycINFO, Scopus and CINAHL will be searched for peer-reviewed literature. This will be supplemented by gray literature searches using Google Scholar, MedNar and WHOLIS. Two reviewers will independently screen and select studies, assess the methodological quality and conduct data extraction. This systematic review will elucidate the different pathways linking housing inequalities and health outcomes, which may guide the development of targeted housing and public health interventions to improve the health and wellbeing of migrant and refugee populations. The review is registered with PROSPERO (CRD42022362868).


Assuntos
Habitação , Refugiados , Humanos , Países Desenvolvidos , Refugiados/psicologia , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Avaliação de Resultados em Cuidados de Saúde
14.
Artigo em Inglês | MEDLINE | ID: mdl-36554321

RESUMO

A growing body of research highlights how communities traumatized by conflict and displacement suffer from long-term mental and psychosocial illnesses. The Russian army's attack on Ukraine has resulted in an estimated 10 million people being internally or externally displaced from Ukraine, of whom more than 3.8 million have left Ukraine to seek refuge elsewhere in Europe. Soleterre has decided to launch an intervention to provide psychological support to Ukrainian refugees and IDPs, aimed at containing war trauma, assessing the severity of symptoms, and enabling those affected to receive psychological support. The intervention model envisioned the administration of an intake form to provide a rapid collection of qualitative and quantitative information for those arriving in Poland or Lviv from Ukraine. Our results showed how most of the samples reported high or very high levels of anxiety, depression, and sleep disturbances. Moreover, results highlighted how being close to families or being able to keep in touch with them work as a protective factor in enhancing resilience, as well as a support network. These findings underscored the importance of re-thinking our perception of "family" in a broader sense, considering the new facets it can take on in post-conflict situations.


Assuntos
Refugiados , Corrida , Transtornos de Estresse Pós-Traumáticos , Humanos , Saúde Mental , Refugiados/psicologia , Ucrânia/epidemiologia , Polônia/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
15.
BMC Psychiatry ; 22(1): 787, 2022 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-36514026

RESUMO

BACKGROUND: Despite broad interest of the Syrian refugee plight in the academic and media circles, there are still limited studies analyzing the lived experiences of torture survivors under the Syrian regime. This qualitative study interviewed torture survivors to examine the form and function of the Syrian regime's security apparatus, and the personal aftermath of survivors. METHODS: Thirteen in-depth interviews were conducted in Arabic with Syrian refugees who endured torture. Study participants were at least 19 years of age, resided as refugees in Jordan, and voluntarily agreed to participate in the study. Participation was anonymous and no incentives were provided. Only oral consent was required. Audio-recorded interviews were transcribed and translated to English, and then analyzed for repetitive themes utilizing the narrative approach. RESULTS: Major themes were observed across three experience-phases: pre-captivity, during captivity, and post-captivity. The pre-captivity phase included two sub-themes: the Syrian regime's initial detection and arrest system, and the intelligence system. The captivity phase was also divided into two sub-themes: environmental conditions in detention facilities, and torture methods including physical and psychological torture. Some of the environmental conditions in detention facilities included lack of sanitation, crowding, starvation, and withholding of medical care. Torture methods encompassed beatings, electric shocks, nail-pulling, hanging, drowning, suffocation, rape, and the witnessing of killing, sexual assault, or torture of others. The post-captivity phase included their release from captivity, escaping Syria, and post-displacement conditions and activism. CONCLUSIONS: The Syrian regime employs a vast security apparatus to track, detain, interrogate, torture, and subjugate its civilian population. A systematic mechanism commences even before captivity and continues for years after release, with negative implications on the well-being of survivors, their families, and the Syrian people as a collective community. The Syrian war saw a shift toward mass detention, torture as a form of social punishment, subjugation, and indeterminate imprisonment. Intervention agencies, host countries, and policymakers must be informed of survivors' experiences to better address their needs. Moreover, the international community must advocate for a firm stance against torture, demand justice, and prosecute all parties engaged in perpetuating such extreme forms of suffering and trauma.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Tortura , Humanos , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Síria , Tortura/psicologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-36498273

RESUMO

The aim of this online, register-based cross-sectional study was to investigate the frequency of psychological distress and protective factors among 136 Syrian students in Germany. The survey measured depression and anxiety (Patient Health Questionnaire-4), post-traumatic stress (Impact of Event-Scale-6), as well as resources social support (ENRICHD Social Support Instrument), optimism (Optimism-Pessimism-2 Scale) and religiosity (Duke Religion Index). A total of 26.50% of the sample were female. A total of 38.93% met criteria for clinically relevant depressive respectively generalized anxiety symptoms and 15.72% showed prominent PTSD scores. Participants screened positive for mental distress reported significantly less social support (p = 0.001) and less optimism (p = 0.002) than participants without mental distress. In multiple regression analyses, higher levels of feeling welcome in Germany, social support and intrinsic religiosity were significantly associated with lower levels of depression and generalized anxiety. Significant associations with lower PTSD levels were found with higher levels of social support and optimism. The results show that Syrian students in Germany are more psychologically burdened compared to other Syrian refugee samples, except for PTSD. This suggests that besides the stress caused by flight and trauma, stressors such as studying and social isolation could be considered as additional impediments for mental health and require intervention measures.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Masculino , Saúde Mental , Estudos Transversais , Transtornos de Estresse Pós-Traumáticos/psicologia , Fatores de Proteção , Ansiedade/epidemiologia , Ansiedade/etiologia , Refugiados/psicologia , Alemanha/epidemiologia , Depressão/epidemiologia , Depressão/etiologia
17.
Epidemiol Psychiatr Sci ; 31: e81, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36377410

RESUMO

AIMS: There is increasing evidence that brief psychological interventions delivered by lay providers can reduce common mental disorders in the short-term. This study evaluates the longer-term impact of a brief, lay provider delivered group psychological intervention (Group Problem Management Plus; gPM+) on the mental health of refugees and their children's mental health. METHODS: This single-blind, parallel, controlled trial randomised 410 adult Syrians in Azraq Refugee Camp in Jordan who screened positive for distress and impaired functioning to either five sessions of gPM+ or enhanced usual care (EUC). Primary outcomes were scores on the Hopkins Symptom Checklist-25 (HSCL-25; depression and anxiety scales) assessed at baseline, 6 weeks, 3 months and 12 months Secondary outcomes included disability, posttraumatic stress, personally identified problems, prolonged grief, prodromal psychotic symptoms, parenting behaviour and children's mental health. RESULTS: Between 15 October 2019 and 2 March 2020, 204 participants were assigned to gPM + and 206 to EUC, and 307 (74.9%) were retained at 12 months. Intent-to-treat analyses indicated that although participants in gPM + had greater reductions in depression at 3 months, at 12 months there were no significant differences between treatment arms on depression (mean difference -0.9, 95% CI -3.2 to 1.3; p = 0.39) or anxiety (mean difference -1.7, 95% CI -4.8 to -1.3; p = 0.06). There were no significant differences between conditions for secondary outcomes except that participants in gPM + had greater increases in positive parenting. CONCLUSIONS: The short-term benefits of a brief, psychological programme delivered by lay providers may not be sustained over longer time periods, and there is a need for sustainable programmes that can prolong benefits gained through gPM + .


Assuntos
Transtornos Mentais , Refugiados , Humanos , Adulto , Criança , Refugiados/psicologia , Intervenção Psicossocial , Síria , Psicoterapia , Método Simples-Cego , Seguimentos , Jordânia , Transtornos Mentais/terapia
18.
BMC Psychol ; 10(1): 257, 2022 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-36348466

RESUMO

BACKGROUND: Syrian refugees comprise the vast majority of refugees in the Netherlands. Although some research has been carried out on factors promoting refugee resilience, there have been few empirical studies on the resilience of Syrian refugees. METHOD: We used a qualitative method to understand adversity, emotion, and the factors contributing to resilience in Syrian refugees. We interviewed eighteen adult Syrian refugees residing in the Netherlands and used thematic analysis to identify the themes. RESULTS: We identified themes and organized them into three main parts describing the challenges (pre and post-resettlement), key emotions pertaining to those experiences, and resilience factors. We found six primary protective factors internally and externally promoting participants' resilience: future orientation, coping strategies, social support, opportunities, religiosity, and cultural identity. In addition, positive emotions constituted a key feature of refugees' resilience. CONCLUSION: The results highlight the challenges and emotions in each stage of the Syrian refugees' journey and the multitude of factors affecting their resilience. Our findings on religiosity and maintaining cultural identity suggest that resilience can be enhanced on a cultural level. So it is worth noting these aspects when designing prevention or intervention programs for Syrian refugees.


Assuntos
Refugiados , Adulto , Humanos , Refugiados/psicologia , Síria , Países Baixos , Emoções , Adaptação Psicológica
19.
Artigo em Inglês | MEDLINE | ID: mdl-36429629

RESUMO

The findings of longitudinal studies on traumatized refugees have shown that factors related to premigration, migration, and post-migration experiences determine changes in mental health over time. The primary aim of this follow-up study was to examine the potential change in the prevalence rates of probable PTSD and depression among Syrian refugees in Iraq. An unselected group of N = 92 Syrian adult refugees was recruited from Arbat camps in Sulaymaniyah Governorate in Iraq's Kurdistan Region, and then interviewed at two different time points between July 2017 and January 2019. Locally validated instruments were used to assess traumatic events and mental health symptoms. The primary results showed no significant change in the mean scores of PTSD and depression symptoms from the first measurement to the second measurement over the course of 18 months. On the individual level, no reliable change was found for either PTSD or depression symptoms in more than three-quarters of the participants (78.3% and 77.2%, respectively). New adversities and traumatic events that occurred over the 18 months between the interviews were a significant predictor of increasing trauma-related symptoms. After the flight from conflict settings, trauma-related disorders seem to be chronic for the majority of Syrian refugees. Further longitudinal studies are needed in order to identify specific risk factors that lead to maintaining or worsening mental health symptoms over time, and to explore effective therapeutic intervention methods for this traumatized population.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Refugiados/psicologia , Síria/epidemiologia , Saúde Mental , Seguimentos , Iraque/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-36429956

RESUMO

In recent years, European countries have made their asylum systems increasingly stricter. Norway has been no exception, taking additional measures to tighten its asylum system to make it less attractive to seek asylum. How does the asylum procedure and living in asylum centres influence psychosocial well-being and, in turn, the prospects of incorporation into a new society? This article identifies the main challenges that a group of women face while seeking asylum and living in asylum centres in Norway, and it explores the influence that these challenges have on their mental health and well-being. To do this, it draws on ethnographic fieldwork conducted during approximately one year (2017-2018) with nine women-of different nationalities, ages and backgrounds-living in asylum centres in Norway. The analysis shows five main elements of the Norwegian asylum and reception system that result in the main challenges that the women deal with during their wait in the asylum centres. These elements are the wait and uncertainty around their asylum application coupled with the inability to influence their circumstances, the limitations to engage in meaningful activities as well as the financial and mobility limitations imposed by the Norwegian authorities. The interconnections of these five elements make the women often feel powerless, unable to influence their circumstances and feel stuck in the present, unable to plan their future, thus, experiencing high levels of uncertainty and existential immobility (Hage 2009). This, in turn, leads to frustration, apathy and even depression in the women, which can have a negative effect on their future incorporation into the Norwegian society.


Assuntos
Refugiados , Humanos , Feminino , Incerteza , Refugiados/psicologia , Hospitais Psiquiátricos , Saúde Mental , Noruega
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