Post-Migration Stressors and Their Association With Symptom Reduction and Non-Completion During Treatment for Traumatic Grief in Refugees

A. A. A. Manik J. Djelantik · Annemiek de Heus · Diede Kuiper · Rolf J. Kleber · Paul A. Boelen · Geert Edzko Smid

67 citations0/0 files storedFrontiers in Psychiatry

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Migration, Health and Trauma Posttraumatic Stress Disorder Research Grief, Bereavement, and Mental Health

Abstract

BACKGROUND: Resettled refugees exposed to trauma and loss are at risk to develop mental disorders such as posttraumatic stress disorder (PTSD) and persistent complex bereavement disorder (PCBD). Post-migration stressors have been linked to poor mental health and smaller treatment effects. AIM: Our aim was to evaluate reductions in PTSD and PCBD symptoms and to explore the presence of post-migration stressors and their associations with symptom change and non-completion in a traumatic grief focused treatment in a cohort of refugees. METHODS: Paired sample t-tests were used to test the significance of the symptom reductions in PTSD and PCBD symptoms during treatment. The presence of post-migration stressors was derived from a qualitative analysis of the patient files. Associations between post-migration stressors and symptom reductions as well as non-completion were calculated. RESULTS: In this uncontrolled study, 81 files of consecutive patients were included. Significant reductions in both PCBD and PTSD symptomatology with medium effect sizes were found. Patients experienced a mean of three different post-migration stressors during the treatment. Undocumented asylum seekers were more likely to be non-completers. Ongoing conflict in the country of origin was associated with smaller PTSD symptom reductions and the total number of post-migration stressors was associated with smaller PCBD symptom reductions. CONCLUSIONS: Treatment for resettled refugees for traumatic grief coincides with alleviations in both PCBD and PTSD symptomatology. Specific post-migration stressors were associated with reduced treatment effects and increased non-completion. This is a first step towards well-informed improvements of mental health interventions for resettled refugees.

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1995The development of a Clinician-Administered PTSD Scale 1996GPOWER: A general power analysis program 2005Predisplacement and Postdisplacement Factors Associated With Mental Health of Refugees and Internally Displaced Persons 2010Common mental health problems in immigrants and refugees: general approach in primary care 2015Long-term mental health of war-refugees: a systematic literature review 2017Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis 2001Lifetime Events and Posttraumatic Stress Disorder in 4 Postconflict Settings 2016The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers

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