The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis
Abstract Background Psychological distress due to the ongoing war, violence, and persecution is particularly common among Afghan asylum seekers and refugees. In addition, individuals face a variety of post-migration living difficulties (PMLDs). Complex posttraumatic stress symptoms are among the mos...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | Conflict and Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13031-022-00455-z |
| _version_ | 1828839602771722240 |
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| author | Jennifer Schiess-Jokanovic Matthias Knefel Viktoria Kantor Dina Weindl Ingo Schäfer Brigitte Lueger-Schuster |
| author_facet | Jennifer Schiess-Jokanovic Matthias Knefel Viktoria Kantor Dina Weindl Ingo Schäfer Brigitte Lueger-Schuster |
| author_sort | Jennifer Schiess-Jokanovic |
| collection | DOAJ |
| description | Abstract Background Psychological distress due to the ongoing war, violence, and persecution is particularly common among Afghan asylum seekers and refugees. In addition, individuals face a variety of post-migration living difficulties (PMLDs). Complex posttraumatic stress symptoms are among the most common mental health problems in this population, and were associated with the overall burden of PMLDs. The complex interplay of posttraumatic symptoms has been investigated from a network perspective in previous studies. However, individuals are embedded in and constantly react to the environment, which makes it important to include external factors in network models to better understand the etiology and maintaining factors of posttraumatic mental health problems. PMLDs are a major risk factor for posttraumatic distress and considering their impact in interventions might improve response rates. However, the interaction of these external factors with posttraumatic psychopathological distress is not yet fully understood. Thus, we aimed to illuminate the complex interaction between PMLDs and CPTSD symptom clusters. Objective The main objective is the exploration of the network structure and the complex interplay of ICD-11 CPTSD symptom clusters and distinct forms of PMLDs. Method The symptom clusters of CPTSD and PMLDs were collected within a randomised controlled trial among 93 treatment-seeking Afghan asylum seekers and refugees via a fully structured face-to-face and interpreter assisted interview. Using a network analytical approach, we explored the complex associations and network centrality of the CPTSD symptom clusters and the PMLD factors: discrimination & socio-economical living conditions, language acquisition & barriers, family concerns, and residence insecurity. Results The results suggest direct links within and between the constructs (CPTSD, PMLD). Almost all PMLD factors were interrelated and associated to CPTSD, family concerns was the only isolated variable. The CPTSD symptom cluster re-experiencing and the PMLD factor language acquisition & barriers connected the two constructs. Affective dysregulation had the highest and avoidance the lowest centrality. Conclusions Re-experiencing and affective dysregulation have the strongest ties to PMLDs. Thus, these domains might explain the strong association of posttraumatic psychopathology with PLMDs and, consequently, prioritization of these domains in treatment approaches might both facilitate treatment response and reduce burden caused by PMLDs. |
| first_indexed | 2024-12-12T19:26:03Z |
| format | Article |
| id | doaj.art-51b0b5e4ad9c4b65957c78b4fa971a6c |
| institution | Directory Open Access Journal |
| issn | 1752-1505 |
| language | English |
| last_indexed | 2024-12-12T19:26:03Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Conflict and Health |
| spelling | doaj.art-51b0b5e4ad9c4b65957c78b4fa971a6c2022-12-22T00:14:30ZengBMCConflict and Health1752-15052022-04-0116111010.1186/s13031-022-00455-zThe boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysisJennifer Schiess-Jokanovic0Matthias Knefel1Viktoria Kantor2Dina Weindl3Ingo Schäfer4Brigitte Lueger-Schuster5Department of Clinical and Health Psychology, Faculty of Psychology, University of ViennaDepartment of Clinical and Health Psychology, Faculty of Psychology, University of ViennaDepartment of Clinical and Health Psychology, Faculty of Psychology, University of ViennaDepartment of Clinical and Health Psychology, Faculty of Psychology, University of ViennaDepartment of Psychiatry and Psychotherapy, University Medical Centre Hamburg-EppendorfDepartment of Clinical and Health Psychology, Faculty of Psychology, University of ViennaAbstract Background Psychological distress due to the ongoing war, violence, and persecution is particularly common among Afghan asylum seekers and refugees. In addition, individuals face a variety of post-migration living difficulties (PMLDs). Complex posttraumatic stress symptoms are among the most common mental health problems in this population, and were associated with the overall burden of PMLDs. The complex interplay of posttraumatic symptoms has been investigated from a network perspective in previous studies. However, individuals are embedded in and constantly react to the environment, which makes it important to include external factors in network models to better understand the etiology and maintaining factors of posttraumatic mental health problems. PMLDs are a major risk factor for posttraumatic distress and considering their impact in interventions might improve response rates. However, the interaction of these external factors with posttraumatic psychopathological distress is not yet fully understood. Thus, we aimed to illuminate the complex interaction between PMLDs and CPTSD symptom clusters. Objective The main objective is the exploration of the network structure and the complex interplay of ICD-11 CPTSD symptom clusters and distinct forms of PMLDs. Method The symptom clusters of CPTSD and PMLDs were collected within a randomised controlled trial among 93 treatment-seeking Afghan asylum seekers and refugees via a fully structured face-to-face and interpreter assisted interview. Using a network analytical approach, we explored the complex associations and network centrality of the CPTSD symptom clusters and the PMLD factors: discrimination & socio-economical living conditions, language acquisition & barriers, family concerns, and residence insecurity. Results The results suggest direct links within and between the constructs (CPTSD, PMLD). Almost all PMLD factors were interrelated and associated to CPTSD, family concerns was the only isolated variable. The CPTSD symptom cluster re-experiencing and the PMLD factor language acquisition & barriers connected the two constructs. Affective dysregulation had the highest and avoidance the lowest centrality. Conclusions Re-experiencing and affective dysregulation have the strongest ties to PMLDs. Thus, these domains might explain the strong association of posttraumatic psychopathology with PLMDs and, consequently, prioritization of these domains in treatment approaches might both facilitate treatment response and reduce burden caused by PMLDs.https://doi.org/10.1186/s13031-022-00455-zComplex posttraumatic stress disorder (CPTSD)RefugeesPost-migration stressorsEmotion regulationLanguage acquisitionRe-experiencing |
| spellingShingle | Jennifer Schiess-Jokanovic Matthias Knefel Viktoria Kantor Dina Weindl Ingo Schäfer Brigitte Lueger-Schuster The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis Conflict and Health Complex posttraumatic stress disorder (CPTSD) Refugees Post-migration stressors Emotion regulation Language acquisition Re-experiencing |
| title | The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis |
| title_full | The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis |
| title_fullStr | The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis |
| title_full_unstemmed | The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis |
| title_short | The boundaries between complex posttraumatic stress disorder symptom clusters and post-migration living difficulties in traumatised Afghan refugees: a network analysis |
| title_sort | boundaries between complex posttraumatic stress disorder symptom clusters and post migration living difficulties in traumatised afghan refugees a network analysis |
| topic | Complex posttraumatic stress disorder (CPTSD) Refugees Post-migration stressors Emotion regulation Language acquisition Re-experiencing |
| url | https://doi.org/10.1186/s13031-022-00455-z |
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