1932

Abstract

The number of refugees and internally displaced people in 2022 is the largest since World War II, and meta-analyses demonstrate that these people experience elevated rates of mental health problems. This review focuses on the role of posttraumatic stress disorder (PTSD) in refugee mental health and includes current knowledge of the prevalence of PTSD, risk factors, and apparent differences that exist between PTSD in refugee populations and PTSD in other populations. An emerging literature on understanding mechanisms of PTSD encompasses neural, cognitive, and social processes, which indicate that these factors may not function exactly as they have functioned previously in other PTSD populations. This review recognizes the numerous debates in the literature on PTSD in refugees, including those on such issues as the conceptualization of mental health and the applicability of the PTSD diagnosis across cultures, as well as the challenge of treating PTSD in low- and middle-income countries that lack mental health resources to offer standard PTSD treatments.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-clinpsy-080921-080359
2023-05-09
2024-06-21
Loading full text...

Full text loading...

/deliver/fulltext/clinpsy/19/1/annurev-clinpsy-080921-080359.html?itemId=/content/journals/10.1146/annurev-clinpsy-080921-080359&mimeType=html&fmt=ahah

Literature Cited

  1. Acarturk C, Uygun E, Ilkkursun Z, Carswell K, Tedeschi F et al. 2022. Effectiveness of a WHO self-help psychological intervention for preventing mental disorders among Syrian refugees in Turkey: a randomized controlled trial. World Psychiatry 21:88–95
    [Google Scholar]
  2. Adenauer H, Pinösch S, Catani C, Gola H, Keil J et al. 2010. Early processing of threat cues in posttraumatic stress disorder—evidence for a cortical vigilance-avoidance reaction. Biol. Psychiatry 68:451–58
    [Google Scholar]
  3. Akhtar A, Koyiet P, Rahman A, Schafer A, Hamdani SU et al. 2022. Residual posttraumatic stress disorder symptoms after provision of brief behavioral intervention in low- and middle-income countries: an individual-patient data meta-analysis. Depress. Anxiety 39:71–82
    [Google Scholar]
  4. Barbui C, Purgato M, Abdulmalik J, Acarturk C, Eaton J et al. 2020. Efficacy of psychosocial interventions for mental health outcomes in low-income and middle-income countries: an umbrella review. Lancet Psychiatry 7:162–72
    [Google Scholar]
  5. Bartlett R, Sarnyai Z, Momartin S, Ooi L, Schwab SG, Matosin N. 2021. Understanding the pathology of psychiatric disorders in refugees. Psychiatry Res. 296:113661
    [Google Scholar]
  6. Beiser M, Hou F. 2016. Mental health effects of premigration trauma and postmigration discrimination on refugee youth in Canada. J. Nerv. Ment. Dis. 204:464–70
    [Google Scholar]
  7. Benish SG, Quintana S, Wampold BE. 2011. Culturally adapted psychotherapy and the legitimacy of myth: a direct-comparison meta-analysis. J. Couns. Psychol. 58:279–89
    [Google Scholar]
  8. Betancourt TS, Newnham EA, Birman D, Lee R, Ellis BH, Layne CM. 2017. Comparing trauma exposure, mental health needs, and service utilization across clinical samples of refugee, immigrant, and U.S.-origin children. J. Trauma Stress 30:209–18
    [Google Scholar]
  9. Bichescu D, Neuner F, Schauer M, Elbert T 2007. Narrative exposure therapy for political imprisonment-related chronic posttraumatic stress disorder and depression. Behav. Res. Ther. 4:2212–20
    [Google Scholar]
  10. Blackmore R, Boyle JA, Fazel M, Ranasinha S, Gray KM et al. 2020a. The prevalence of mental illness in refugees and asylum seekers: a systematic review and meta-analysis. PLOS Med. 17:e1003337
    [Google Scholar]
  11. Blackmore R, Gray KM, Boyle JA, Fazel M, Ranasinha S et al. 2020b. Systematic review and meta-analysis: the prevalence of mental illness in child and adolescent refugees and asylum seekers. J. Am. Acad. Child Adolesc. Psychiatry 59:705–14
    [Google Scholar]
  12. Bogdanov S, Augustinavicius J, Bass JK, Metz K, Skavenski S et al. 2021. A randomized-controlled trial of community-based transdiagnostic psychotherapy for veterans and internally displaced persons in Ukraine. Glob. Ment. Health 8:e32
    [Google Scholar]
  13. Bogic M, Ajdukovic D, Bremner S, Franciskovic T, Galeazzi GM et al. 2012. Factors associated with mental disorders in long-settled war refugees: refugees from the former Yugoslavia in Germany, Italy and the UK. Br. J. Psychiatry 200:216–23
    [Google Scholar]
  14. Bogic M, Njoku A, Priebe S. 2015. Long-term mental health of war-refugees: a systematic literature review. BMC Int. Health Hum. Rights 15:29
    [Google Scholar]
  15. Bolton P, Lee C, Haroz EE, Murray L, Dorsey S, Robinson C et al. 2014. A transdiagnostic community-based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand. PLOS Med. 11:e1001757
    [Google Scholar]
  16. Braun-Lewensohn O, Al-Sayed K. 2018. Syrian adolescent refugees: How do they cope during their stay in refugee camps?. Front. Psychol. 9:1258
    [Google Scholar]
  17. Brewin CR, Cloitre M, Hyland P, Shevlin M, Maercker A et al. 2017. A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clin. Psychol. Rev. 58:1–15
    [Google Scholar]
  18. Browne DT, Kumar A, Puente-Duran S, Georgiades K, Leckie G et al. 2017. Emotional problems among recent immigrants and parenting status: findings from a national longitudinal study of immigrants in Canada. PLOS ONE 12:e0175023
    [Google Scholar]
  19. Bryant RA, Bawaneh A, Awwad M, Al-Hayek H, Giardinelli L et al. 2022. Effectiveness of a brief group behavioral intervention for common mental disorders in Syrian refugees in Jordan: a randomized controlled trial. PLOS Med. 19:e1003949
    [Google Scholar]
  20. Bryant RA, Bawaneh A, Giardinelli L, Awwad M, Al-Hayek H, Akhtar A 2021. A prevalence assessment of prolonged grief disorder in Syrian refugees. World Psychiatry 20:302–3
    [Google Scholar]
  21. Bryant RA, Edwards B, Creamer MC, O'Donnell ML, Forbes D et al. 2018. The effect of post-traumatic stress disorder on refugees’ parenting and their children's mental health: a cohort study. Lancet Public Health 3:e249–58
    [Google Scholar]
  22. Bryant RA, Edwards B, Creamer M, O'Donnell M, Forbes D et al. 2020. A population study of prolonged grief in refugees. Epidemiol. Psychiatr. Sci. 29:e44
    [Google Scholar]
  23. Byrow Y, Pajak R, Specker P, Nickerson A. 2020. Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: a systematic review. Clin. Psychol. Rev. 75:101812
    [Google Scholar]
  24. Carlsson JM, Olsen DR, Mortensen EL, Kastrup M. 2006. Mental health and health-related quality of life: a 10-year follow-up of tortured refugees. J. Nerv. Ment. Dis. 194:725–31
    [Google Scholar]
  25. Catani C, Adenauer H, Keil J, Aichinger H, Neuner F. 2009. Pattern of cortical activation during processing of aversive stimuli in traumatized survivors of war and torture. Eur. Arch. Psychiatry Clin. Neurosci. 259:340–51
    [Google Scholar]
  26. Charlson F, van Ommeren M, Flaxman A, Cornett J, Whiteford H et al. 2019. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet 394:240–48
    [Google Scholar]
  27. Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F et al. 2016. Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry 3:415–24
    [Google Scholar]
  28. Chung MC, AlQarni N, AlMazrouei M, Al Muhairi S, Shakra M et al. 2021. Posttraumatic stress disorder and psychiatric co-morbidity among Syrian refugees: the role of trauma exposure, trauma centrality, self-efficacy and emotional suppression. J. Ment. Health 30:681–89
    [Google Scholar]
  29. Dajani R, Hadfield K, van Uum S, Greff M, Panter-Brick C. 2018. Hair cortisol concentrations in war-affected adolescents: a prospective intervention trial. Psychoneuroendocrinology 89:138–46
    [Google Scholar]
  30. Daskalakis NP, Lehrner A, Yehuda R. 2013. Endocrine aspects of post-traumatic stress disorder and implications for diagnosis and treatment. Endocrinol. Metab. Clin. North Am. 42:503–13
    [Google Scholar]
  31. Dawson KS, Bryant RA, Harper M, Tay AK, Rahman A et al. 2015. Problem Management Plus (PM+): a WHO transdiagnostic psychological intervention for common mental health problems. World Psychiatry 14:354–57
    [Google Scholar]
  32. de Graaff AM, Cuijpers P, McDaid D, Park A-L, Woodward A et al. 2020. Peer-provided Problem Management Plus (PM+) for adult Syrian refugees: a pilot randomised controlled trial on effectiveness and cost-effectiveness. Epidemiol. Psychiatr. Sci. 29:e162
    [Google Scholar]
  33. De Haene L, Grietens H, Verschueren K. 2010. Adult attachment in the context of refugee traumatisation: the impact of organized violence and forced separation on parental states of mind regarding attachment. Attach. Hum. Dev. 12:249–64
    [Google Scholar]
  34. Djelantik AAAMJ, de Heus A, Kuiper D, Kleber RJ, Boelen PA, Smid GE. 2020. Post-migration stressors and their association with symptom reduction and non-completion during treatment for traumatic grief in refugees. Front. Psychiatry 11:407
    [Google Scholar]
  35. Doolan EL, Bryant RA, Liddell BJ, Nickerson A. 2017. The conceptualization of emotion regulation difficulties, and its association with posttraumatic stress symptoms in traumatized refugees. J. Anxiety Disord. 50:7–14
    [Google Scholar]
  36. Epping-Jordan JE, Harris R, Brown FL, Carswell K, Foley C et al. 2016. Self-Help Plus (SH+): a new WHO stress management package. World Psychiatry 15:295–96
    [Google Scholar]
  37. Ertl V, Pfeiffer A, Schauer E, Elbert T, Neuner F 2011. Community-implemented trauma therapy for former child soldiers in Northern Uganda: a randomized controlled trial. JAMA 306:503–12
    [Google Scholar]
  38. Eruyar S, Maltby J, Vostanis P. 2020. How do Syrian refugee children in Turkey perceive relational factors in the context of their mental health?. Clin. Child Psychol. Psychiatry 25:260–72
    [Google Scholar]
  39. Fazel M. 2018. Psychological and psychosocial interventions for refugee children resettled in high-income countries. Epidemiol. Psychiatr. Sci. 27:117–23
    [Google Scholar]
  40. Fazel M, Patel V, Thomas S, Tol W. 2014. Mental health interventions in schools in low-income and middle-income countries. Lancet Psychiatry 1:388–98
    [Google Scholar]
  41. Fazel M, Wheeler J, Danesh J. 2005. Prevalence of serious mental disorder in 7000 refugees resettled in Western countries: a systematic review. Lancet 365:1309–14
    [Google Scholar]
  42. Fogden G, Berle D, Steel Z. 2020. The impact of family separation and worry about family on psychological adjustment in refugees resettled in Australia. J. Trauma Stress 33:894–907
    [Google Scholar]
  43. Gola H, Engler H, Schauer M, Adenauer H, Riether C et al. 2012. Victims of rape show increased cortisol responses to trauma reminders: a study in individuals with war- and torture-related PTSD. Psychoneuroendocrinology 37:213–20
    [Google Scholar]
  44. Gold SM, Enck P, Hasselmann H, Friede T, Hegerl U et al. 2017. Control conditions for randomised trials of behavioural interventions in psychiatry: a decision framework. Lancet Psychiatry 4:725–32
    [Google Scholar]
  45. Graham B, Herlihy J, Brewin CR. 2014. Overgeneral memory in asylum seekers and refugees. J. Behav. Ther. Exp. Psychiatry 45:375–80
    [Google Scholar]
  46. Haagen JFG, Ter Heide FJJ, Mooren TM, Knipscheer JW, Kleber RJ 2017. Predicting post-traumatic stress disorder treatment response in refugees: multilevel analysis. Br. J. Clin. Psychol. 56:69–83
    [Google Scholar]
  47. Hall GC, Ibaraki AY, Huang ER, Marti CN, Stice E. 2016. A meta-analysis of cultural adaptations of psychological interventions. Behav. Ther. 47:993–1014
    [Google Scholar]
  48. Hareli S, Kafetsios K, Hess U. 2015. A cross-cultural study on emotion expression and the learning of social norms. Front. Psychol. 6:1501
    [Google Scholar]
  49. Henkelmann J-R, de Best S, Deckers C, Jensen K, Shahab M et al. 2020. Anxiety, depression and post-traumatic stress disorder in refugees resettling in high-income countries: systematic review and meta-analysis. BJPsych Open 6:e68
    [Google Scholar]
  50. Hinton DE, Lewis-Fernández R. 2011. The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5. Depress. Anxiety 28:783–801
    [Google Scholar]
  51. Hinton DE, Pich V, Marques L, Nickerson A, Pollack MH. 2010. Khyâl attacks: a key idiom of distress among traumatized Cambodia refugees. Cult. Med. Psychiatry 34:244–78
    [Google Scholar]
  52. Hoffman J, Liddell B, Bryant RA, Nickerson A. 2019. A latent profile analysis of moral injury appraisals in refugees. Eur. J. Psychotraumatol. 10:1686805
    [Google Scholar]
  53. Hou WK, Liu H, Liang L, Ho J, Kim H et al. 2020. Everyday life experiences and mental health among conflict-affected forced migrants: a meta-analysis. J. Affect. Disord. 264:50–68
    [Google Scholar]
  54. Jensen TK, Skar A-MS, Andersson ES, Birkeland MS. 2019. Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors. Eur. Child Adolesc. Psychiatry 28:1671–82
    [Google Scholar]
  55. Jeon S, Lee YJ, Park I, Kim N, Kim S et al. 2020. Resting state functional connectivity of the thalamus in North Korean refugees with and without posttraumatic stress disorder. Sci. Rep. 10:3194
    [Google Scholar]
  56. Jobson L, Dalgleish T. 2014. Cultural differences in the relationship between intrusions and trauma narratives using the trauma film paradigm. PLOS ONE 9:e106759
    [Google Scholar]
  57. Jobson L, Haque S, Abdullah SZ, Lee B, Li H et al. 2022. Examining cultural differences in the associations between appraisals and emotion regulation and posttraumatic stress disorder in Malaysian and Australian trauma survivors. Int. J. Environ. Res. Public Health 19:1163
    [Google Scholar]
  58. Keller A, Joscelyne A, Granski M, Rosenfeld B. 2017. Pre-migration trauma exposure and mental health functioning among Central American migrants arriving at the US border. PLOS ONE 12:1e0168692
    [Google Scholar]
  59. Khamis V. 2019. Posttraumatic stress disorder and emotion dysregulation among Syrian refugee children and adolescents resettled in Lebanon and Jordan. Child Abuse Negl. 89:29–39
    [Google Scholar]
  60. Khamis V. 2021. Impact of pre-trauma, trauma-specific, and post-trauma variables on psychosocial adjustment of Syrian refugee school-age children. J. Health Psychol. 26:1780–90
    [Google Scholar]
  61. Khan S, Kuhn SK, Haque S. 2021. A systematic review of autobiographical memory and mental health research on refugees and asylum seekers. Front. Psychiatry 12:658700
    [Google Scholar]
  62. Kien C, Sommer I, Faustmann A, Gibson L, Schneider M et al. 2019. Prevalence of mental disorders in young refugees and asylum seekers in European countries: a systematic review. Eur. Child Adolesc. Psychiatry 28:1295–310
    [Google Scholar]
  63. Kim N, Park I, Lee YJ, Jeon S, Kim S et al. 2020. Alexithymia and frontal-amygdala functional connectivity in North Korean refugees. Psychol. Med. 50:334–41
    [Google Scholar]
  64. Kip A, Priebe S, Holling H, Morina N. 2020. Psychological interventions for posttraumatic stress disorder and depression in refugees: a meta-analysis of randomized controlled trials. Clin. Psychol. Psychother. 27:489–503
    [Google Scholar]
  65. Koch T, Liedl A, Ehring T. 2020. Emotion regulation as a transdiagnostic factor in Afghan refugees. Psychol. Trauma 12:235–43
    [Google Scholar]
  66. Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ et al. 2017. Posttraumatic stress disorder in the World Mental Health Surveys. Psychol. Med. 47:2260–74
    [Google Scholar]
  67. Kokou-Kpolou CK, Moukouta CS, Masson J, Bernoussi A, Cénat JM, Bacqué M-F. 2020. Correlates of grief-related disorders and mental health outcomes among adult refugees exposed to trauma and bereavement: a systematic review and future research directions. J. Affect Disord. 267:171–84
    [Google Scholar]
  68. Kolassa I-T, Kolassa S, Ertl V, Papassotiropoulos A, De Quervain DJ-F. 2010. The risk of posttraumatic stress disorder after trauma depends on traumatic load and the catechol-O-methyltransferase Val158Met polymorphism. Biol. Psychiatry 67:304–8
    [Google Scholar]
  69. Le L, Morina N, Schnyder U, Schick M, Bryant RA, Nickerson A. 2018. The effects of perceived torture controllability on symptom severity of posttraumatic stress, depression and anger in refugees and asylum seekers: a path analysis. Psychiatry Res. 264:143–50
    [Google Scholar]
  70. Lee KH, Lee HY, Park I, Lee YJ, Kim N et al. 2021. Neural correlates of emotional reactivity and regulation in traumatized North Korean refugees. Transl. Psychiatry 11:452
    [Google Scholar]
  71. Li SSY, Liddell BJ, Nickerson A. 2016. The relationship between post-migration stress and psychological disorders in refugees and asylum seekers. Curr. Psychiatry Rep. 18:82
    [Google Scholar]
  72. Liddell B, Malhi GS, Felmingham KL, Cheung J, Outhred T et al. 2021a. The impact of torture on interpersonal threat and reward neurocircuitry. Aust. N. Z. J. Psychiatry 55:153–66
    [Google Scholar]
  73. Liddell BJ, Byrow Y, O'Donnell M, Mau V, Batch N et al. 2021b. Mechanisms underlying the mental health impact of family separation on resettled refugees. Aust. N. Z. J. Psychiatry 55:699–710
    [Google Scholar]
  74. Liddell BJ, Cheung J, Outhred T, Das P, Malhi GS et al. 2019a. Neural correlates of posttraumatic stress disorder symptoms, trauma exposure, and postmigration stress in response to fear faces in resettled refugees. Clin. Psychol. Sci. 7:811–25
    [Google Scholar]
  75. Liddell BJ, Das P, Malhi GS, Felmingham KL, Outhred T, Cheung J et al. 2022. Torture exposure and the functional brain: investigating disruptions to intrinsic network connectivity using resting state fMRI. Transl. Psychiatry 12:37
    [Google Scholar]
  76. Liddell BJ, Jobson L. 2016. The impact of cultural differences in self-representation on the neural substrates of posttraumatic stress disorder. Eur. J. Psychotraumatol. 7:30464
    [Google Scholar]
  77. Liddell BJ, Malhi GS, Felmingham KL, Den M, Das P et al. 2021c. Activating the attachment system modulates neural responses to threat in refugees with PTSD. Soc. Cogn. Affect. Neurosci. 16:1244–55
    [Google Scholar]
  78. Liddell BJ, Nickerson A, Bryant RA. 2018. Clinical science and torture survivors’ right to rehabilitation. Lancet Psychiatry 5:102–3
    [Google Scholar]
  79. Liddell BJ, Nickerson A, Felmingham KL, Malhi GS, Cheung J et al. 2019b. Complex posttraumatic stress disorder symptom profiles in traumatized refugees. J. Trauma Stress 32:822–32
    [Google Scholar]
  80. Lindert J, von Ehrenstein OS, Priebe S, Mielck A, Brähler E. 2009. Depression and anxiety in labor migrants and refugees—a systematic review and meta-analysis. Soc. Sci. Med. 69:246–57
    [Google Scholar]
  81. Litz BT, Stein N, Delaney E, Lebowitz L, Nash WP et al. 2009. Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin. Psychol. Rev. 29:695–706
    [Google Scholar]
  82. Loerinc AG, Meuret AE, Twohig MP, Rosenfield D, Bluett EJ, Craske MG. 2015. Response rates for CBT for anxiety disorders: need for standardized criteria. Clin. Psychol. Rev. 42:72–82
    [Google Scholar]
  83. Logie CH, Okumu M, Mwima S, Hakiza R, Irungi KP et al. 2019. Social ecological factors associated with experiencing violence among urban refugee and displaced adolescent girls and young women in informal settlements in Kampala, Uganda: a cross-sectional study. Confl. Health 13:60
    [Google Scholar]
  84. Mace AO, Mulheron S, Jones C, Cherian S. 2014. Educational, developmental and psychological outcomes of resettled refugee children in Western Australia: a review of School of Special Educational Needs: Medical and Mental Health input. J. Paediatr. Child Health 50:985–92
    [Google Scholar]
  85. MacLean SA, Agyeman PO, Walther J, Singer EK, Baranowski KA, Katz CL. 2019. Mental health of children held at a United States immigration detention center. Soc. Sci. Med. 230:303–8
    [Google Scholar]
  86. Marx BP, Sloan DM. 2005. Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behav. Res. Ther. 43:569–83
    [Google Scholar]
  87. Matheson K, Jorden S, Anisman H. 2008. Relations between trauma experiences and psychological, physical and neuroendocrine functioning among Somali refugees: mediating role of coping with acculturation stressors. J. Immigr. Minor. Health 10:291–304
    [Google Scholar]
  88. May S, Rapee RM, Coello M, Momartin S, Aroche J. 2014. Mental health literacy among refugee communities: differences between the Australian lay public and the Iraqi and Sudanese refugee communities. Soc. Psychiatry Psychiatr. Epidemiol. 49:757–69
    [Google Scholar]
  89. Mellor R, Werner A, Moussa B, Mohsin M, Jayasuriya R, Tay AK. 2021. Prevalence, predictors and associations of complex post-traumatic stress disorder with common mental disorders in refugees and forcibly displaced populations: a systematic review. Eur. J. Psychotraumatol. 12:1863579
    [Google Scholar]
  90. Mewes R, Reich H, Skoluda N, Seele F, Nater UM. 2017. Elevated hair cortisol concentrations in recently fled asylum seekers in comparison to permanently settled immigrants and non-immigrants. Transl. Psychiatry 7:e1051
    [Google Scholar]
  91. Michelson D, Sclare I. 2009. Psychological needs, service utilization and provision of care in a specialist mental health clinic for young refugees: a comparative study. Clin. Child Psychol. Psychiatry 14:273–96
    [Google Scholar]
  92. Miller KE, Rasmussen A. 2010. War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc. Sci. Med. 70:7–16
    [Google Scholar]
  93. Miller KE, Rasmussen A. 2017. The mental health of civilians displaced by armed conflict: an ecological model of refugee distress. Epidemiol. Psychiatr. Sci. 26:129–38
    [Google Scholar]
  94. Morina N, Bryant RA, Doolan EL, Martin-Sölch C, Plichta MM et al. 2018a. The impact of enhancing perceived self-efficacy in torture survivors. Depress. Anxiety 35:58–64
    [Google Scholar]
  95. Morina N, Kuenburg A, Schnyder U, Bryant RA, Nickerson A, Schick M. 2018b. The association of post-traumatic and postmigration stress with pain and other somatic symptoms: an explorative analysis in traumatized refugees and asylum seekers. Pain Med. 19:50–59
    [Google Scholar]
  96. Morina N, Malek M, Nickerson A, Bryant RA. 2017a. Meta-analysis of interventions for posttraumatic stress disorder and depression in adult survivors of mass violence in low- and middle-income countries. Depress. Anxiety 34:679–91
    [Google Scholar]
  97. Morina N, Malek M, Nickerson A, Bryant RA. 2017b. Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: meta-analysis. Br. J. Psychiatry 210:247–54
    [Google Scholar]
  98. Morina N, Schnyder U, Schick M, Nickerson A, Bryant RA. 2016. Attachment style and interpersonal trauma in refugees. Aust. N. Z. J. Psychiatry 50:1161–68
    [Google Scholar]
  99. Müller LRF, Gossmann K, Hartmann F, Büter KP, Rosner R, Unterhitzenberger J. 2019. 1-year follow-up of the mental health and stress factors in asylum-seeking children and adolescents resettled in Germany. BMC Public Health 19:908
    [Google Scholar]
  100. Murray LK, Dorsey S, Haroz E, Lee C, Alsiary MM et al. 2014. A common elements treatment approach for adult mental health problems in low- and middle-income countries. Cogn. Behav. Pract. 21:111–23
    [Google Scholar]
  101. Nguyen TP, Guajardo MGU, Sahle BW, Renzaho AMN, Slewa-Younan S. 2022. Prevalence of common mental disorders in adult Syrian refugees resettled in high income Western countries: a systematic review and meta-analysis. BMC Psychiatry 22:15
    [Google Scholar]
  102. Nickerson A, Bryant RA, Rosebrock L, Litz BT. 2014a. The mechanisms of psychosocial injury following human rights violations, mass trauma, and torture. Clin. Psychol. Sci. Pract. 21:172–91
    [Google Scholar]
  103. Nickerson A, Byrow Y, Hoffman J, O'Donnell M, Bryant RA et al. 2022. The longitudinal association between moral injury appraisals and psychological outcomes in refugees. Psychol. Med. 52:2352–64
    [Google Scholar]
  104. Nickerson A, Byrow Y, O'Donnell M, Mau V, McMahon T et al. 2019. The association between visa insecurity and mental health, disability and social engagement in refugees living in Australia. Eur. J. Psychotraumatol. 10:1688129
    [Google Scholar]
  105. Nickerson A, Garber B, Ahmed O, Asnaani A, Cheung J et al. 2016. Emotional suppression in torture survivors: relationship to posttraumatic stress symptoms and trauma-related negative affect. Psychiatry Res 242:233–39
    [Google Scholar]
  106. Nickerson A, Garber B, Liddell BJ, Litz BT, Hofmann SG et al. 2017. Impact of cognitive reappraisal on negative affect, heart rate, and intrusive memories in traumatized refugees. Clin. Psychol. Sci. 5:497–512
    [Google Scholar]
  107. Nickerson A, Liddell BJ, Maccallum F, Steel Z, Silove D, Bryant RA. 2014b. Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss. BMC Psychiatry 14:106
    [Google Scholar]
  108. Nickerson A, Steel Z, Bryant R, Brooks R, Silove D. 2011. Change in visa status amongst Mandaean refugees: relationship to psychological symptoms and living difficulties. Psychiatry Res. 187:267–74
    [Google Scholar]
  109. Nosè M, Ballette F, Bighelli I, Turrini G, Purgato M et al. 2017. Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: systematic review and meta-analysis. PLOS ONE 12:e0171030
    [Google Scholar]
  110. Nosè M, Tarsitani L, Tedeschi F, Lotito C, Massetti P et al. 2020. Association of traumatic events with levels of psychological distress and depressive symptoms in male asylum seekers and refugees resettled in Italy. BMC Psychiatry 20:576
    [Google Scholar]
  111. Panter-Brick C, Grimon M-P, Kalin M, Eggerman M. 2015. Trauma memories, mental health, and resilience: a prospective study of Afghan youth. J. Child Psychol. Psychiatry 56:814–25
    [Google Scholar]
  112. Papadopoulos C, Foster J, Caldwell K 2013.. ‘ Individualism-collectivism’ as an explanatory device for mental illness stigma. Commun. Ment. Health J. 49:270–80
    [Google Scholar]
  113. Patel V, Weiss HA, Chowdhary N, Naik S, Pednekar S et al. 2010. Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial. Lancet 376:2086–95
    [Google Scholar]
  114. Perera C, Salamanca-Sanabria A, Caballero-Bernal J, Feldman L, Hansen M et al. 2020. No implementation without cultural adaptation: a process for culturally adapting low-intensity psychological interventions in humanitarian settings. Confl. Health 14:46
    [Google Scholar]
  115. Pérez-Vázquez S, Bonilla-Campos A. 2022. Women refugee's perceptions, experiences and coping mechanisms in situations of sexual and gender-based violence (SGBV): a metasynthesis. Trauma Violence Abuse In press https://doi.org/10.1177/15248380221126470
    [Google Scholar]
  116. Pitts KP, Joksimovic L, Steudte-Schmiedgen S, Rohleder N, Wolf JM. 2016. Determinants of altered intracellular endocrine-immune interplay in Bosnian war refugees suffering from PTSD. Biol. Psychol. 118:1–7
    [Google Scholar]
  117. Porter M, Haslam N. 2005. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294:602–12
    [Google Scholar]
  118. Purgato M, Carswell K, Tedeschi F, Acarturk C, Anttila M et al. 2021. Effectiveness of self-help plus in preventing mental disorders in refugees and asylum seekers in Western Europe: a multinational randomized controlled trial. Psychother. Psychosom. 90:403–14
    [Google Scholar]
  119. Reebs A, Yuval K, Bernstein A. 2017. Remembering and responding to distressing autobiographical memories: exploring risk and intervention targets for posttraumatic stress in traumatized refugees. Clin. Psychol. Sci. 5:789–97
    [Google Scholar]
  120. Robjant K, Robbins I, Senior V. 2009. Psychological distress amongst immigration detainees: a cross-sectional questionnaire study. Br. J. Clin. Psychol. 48:275–86
    [Google Scholar]
  121. Rohleder N, Joksimovic L, Wolf JM, Kirschbaum C. 2004. Hypocortisolism and increased glucocorticoid sensitivity of pro-inflammatory cytokine production in Bosnian war refugees with posttraumatic stress disorder. Biol. Psychiatry 55:745–51
    [Google Scholar]
  122. Saadi A, Hampton K, de Assis MV, Mishori R, Habbach H, Haar RJ. 2021. Associations between memory loss and trauma in US asylum seekers: a retrospective review of medico-legal affidavits. PLOS ONE 16:e0247033
    [Google Scholar]
  123. Sabioncello A, Kocijan-Hercigonja D, Rabatić S, Tomasić J, Jeren T et al. 2000. Immune, endocrine, and psychological responses in civilians displaced by war. Psychosom. Med. 62:502–8
    [Google Scholar]
  124. Scharpf F, Kaltenbach E, Nickerson A, Hecker T. 2021. A systematic review of socio-ecological factors contributing to risk and protection of the mental health of refugee children and adolescents. Clin. Psychol. Rev. 83:101930
    [Google Scholar]
  125. Siehl S, King JA, Burgess N, Flor H, Nees F 2018. Structural white matter changes in adults and children with posttraumatic stress disorder: a systematic review and meta-analysis. Neuroimage Clin. 19:581–98
    [Google Scholar]
  126. Silove D, Momartin S, Marnane C, Steel Z, Manicavasagar V. 2010. Adult separation anxiety disorder among war-affected Bosnian refugees: comorbidity with PTSD and associations with dimensions of trauma. J. Trauma Stress 23:169–72
    [Google Scholar]
  127. Sim A, Bowes L, Gardner F. 2018. Modeling the effects of war exposure and daily stressors on maternal mental health, parenting, and child psychosocial adjustment: a cross-sectional study with Syrian refugees in Lebanon. Glob. Ment. Health 5:e40
    [Google Scholar]
  128. Singla DR, Kohrt B, Murray LK, Anand A, Chorpita BF et al. 2017. Psychological treatments for the world: lessons from low- and middle-income countries. Annu. Rev. Clin. Psychol. 13:149–81
    [Google Scholar]
  129. Singla DR, Waqas A, Hamdani SU, Suleman N, Zafar SW et al. 2020. Implementation and effectiveness of adolescent life skills programs in low- and middle-income countries: a critical review and meta-analysis. Behav. Res. Ther. 130:103402
    [Google Scholar]
  130. Slewa-Younan S, Mond J, Bussion E, Mohammad Y, Uribe Guajardo MG et al. 2014. Mental health literacy of resettled Iraqi refugees in Australia: knowledge about posttraumatic stress disorder and beliefs about helpfulness of interventions. BMC Psychiatry 14:320
    [Google Scholar]
  131. Sommershof A, Aichinger H, Engler H, Adenauer H, Catani C et al. 2009. Substantial reduction of naïve and regulatory T cells following traumatic stress. Brain Behav. Immun. 23:1117–24
    [Google Scholar]
  132. Specker P, Nickerson A. 2023. An experimental investigation of spontaneous emotion regulation variability, negative affect, and posttraumatic stress disorder among traumatized refugees. Psychol. Trauma 15:2219–26
    [Google Scholar]
  133. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, van Ommeren M. 2009. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA 302:537–49
    [Google Scholar]
  134. Steel Z, Silove D, Brooks R, Momartin S, Alzuhairi B, Susljik I. 2006. Impact of immigration detention and temporary protection on the mental health of refugees. Br. J. Psychiatry 188::58–64
    [Google Scholar]
  135. Storm T, Engberg M. 2013. The impact of immigration detention on the mental health of torture survivors is poorly documented—a systematic review. Dan. Med. J. 60:A4728
    [Google Scholar]
  136. Sulaiman-Hill CMR, Thompson SC 2013. Learning to fit in: an exploratory study of general perceived self efficacy in selected refugee groups. J. Immig. Minor. Health 15:125–31
    [Google Scholar]
  137. Tay AK, Rees S, Chen J, Kareth M, Silove D. 2015. Pathways involving traumatic losses, worry about family, adult separation anxiety and posttraumatic stress symptoms amongst refugees from West Papua. J. Anxiety Disord. 35:1–8
    [Google Scholar]
  138. Teodorescu DS, Heir T, Siqveland J, Hauff E, Wentzel-Larsen T, Lien L 2015. Chronic pain in multi-traumatized outpatients with a refugee background resettled in Norway: a cross-sectional study. BMC Psychol. 3:7
    [Google Scholar]
  139. Tol WA, Leku MR, Lakin DP, Carswell K, Augustinavicius J et al. 2020. Guided self-help to reduce psychological distress in South Sudanese female refugees in Uganda: a cluster randomized trial. Lancet Glob. Health 8:e254–63
    [Google Scholar]
  140. Turrini G, Purgato M, Acarturk C, Anttila M, Au T et al. 2019. Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis. Epidemiol. Psychiatr. Sci. 28:376–88
    [Google Scholar]
  141. Turrini G, Purgato M, Ballette F, Nosè M, Ostuzzi G, Barbui C. 2017. Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies. Int. J. Ment. Health Syst. 11:51
    [Google Scholar]
  142. Turrini G, Tedeschi F, Cuijpers P, Del Giovane C, Kip A et al. 2021. A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD. BMJ Glob. Health 6:e005029
    [Google Scholar]
  143. Uldall SW, Lundell H, Baaré WFC, Siebner HR, Rostrup E, Carlsson JM. 2022. White matter diffusivity and its correlations to state measures of psychopathology in male refugees with posttraumatic stress disorder. Neuroimage Clin. 33:102929
    [Google Scholar]
  144. UN Gen. Assem 1967. Protocol relating to the status of refugees. UN Treaty Ser. 606:267–76 https://www.refworld.org/docid/3ae6b3ae4.html
    [Google Scholar]
  145. UNHCR (UN High Comm. Refug.) 2014. Asylum-seekers. UNHCR http://www.unhcr.org/pages/49c3646c137.html
    [Google Scholar]
  146. UNHCR (UN High Comm. Refug.) 2020a. Global trends: forced displacement in 2019 Rep. UNHCR Glob. Data Serv. Copenhagen: https://www.unhcr.org/globaltrends2019/
    [Google Scholar]
  147. UNHCR (UN High Comm. Refug.) 2020b. Refugee camps. UNHCR https://www.unrefugees.org/refugee-facts/camps/
    [Google Scholar]
  148. UNHCR (UN High Comm. Refug.) 2022a. Global trends: forced displacement in 2021 Rep. UNHCR Glob. Data Serv. Copenhagen: https://www.unhcr.org/62a9d1494/global-trends-report-2021
    [Google Scholar]
  149. UNHCR (UN High Comm. Refug.) 2022b. Ukraine, other conflicts push forcibly displaced total over 100 million for first time Press Release May 23. https://www.unhcr.org/en-au/news/press/2022/5/628a389e4/unhcr-ukraine-other-conflicts-push-forcibly-displaced-total-100-million.html
    [Google Scholar]
  150. van Ee E, Jongmans MJ, van der Aa N, Kleber RJ. 2017. Attachment representation and sensitivity: the moderating role of posttraumatic stress disorder in a refugee sample. Fam. Process 56:781–92
    [Google Scholar]
  151. van Ee E, Kleber RJ, Jongmans MJ, Mooren TT, Out D. 2016. Parental PTSD, adverse parenting and child attachment in a refugee sample. Attach. Hum. Dev. 18:273–91
    [Google Scholar]
  152. van Heemstra HE, Scholte WF, Haagen JFG, Boelen PA. 2019. 7ROSES, a transdiagnostic intervention for promoting self-efficacy in traumatized refugees: a first quantitative evaluation. Eur. J. Psychotraumatol. 10:1673062
    [Google Scholar]
  153. van Heemstra HE, Scholte WF, Nickerson A, Boelen PA. 2021. Can circumstances be softened? Self-efficacy, post-migratory stressors, and mental health among refugees. Int. J. Environ. Res. Public Health 18:1440
    [Google Scholar]
  154. Vervliet M, Lammertyn J, Broekaert E, Derluyn I. 2014. Longitudinal follow-up of the mental health of unaccompanied refugee minors. Eur. Child Adolesc. Psychiatry 23:337–46
    [Google Scholar]
  155. von Werthern M, Robjant K, Chui Z, Schon R, Ottisova L et al. 2018. The impact of immigration detention on mental health: a systematic review. BMC Psychiatry 18:382
    [Google Scholar]
  156. Weiss WM, Murray LK, Zangana GAS, Mahmooth Z, Kaysen D et al. 2015. Community-based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial. BMC Psychiatry 15:249
    [Google Scholar]
  157. WHO (World Health Organ.) 2018. International Classification of Diseases for Mortality and Morbidity Statistics Geneva: WHO 11th rev. http://www.who.int/classifications/icd/revision/en/
    [Google Scholar]
  158. Wittekind CE, Jelinek L, Kleim B, Muhtz C, Moritz S, Berna F. 2017. Age effect on autobiographical memory specificity: a study on autobiographical memory specificity in elderly survivors of childhood trauma. J. Behav. Ther. Exp. Psychiatry 54:247–53
    [Google Scholar]
  159. Zandieh S, Bernt R, Knoll P, Wenzel T, Hittmair K et al. 2016. Analysis of the metabolic and structural brain changes in patients with torture-related post-traumatic stress disorder (TR-PTSD) using 18F-FDG PET and MRI. Medicine 95:e3387
    [Google Scholar]
/content/journals/10.1146/annurev-clinpsy-080921-080359
Loading
  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error