Mental health in Iraqi refugees: Importance of post-displacement social stressors

伊拉克难民的心理健康：流离失所后社会压力源的重要性

基本信息

批准号：
8098996
负责人：
Bengt Birger Arnetz
金额：
$ 56.11万
依托单位：
WAYNE STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2015-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8098996
关键词：
Accounting Acculturation Address Adjustment Disorders Affect American Anxiety Arabs Attenuated Childhood Clinic Clinical Collaborations Communities Community Health Control Groups Controlled Study Coping Skills Country Coupled Data Development Diagnosis Diagnostic Disease Education Effectiveness Environment Environmental Risk Factor Evaluation Exposure to Goals Health Health Status Immigrant Incidence Individual Inservice Training Interview Interviewer Knowledge Language Lead Legal Link Major Depressive Disorder Measures Mediating Mental Depression Mental Health Mental disorders Methods Middle East Occupational Occupations Outcome Participant Play Policies Population Post-Traumatic Stress Disorders Prevalence Process Public Health Publications Recovery Recruitment Activity Refugees Research Research Design Research Personnel Resources Review Literature Risk Risk Factors Role Sampling Sampling Studies Services Social Functioning Social Work Social support Stress Symptoms Time Torture Training Translating Trauma Victimization Violence War base community organizations comparison group coping cost cost effective design displaced person experience improved innovation migration novel prevent primary outcome programs prospective psychosocial public health relevance response secondary outcome service utilization social social implication socioeconomics stressor

项目摘要

DESCRIPTION (provided by applicant): Refugees are at a strikingly elevated risk of suffering from post-displacement mental disorders, with severe implications for social and occupational functioning while increasing the burden and costs of mental health and social services. Studies have identified pre-displacement individuals and socio-environmental risk factors for refugee mental health. These factors, e.g., exposure to war trauma, are largely non-malleable. However, there is increasing scientific evidence of adverse mental health effects from post-displacement trauma, including violence, and marginalization. As a result, there is a need to assess the efficacy of post-displacement institutional resources, such as language and vocational training. Although significant resources are devoted to such post-displacement programs, there is a void of prospective, controlled studies examining their effectiveness in promoting refugees' mental health. The long-term goal of this research is to further our understanding of post-displacement institutional risk and resiliency factors for mental health. The overall objective of this proposal is to compare mental health over time in a random sample of newly arrived Iraqi refugees and legal Middle East immigrant controls. The central hypothesis, based on our pilot data, is that post-displacement institutional resources attenuate mental health consequences of post-displacement stress, controlling for pre-displacement trauma. The primary specific aims are to: 1) Describe the differences in mental health disorders, specifically post-traumatic stress disorder (PTSD) and depression, between newly arrived Iraqi refugees and non-war exposed Arab immigrant to the U.S. and their relationship to pre-displacement trauma; 2: Determine the relationship between pre-displacement trauma and post-displacement stressors as it relates prospectively to mental health over a 2-year period, and whether this relationship differs between refugees and immigrants; and 3: Determine the impact of post-migration institutional services on mental health and whether effects differ by group. This research is innovative in that it uses a random sampling, prospective, controlled design to study important mental health among newly arrived refugees. Our multi-disciplinary team, with excellent relationships to the Arab and Chaldean American community, will thus evaluate multiple levels of predictors of mental health: group (refugee vs. immigrant), pre- and post-displacement trauma, institutional resources (service utilization), and interactions between these factors. The expected outcome is improved understanding of the relationship between trauma, social service utilization and mental health. The project is of public health relevance in that it will examine the impact of post-migration institutional resources on refugee mental health, with implication for social and occupational integration. PUBLIC HEALTH RELEVANCE: Due to methodological limitations, studies to date have not been able to ascertain whether refugees are at a disproportionally increased risk for serious and costly mental health disorders as compared to non-war exposed immigrants. In collaboration with Arab and Chaldean community organizations, we propose to study and compare a hypothesized beneficial effect of post-displacement institutional resources, i.e., language and job training on refugee and immigrant mental health. The proposed research is substantially relevant to public heath both in contributing new and generalizable knowledge of relationships between pre and post- displacement factors, institutional resources and mental health in refugees, and also in its capacity to inform the development of cost-effective, beneficial mental health resettlement policies.

描述（由申请人提供）：难民患流离失所后精神障碍的风险显着升高，对社会和职业功能产生严重影响，同时增加了心理健康和社会服务的负担和成本。研究已经确定了流离失所前的个人和社会环境对难民心理健康的危险因素。这些因素，例如遭受战争创伤，在很大程度上是不可塑性的。然而，越来越多的科学证据表明，流离失所后的创伤（包括暴力和边缘化）会对心理健康产生不利影响。因此，有必要评估流离失所后机构资源的有效性，例如语言和职业培训。尽管此类流离失所后项目投入了大量资源，但缺乏前瞻性、对照研究来检验其在促进难民心理健康方面的有效性。这项研究的长期目标是进一步了解流离失所后的机构风险和心理健康的弹性因素。该提案的总体目标是比较新抵达的伊拉克难民和合法中东移民控制的随机样本随时间变化的心理健康状况。基于我们的试点数据，中心假设是流离失所后的机构资源减轻了流离失所后压力对心理健康的影响，控制了流离失所前的创伤。主要的具体目标是： 1) 描述新抵达美国的伊拉克难民和未经历过战争的阿拉伯移民在精神健康障碍方面的差异，特别是创伤后应激障碍 (PTSD) 和抑郁症，以及他们与之前的关系。移位创伤； 2：确定流离失所前创伤和流离失所后压力源之间的关系，因为它与两年内的心理健康前瞻性相关，以及难民和移民之间的这种关系是否不同； 3：确定移民后机构服务对心理健康的影响以及影响是否因群体而异。这项研究的创新之处在于它采用随机抽样、前瞻性、受控设计来研究新抵达难民的重要心理健康状况。我们的多学科团队与阿拉伯和迦勒底裔美国人社区有着良好的关系，因此将评估心理健康的多个预测因素：群体（难民与移民）、流离失所前和流离失所后的创伤、机构资源（服务利用），以及这些因素之间的相互作用。预期结果是加深对创伤、社会服务利用和心理健康之间关系的理解。该项目具有公共卫生相关性，因为它将研究移民后机构资源对难民心理健康的影响，并对社会和职业融合产生影响。公共卫生相关性：由于方法学的局限性，迄今为止的研究尚无法确定与未经历战争的移民相比，难民患严重且代价高昂的精神健康疾病的风险是否不成比例地增加。我们与阿拉伯和迦勒底社区组织合作，建议研究和比较流离失所后机构资源（即语言和工作培训对难民和移民心理健康的假设有益影响）。拟议的研究与公共卫生密切相关，不仅提供了有关流离失所前和流离失所后因素、机构资源和难民心理健康之间关系的新的和普遍的知识，而且还能够为制定具有成本效益、有益的心理健康提供信息。卫生安置政策。