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Giordano F, Lipscomb S, Jefferies P, Kwon KA, Giammarchi M. Resilience processes among Ukrainian youth preparing to build resilience with peers during the Ukraine-Russia war. Front Psychol 2024; 15:1331886. [PMID: 38445056 PMCID: PMC10913279 DOI: 10.3389/fpsyg.2024.1331886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
The war in Ukraine significantly impacts the mental health and well-being of its youth. Like other communities affected by war, Ukraine's youth are at risk of developing psychopathological symptoms, and there is a shortage of mental health and psychosocial support services to address this. Resilience-building initiatives present an alternative approach to supporting the well-being of young people by promoting protective processes to enhance the likelihood of positive development in the context of adversity. Emerging research findings suggest that young people themselves can serve as powerful facilitators of such initiatives with one another. Yet, evidence about culturally and contextually relevant protective processes is needed to guide such interventions, especially among young people experiencing the war and working to boost resilience within their communities. In this study, we identified key protective processes Ukrainian youth depend on as they adapt to the conflict while also preparing to implement a resilience-building intervention as a facilitator. Through thematic analysis of transcripts of three training sessions with Ukrainian youth (n = 15, 100% female; aged 18-22), we identified the following themes: positive thinking, sense of control, emotion awareness and regulation, close personal relationships, and community support. Findings also highlighted the cultural and contextual nuance of these protective processes, as well as individual differences in the ways they co-occurred and manifested within each youth. Results have implications for developing tailored yet flexible resilience-building interventions that can be delivered by lay people, including youth with their peers, in Ukraine and other cultures and contexts.
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Affiliation(s)
- Francesca Giordano
- Resilience Research Unit, C.R.I.d.e.e., Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Shannon Lipscomb
- Human Development and Family Sciences, College of Health, Oregon State University—Cascades, Bend, OR, United States
| | - Philip Jefferies
- Resilience Research Centre, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Kyong-Ah Kwon
- Instructional Leadership and Academic Curriculum, Jeannine Rainbolt College of Education, University of Oklahoma, Tulsa, OK, United States
| | - Marianna Giammarchi
- Resilience Research Unit, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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Sultani G, Heinsch M, Wilson J, Pallas P, Tickner C, Kay-Lambkin F. 'Now I Have Dreams in Place of the Nightmares': An Updated Systematic Review of Post-Traumatic Growth Among Refugee Populations. TRAUMA, VIOLENCE & ABUSE 2024; 25:795-812. [PMID: 37097092 PMCID: PMC10666490 DOI: 10.1177/15248380231163641] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Trauma exposure places refugees at serious risk of developing mental health difficulties. However, research also recognizes that refugees can respond to trauma with psychological development and growth, commonly referred to as post-traumatic growth (PTG). An updated systematic review was conducted to investigate PTG across different refugee populations, including the processes that mediate this phenomenon, and the use of therapy in promoting PTG. A systematic search of CINAHL Complete, Proquest 5000, PsychINFO, Scopus, and Web of Science was performed to identify studies exploring PTG in refugee populations, published between June 2013 and November 2021. In all, 26 studies met the inclusion criteria for this review. Quantitative results reveal a positive correlation between PTG and religious commitment and coping, and the effectiveness of narrative and community-based interventions in facilitating PTG. Qualitative results facilitate insight into the complex ways refugees find meaning and strength after trauma through religion, comparison-based thinking, helping others, and storytelling. Findings highlight the need for future research and interventions to recognize the distinct PTG experiences of different refugee populations.
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Tesfai A, Captari LE, Meyer-Weitz A, Cowden RG. Coping Resources among Forced Migrants in South Africa: Exploring the Role of Character Strengths in Coping, Adjustment, and Flourishing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:50. [PMID: 38248515 PMCID: PMC10815753 DOI: 10.3390/ijerph21010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/25/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024]
Abstract
This phenomenological qualitative study explored how forced migrants in South Africa cope with violent, traumatic experiences and precarious resettlement conditions. Data came from a larger empirical project examining migration, psychological distress, and coping. In-depth interviews were conducted with 14 refugees and asylum seekers (Mage = 30.27, SDage = 9.27; male = 71.43%) who migrated from five African countries to Durban, South Africa. Despite overwhelming stressors, participants described pathways to transcend victimhood and hardship through engaging character strengths in ways that promote post-traumatic growth. Qualitative analysis revealed five overarching domains: spirituality and religiousness, love and kindness, hope and optimism, persistence and fortitude, and gratitude and thankfulness. Findings are framed within positive existential psychology and dual-factor understandings of mental health, which attend to both human suffering and flourishing. Limitations, future research directions, and clinical and community implications are discussed, with attention to the role of character strengths in adaptive coping and psychological well-being. The intergenerational transmission of strengths is explored as one potential means of buffering intergenerational trauma impacts and promoting family post-traumatic growth.
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Affiliation(s)
- Aron Tesfai
- Discipline Psychology, School of Applied Human Science, College of Humanities, Howard College Campus, University of KwaZulu-Natal, Durban 4041, South Africa;
| | - Laura E. Captari
- The Albert and Jessie Danielsen Institute, Boston University, Boston, MA 02446, USA;
| | - Anna Meyer-Weitz
- Discipline Psychology, School of Applied Human Science, College of Humanities, Howard College Campus, University of KwaZulu-Natal, Durban 4041, South Africa;
| | - Richard G. Cowden
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA 02138, USA
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4
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Lindert J, Samkange-Zeeb F, Jakubauskiene M, Bain PA, Mollica R. Factors Contributing to Resilience Among First Generation Migrants, Refugees and Asylum Seekers: A Systematic Review. Int J Public Health 2023; 68:1606406. [PMID: 38146483 PMCID: PMC10749365 DOI: 10.3389/ijph.2023.1606406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/07/2023] [Indexed: 12/27/2023] Open
Abstract
Objectives: We aimed at 1) collating and evaluating the current evidence on factors contributing to resilience of adult transnational migrants, 2) identifying methodological factors which contribute to the findings, 3) identifying and analyzing promotive and preventive factors contributing to the findings. Methods: A systematic search for relevant studies published until 2021 was conducted in PubMed, PsycINFO, PTSDPubs, and Web of Science. Both, quantitative and qualitative peer-reviewed observational studies reporting on resilience and wellbeing, sense of coherence, or post-traumatic growth outcomes among transnational migrants (aged 18+). Risk of Bias was assessed using the Critical Appraisal Skills Program for qualitative studies and the Appraisal Tool for cross-sectional studies. Due to the heterogeneity of studies we did a narrative review. Results: Database search yielded 3,756 unique records, of those n = 80 records, representing n = 76 studies met the inclusion criteria. The studies provided knowledge on resilience for n = 9,845 transnational migrants across 23 countries. All studies except two were cross sectional. N = 45 reported on resilience, n = 4 on Sense of Coherence and n = 15 on Post-Traumatic Growth. The study methods were not related to the findings. Future orientation, hope and religion/spirituality, caring for others and having opportunities were shown to be more pertinent to resilience outcomes than institutional care structures. Conclusion: Our findings highlight that mental health professionals and policymakers should try to support positive perspectives for the future and encourage policies tailored towards giving refugees opportunities to work, learn and care and to help others.
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Affiliation(s)
- Jutta Lindert
- Department of Health and Social Work, University of Applied Sciences Emden/Leer, Emden, Germany
- Women’s Research Center, Brandeis University, Waltham, MA, United States
| | | | | | - Paul A. Bain
- Countway Library of Medicine, Harvard Medical School, Boston, MA, United States
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Nyikavaranda P, Pantelic M, Jones CJ, Paudyal P, Tunks A, Llewellyn CD. Barriers and facilitators to seeking and accessing mental health support in primary care and the community among female migrants in Europe: a "feminisms" systematic review. Int J Equity Health 2023; 22:196. [PMID: 37752502 PMCID: PMC10523615 DOI: 10.1186/s12939-023-01990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to accessing mental health services in their host countries. This systematic review aims to summarise the barriers and facilitators to accessing mental health support for female migrants in Europe. METHODS The review follows PRISMA guidelines, and the protocol was pre-published on PROSPERO. Six electronic databases were searched: CINAHL, Global Health Database, Medline, PsycARTICLES, PsycINFO and Web of Science. Thematic analysis was undertaken on the identified studies. A feminist quality appraisal tool was applied. RESULTS Eight qualitative, six quantitative and five mixed methods studies were identified. Barriers included a lack of information, stigma, religious and cultural practices and beliefs, and a lack of consideration of gender-specific needs within the health system. Gender-sensitive services, supportive general practitioners and religious leaders facilitated access. CONCLUSIONS The design of mental health research, services, policies, and commissioning of support for migrants must consider female migrant needs. Mental health support services must be culturally aware and gender sensitive. REGISTRATION The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42021235571.
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Affiliation(s)
- Patrick Nyikavaranda
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK.
| | - Marija Pantelic
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Priyamvada Paudyal
- Institute for Global Health and Wellbeing School of Medicine, Keele University, Keele, Staffordshire, ST5 5GB, UK
| | - Alice Tunks
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Carrie D Llewellyn
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
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Ceccon C, Moscardino U. Impact of COVID-19 and lockdown on mental health and future orientation among young adult asylum seekers in Italy: A mixed-methods study. Transcult Psychiatry 2022; 59:782-796. [PMID: 35549951 PMCID: PMC9111910 DOI: 10.1177/13634615221098306] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The COVID-19 outbreak caused a worldwide health emergency which disproportionately affected migrants and ethnic minorities. Yet, little is known about the psychosocial effects of the pandemic among refugees and asylum seekers. This study used a convergent parallel mixed-method design to explore knowledge and opinions concerning COVID-19 and the impact of lockdown on perceived mental health and future orientation among 42 young adult asylum seekers residing in northeastern Italy. Participants took part in individual interviews comprising both qualitative and quantitative questions. Qualitative reports were analyzed using thematic content analysis, whereas descriptive statistics and paired sample t-tests were computed on quantitative data. Results indicated that most participants were correctly informed about the nature, origin, and spread of COVID-19, expressed moderate or high satisfaction concerning the clarity of communication about safety measures, and followed them most of the time. Worries about family in the home country, loneliness, fear for own and loved ones' health, and concerns about delays in the asylum application were the most frequently mentioned stressful events. Psychological and physical distress significantly increased, and positive future orientation significantly decreased during the lockdown. However, participants also emphasized the usefulness of instrumental support from social workers and exhibited a resilient attitude characterized by the acceptance of uncertainty, sense of connectedness, and positive outlook. Overall, findings suggest that the current emergency may exacerbate psychological vulnerabilities of asylum seekers due to continued existential uncertainty. Thus, individual and contextual assets should be strengthened to promote psychosocial adjustment and coping resources in the context of the pandemic.
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Affiliation(s)
- Chiara Ceccon
- Department of Developmental Psychology and Socialization, 9308University of Padova, Padova, Italy
| | - Ughetta Moscardino
- Department of Developmental Psychology and Socialization, 9308University of Padova, Padova, Italy
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Ciaramella M, Monacelli N, Cocimano LCE. Promotion of Resilience in Migrants: A Systematic Review of Study and Psychosocial Intervention. J Immigr Minor Health 2022; 24:1328-1344. [PMID: 34324124 PMCID: PMC9388436 DOI: 10.1007/s10903-021-01247-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
This systematic review aimed to contribute to a better and more focused understanding of the link between the concept of resilience and psychosocial interventions in the migrant population. The research questions concerned the type of population involved, definition of resilience, methodological choices and which intervention programmes were targeted at migrants. In the 90 articles included, an heterogeneity in defining resilience or not well specified definition resulted. Different migratory experiences were not adequately considered in the selection of participants. Few resilience interventions on migrants were resulted. A lack of procedure's descriptions that keep in account specific migrants' life-experiences and efficacy's measures were highlighted.
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Affiliation(s)
- Maria Ciaramella
- Department of Letters, Arts, History and Society, University of Study of Parma, Via Kennedy, 6, 43125, Parma, PR, Italy.
| | - Nadia Monacelli
- Department of Economics and Business Sciences, University of Study of Parma, Parma, Italy
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Ramadan M, Kheirallah K, Saleh T, Bellizzi S, Shorman E. The Relationship Between Spirituality and Post-Traumatic Stress Symptoms in Syrian Adolescents in Jordan. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:585-593. [PMID: 35958726 PMCID: PMC9360348 DOI: 10.1007/s40653-021-00401-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 05/07/2023]
Abstract
The civil war in Syria began in 2011 and escalated over years resulting in one of the largest humanitarian crises since the Second World War. Injury, loss, poverty, and immigration trapped the Syrian population in a diversity of psychological disorders, including post-traumatic stress disorder (PTSD). Spirituality has, on the other hand, been consistently reported as a resilient factor against developing mental disorders. Hence, spirituality or religiosity have been incorporated in clinical and psychotherapeutic practice for several mental disorders. We explored the association between spirituality and the development of PTSD symptoms among Syrian refugee adolescents in Jordanian schools. A sample of 418 Syrian adolescent students (age range between 12-16 years) from Jordanian schools in the northern part of the country were enrolled in the study after informing on study context and objectives. The study questionnaire included sample demographics, smoking status, PTSD checklist - Civilian Version (PCL-C), two spirituality-targeting questions, and trauma and loss history. `Almost half of participants (N = 196) showed moderate PTSD symptoms while around 30% (N = 124) had a severe level of PTSD symptoms. On the other hand, 3 out of four students perceived themselves as highly spiritual. The study resulted in a positive correlation between belief in God and God's thankfulness. Furthermore, increased spirituality level did not appear to lower the risk of developing PTSD symptoms. Spiritual self-perception of Syrian refugee adolescents showed neither protective nor aggravating effect of on the occurrence of post-traumatic stress symptoms. Additional research and more accurate tools are needed to assess the potential impact of spiritual/religious values towards PTSD symptoms among adolescents.
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Affiliation(s)
| | - Khalid Kheirallah
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Tareq Saleh
- Department of Basic Medical Sciences, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Saverio Bellizzi
- Medical Epidemiologist, Independent Consultant, Geneva, Switzerland
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Im H, Swan LET. Factors Influencing Improvement of Trauma-Related Symptoms Among Somali Refugee Youth in Urban Kenya. Community Ment Health J 2022; 58:1179-1190. [DOI: https:/doi.org/10.1007/s10597-021-00928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/29/2021] [Indexed: 06/22/2023]
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10
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Im H, Swan LET. Factors Influencing Improvement of Trauma-Related Symptoms Among Somali Refugee Youth in Urban Kenya. Community Ment Health J 2022; 58:1179-1190. [PMID: 35013831 DOI: 10.1007/s10597-021-00928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/29/2021] [Indexed: 11/03/2022]
Abstract
Somali refugee youth present with a heightened risk for common mental disorders (CMDs), and yet few studies have discussed factors influencing mental health outcomes after psychosocial interventions. This study aimed to identify key factors that contribute to the improvement of CMD symptoms among Somali youth displaced in urban Kenya. Logistic regression analyses revealed that trauma exposure and emotional coping predict overall symptom improvement, pointing to a differential intervention effect on those with differing levels of religious belief and attitudes toward violence. This study provides insights into how psychosocial factors likely contribute to positive intervention outcomes in Somali refugee youth.
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Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Ave., 3rd Floor, Richmond, VA, 23284, USA.
| | - Laura E T Swan
- Department of Population Health Sciences, University of Wisconsin - Madison, 610 Walnut St., Madison, WI, 53726, USA
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Kim GU, Jung E, Shim MS, Kim GS. Association between post-traumatic stress symptoms and functional health among internally displaced people in Myanmar. J Psychiatr Ment Health Nurs 2022; 29:555-567. [PMID: 35467061 DOI: 10.1111/jpm.12837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 01/27/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Internally displaced persons (IDPs) in Myanmar have been exposed to conflict and violence for a long time and experience physical, psychological and social problems. Post-traumatic stress symptoms (PTSS) are more prevalent among IDPs than among general populations and refugees, and limited research is available on this topic among IDPs in Myanmar. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: More than one-third of the IDPs in our sample from Myanmar camps had a high PTSS score. More than two-thirds experienced traumatic events and left home after age 18. The overall functional health of IDPs was poor, and the presence or absence of PTSS led to differences in the factors associated with functional health in each group. Resilience and PTSS were associated with the functional health of IDPs in Myanmar. Further, functional health was positively correlated with levels of resilience among those relatively low in PTSS. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses need to assess IDPs' health status and PTSS by first performing health screening at camps in Myanmar. Subsequently, tailored interventions can be provided according to individual health conditions and PTSS severity. IDPs in Myanmar need psychological first aid to cope with the ongoing conflict and violence, and further mental health nurse training is necessary to implement this aid and tailored interventions for PTSS. ABSTRACT INTRODUCTION: Internally displaced persons (IDPs) are individuals forced to leave their homes and move within their country. Post-traumatic stress symptoms (PTSS) are prevalent in this population. AIM To investigate trauma symptoms and functional health of IDPs in Myanmar and identify the factors associated with their functional health according to the presence/absence of PTSS. METHOD This cross-sectional study included 201 IDPs who completed a questionnaire on functional health, PTSS, resilience, social support and hope. The analysis included descriptive statistics, t-tests, Pearson's correlation coefficients and multiple linear regression with interaction analyses. RESULTS Over one-third of the participants had PTSS, with low functional health scores. The greater the resilience, the better the functional health. The higher participants' PTSS, the poorer their functional health. There was a significant interaction between resilience and PTSS. DISCUSSION Tailored resilience-building programs, as well as health policies and services, are needed to enhance IDPs' functional health and help them overcome PTSS. IMPLICATIONS FOR PRACTICE Psychological first aid should be provided to minimize PTSS experienced in situations of ongoing conflict and violence. Mental health nurses should be trained to assess IDPs' health status and tailor interventions accordingly.
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Affiliation(s)
- Go-Un Kim
- College of Nursing, Inje University, Busan, South Korea
| | - Eunyoung Jung
- Korea Armed Forces Nursing Academy, Daejeon, South Korea
| | - Mi-So Shim
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Gwang Suk Kim
- College of Nursing, Yonsei University, Seoul, South Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
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Abraham R, Leonhardt M, Lien L, Hanssen I, Hauff E, Thapa SB. The relationship between religiosity/spirituality and quality of life among female Eritrean refugees living in Norwegian asylum centres. Int J Soc Psychiatry 2022; 68:881-890. [PMID: 33876654 DOI: 10.1177/00207640211010207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Women are more vulnerable to mental health problems than men after migration, but little is known about the influence of religiosity/spirituality on their quality of life. The purpose of this study was to explore religiosity/spirituality, in relationships with various domains of quality of life, among female Eritrean refugees staying in Norwegian asylum centres. METHOD A questionnaire assessing sociodemographic characteristics was used together with the World Health OrganizationQuality of Life - Spirituality, Religiosity and Personal Beliefs (WHOQOL-SRPB) questionnaire, which assesses religiosity/spirituality and domains of quality of life. A total of 63 adult female Eritrean refugees who had been granted asylum but were still living in asylum reception centres located in southern and central Norway participated. RESULTS Religiosity/spirituality was independently associated with psychological quality of life (B = 0.367, p < .001), level of independence (B = 0.184, p = .028), social quality of life (B = 0.500, p = .003), environmental quality of life (B = 0.323, p < .001) and overall quality of life (B = 0.213, p < .001), but not with physical quality of life (B = 0.056, p = .679). There were no significant differences between religious affiliations on religiosity/spirituality or quality of life measures. CONCLUSION Consistent with previous research, this study highlights the correlation between religiosity/spirituality and overall quality of life. We recommend a longitudinal follow-up study of similar populations, after they are resettled and integrated into their host countries, to understand the associations between quality of life and religiosity/spirituality over time.
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Affiliation(s)
- Ruth Abraham
- Department of Psychiatry, Lovisenberg Diaconal Hospital, Oslo, Norway.,Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Marja Leonhardt
- Faculty of Health Studies, VID - Specialized University, Oslo, Akershus, Norway.,KoRus Øst, Inland Hospital Trust, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Hamar, Norway.,Department of Health and Social Sciences, Innlandet University Collage, Elverum, Norway
| | - Ingrid Hanssen
- Section of Clinical Nursing Research, Lovisenberg Diaconal University College, Oslo, Norway
| | - Edvard Hauff
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Suraj Bahadur Thapa
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Norway
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Marchi M, Artoni C, Longo F, Magarini FM, Aprile G, Reggianini C, Florio D, De Fazio GL, Galeazzi GM, Ferrari S. The impact of trauma, substance abuse, and psychiatric illness on suicidal and self-harm behaviours in a cohort of migrant detainees: An observational, prospective study. Int J Soc Psychiatry 2022; 68:514-524. [PMID: 33269641 DOI: 10.1177/0020764020979007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND According to the WHO, detainees attempt suicide ten times more than the general population. AIMS To investigate the impact of migration trauma on Suicidal and Self-Harm Behaviours (SSHB) of migrants in jail and to explore how substance use and other psychiatric features affect this relationship. METHODS Prospective cohort study, conducted at the 'Sant'Anna' jail in Modena (Italy) between February 2017 and September 2019. Socio-demographic, psychiatric features and records of previous SSHB were collected. Experience of migration-related trauma was assessed with the LiMEs (List of Migration Experiences) checklist. Participants were followed-up for the occurrence of further SSHB. Survival analysis was performed and Cox's Hazard Ratios (HR) were used as a measure of association of comparisons. RESULTS Amongst the 112 subjects (96% male, median age 33), the prevalence of any mental disorder was 26% and of substance abuse 59%. History of SSHB was present in 36% of the sample. Median follow-up time was 80 days. During follow-up, 11 events were observed (of which three were suicide attempts). Cumulative survival probability was 85%. Having experienced trauma related to war and violence was significantly associated with SSHB, HR: 7.05. No SSHB were recorded amongst subjects without substance abuse. CONCLUSIONS Migrants in custody who experienced trauma in the post-migration period, attempt SSHB seven times more frequently than those without traumas at any time. War trauma and post-migration trauma due to exposure to violence seem to be more strongly associated with SSHB, also controlling for psychiatric diagnosis, ongoing psychopharmacological therapy and substance abuse. Further research and possible intervention programs should focus on addressing post-migration living-difficulties.
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Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Cecilia Artoni
- Department of Mental Health, AUSL Modena, Modena, Emilia-Romagna, Italy
| | - Fedora Longo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Federica Maria Magarini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Giovanni Aprile
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | | | - Debora Florio
- Department of Primary Care, AUSL Modena, Modena, Italy
| | | | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
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14
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Şimşir Gökalp Z, Haktanir A. Posttraumatic growth experiences of refugees: A metasynthesis of qualitative studies. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1395-1410. [PMID: 34606620 DOI: 10.1002/jcop.22723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/20/2021] [Indexed: 06/13/2023]
Abstract
Although forced displacement may lead to many adverse psychological problems, this experience may also result in positive psychological consequences. Given the increasing disturbance in countries, many people are forcibly displaced, a comprehensive understanding of the posttraumatic growth (PTG) experiences of refugees is warranted. In this study, we examined 12 primary studies exploring PTG among refugees using the qualitative metasynthesis method. Our analysis of the primary studies consisting of 319 adults revealed four themes: (a) improved psychologic functioning; (b) enhanced interpersonal relationships; (c) reconstruction of the meaning of life; and (d) positive future direction. These findings indicate that no matter how traumatic experiences are painful, people can hold on to life, build a new life, and grow from adversity.
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Affiliation(s)
- Zeynep Şimşir Gökalp
- Department of Guidance and Psychological Counseling, Selçuk University, Konya, Turkey
| | - Abdulkadir Haktanir
- Department of Guidance and Psychological Counseling, Necmettin Erbakan University, Konya, Turkey
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15
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Perry JM, Modesti C, Nicolais C, Talamo A, Nicolais G. The multifaceted nature of the response to adversity in an Italian sample of refugee community leaders. J Trauma Stress 2022; 35:362-374. [PMID: 34644437 DOI: 10.1002/jts.22745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/22/2021] [Accepted: 07/21/2021] [Indexed: 11/12/2022]
Abstract
The end of the last decade saw record numbers of refugee arrivals to Italy, straining the existing reception and integration systems. Although significant research attention has focused on the prevalence of posttraumatic stress disorder (PTSD), depression, and suicidal ideation in refugee populations, there are increasing calls to study the interactions between distress, resilience, and positive outcomes of adversity. To fully understand the complexity of the refugee experience, these voices must be heard in dialogue. Studies must be framed within a more nuanced view of refugees, characterizing them not exclusively as victims but also as advocates for their own well-being and the well-being of their communities. This exploratory study performed a thematic analysis of 15 interviews conducted with refugee community leaders in Italy, each a founder or leader of a community association and actively engaged in civil society. In keeping with Papadopoulos' (2007) construct of adversity-activated development, an inductive analysis identified three distinct patterns of positive adversity response: meaning, motivation, and mobilization. A deductive analysis identified the most appropriate theories of resilience to describe the sample, which included resilience as a dynamic positive adaptation and resilience as resistance to change in moral codes and personal value systems. The resulting image of refugee community leaders in Italy is that of individuals who are exposed to adversity and experiences of suffering and distress but safeguard their core values while positively adapting to a new country.
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Affiliation(s)
| | - Camilla Modesti
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Alessandra Talamo
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Giampaolo Nicolais
- Department of Dynamic, Clinical, and Health Psychology, Sapienza University of Rome, Rome, Italy
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Grupp F, Moro MR, Skandrani S, Mewes R. Coping with Trauma and Symptoms of Post-Traumatic Stress Disorder: Exploring Intentions and Lay Beliefs about Appropriate Strategies among Asylum-Seeking Migrants from Sub-Saharan Africa in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1783. [PMID: 35162807 PMCID: PMC8834703 DOI: 10.3390/ijerph19031783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 11/16/2022]
Abstract
Asylum-seekers are at high risk of developing post-traumatic stress disorder (PTSD) due to frequent exposure to trauma. We investigated the coping intentions and lay beliefs about appropriate coping strategies among asylum-seekers from Sub-Saharan Africa in Germany. The study applied a methodological triangulation strategy with a vignette describing symptoms of PTSD. In a quantitative part, asylum-seekers (n = 119) that were predominantly from Eritrea (n = 41), Somalia (n = 36), and Cameroon (n = 25), and a native comparison sample (n = 120) responded to questionnaires assessing coping, traumatic events, and post-traumatic symptoms. In a qualitative part, asylum-seekers (n = 26) discussed coping strategies in focus groups. In the quantitative part, asylum-seekers displayed higher intentions for religious coping, emotional support, and denial compared to the native participants. Asylum-seekers with a higher symptom load expressed lower intentions to seek instrumental support. Asylum-seekers with a lower educational level and those with a higher symptom load expressed higher intentions for substance use. In the qualitative part, we identified three superordinate themes: (a) religion, (b) social support systems, and (c) cognitive strategies. Asylum-seekers expressed coping intentions that are associated with an adaptive response to trauma. Less-educated asylum-seekers with a higher symptom load might constitute a particularly vulnerable group.
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Affiliation(s)
- Freyja Grupp
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Marburg, 35032 Marburg, Germany;
| | - Marie Rose Moro
- AP-HP, Hospital Cochin, University of Paris, Unité Inserm 1018, CESP, 75014 Paris, France;
| | - Sara Skandrani
- Hospital Cochin Paris, University of Paris Nanterre UR4430, 75014 Paris, France;
| | - Ricarda Mewes
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria
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17
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At Home: Place Attachment and Identity in an Italian Refugee Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168273. [PMID: 34444021 PMCID: PMC8391704 DOI: 10.3390/ijerph18168273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022]
Abstract
The central tenet of Place Attachment theory states that an individual has an inborn predisposition to form strong bonds with places as well as with people. Our qualitative study applies this theory to understand how, despite loss and adversity, refugees are able to reconstruct a sense of identity, community, and “home”. Participants included 15 forcibly displaced people from different countries of origin. Semistructured interviews explored factors that facilitate participants’ integration in a new context and the impact of this context on their sense of identity. Data were analysed using Consensual Qualitative Research Methodology to identify recurrent themes and their frequencies within interview transcripts. Within the relational dimensions of place attachment, affiliation, and seeking help from others, the study explores the factors that facilitate the integration of refugees in a new context and the impact of this context on their sense of identity, identifying recurrent themes and their frequencies within interview transcripts. The most frequent resulting themes were (a) a sense of identity and (b) expectations toward the resettlement country. Additional, though less frequent, themes included: (c) sense of belonging, (d) community integration, (e) trust, (f) opportunity seizing, (g) being a point of reference for others, (h) sense of community, (i) positive memories, (j) refusal. These results begin to describe the ways by which Place Attachment, toward both birth and resettlement countries, contributes to a restructured identity and sense of “feeling at home” for refugees.
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African Refugee Youth's Experiences of Navigating Different Cultures in Canada: A "Push and Pull" Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042063. [PMID: 33672518 PMCID: PMC7923778 DOI: 10.3390/ijerph18042063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Abstract
Refugee youth face challenges in navigating different cultures in destination countries and require better support. However, we know little about the adaptation experiences of African refugee youth in Canada. Accordingly, this paper presents the adaptation experiences of African refugee youth and makes recommendations for ways to support youth. Twenty-eight youth took part in semi-structured interviews. Using a thematic analysis approach, qualitative data revealed four themes of: (1) ‘disruption in the family,’ where youth talked about being separated from their parent(s) and the effect on their adaptation; (2) ‘our cultures are different,’ where youth shared differences between African and mainstream Canadian culture; (3) ‘searching for identity: a cultural struggle,’ where youth narrated their struggles in finding identity; and (4) ‘learning the new culture,’ where youth narrated how they navigate African and Canadian culture. Overall, the youth presented with challenges in adapting to cultures in Canada and highlighted how these struggles were influenced by their migration journey. To promote better settlement and adaptation, youth could benefit from supports and activities that promote cultural awareness with attention to their migration experiences. Service providers could benefit from newcomer-friendly and culturally sensitive training on salient ways of how experiences of multiple cultures affect integration outcomes.
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Liu J, Mansoor Y, Johar J, Kim S, Sidiqi A, Kapoor V. Strengths-based inquiry of resiliency factors among refugees in Metro Vancouver: A comparison of newly-arrived and settled refugees. Soc Sci Med 2020; 263:113243. [PMID: 32777631 DOI: 10.1016/j.socscimed.2020.113243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/08/2020] [Accepted: 07/20/2020] [Indexed: 11/15/2022]
Abstract
STRENGTHS-BASED INQUIRY OF RESILIENCY FACTORS AMONG REFUGEES IN METRO VANCOUVER: A comparison of newly-arrived and settled refugees. OBJECTIVE To identify the resiliency factors among refugees in the Metro Vancouver area, and compare these factors between newly-arrived and settled refugees. DESIGN Semi-structured individual interviews. SETTING Vancouver, British Columbia, and surrounding suburban communities. PARTICIPANTS 13 key informants from resettlement, healthcare, and public education sectors who work closely with refugees, 13 refugees who have resided less than five years in Canada (LTFYRs), and 8 refugees who have resided greater than five years in Canada (GTFYRs). Refugee source countries were Syria, Iraq, Afghanistan, Iran, Kenya, Vietnam, Somalia, and Mexico. MAIN FINDINGS Key informants stated that knowledge from this study would help create and improve current supports for refugees, inform policy, increase understanding of refugee perspectives, and promote strengths-based resettlement strategies. Resiliency factors were grouped into themes, which were categorized as internal or external resiliency factors. Internal resiliency factors included fixed characteristics (age at arrival, female gender, and past education/skills), positive coping strategies (acceptance and positivity), proactivity, and integration (personal identity and adaptation). External resiliency factors identified were support systems, employment and finances, living environment, and societal encouragement of refugees. Comparison of responses between LTFYRs and GTFYRs revealed overall consistency in resiliency factors, but with LTFYRs identifying characteristics that assisted with acute integration, such as age at arrival, more often than GTFYRs. Comparison of responses between refugees and key informants revealed that key informants less frequently identified internal resiliency factors. CONCLUSION This study qualitatively describes several internal and external resiliency factors of refugees in Vancouver. Awareness and promotion of these resiliency factors in refugee populations, in collaboration with healthcare providers, settlement organizations and education systems, may improve refugee resettlement. These findings will also help generate the groundwork for local interventions that can support refugee resiliency in the population studied.
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Affiliation(s)
- John Liu
- University of British Columbia, Canada.
| | | | | | | | | | - Videsh Kapoor
- Division of Global Health, Department of Family Practice, University of British Columbia, Canada
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20
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Zbidat A, Georgiadou E, Borho A, Erim Y, Morawa E. The Perceptions of Trauma, Complaints, Somatization, and Coping Strategies among Syrian Refugees in Germany-A Qualitative Study of an At-Risk Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030693. [PMID: 31973104 PMCID: PMC7037213 DOI: 10.3390/ijerph17030693] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 01/09/2020] [Accepted: 01/12/2020] [Indexed: 12/21/2022]
Abstract
Background: A high prevalence of mental distress, especially posttraumatic stress disorder, has been widely confirmed among refugees. In order to establish adequate interventions in psychotherapy, however, it must first be examined whether refugees have similar ideas and concepts of stress, trauma, and healing. This study, therefore, aimed to analyze the representations of trauma, self-reported complaints, indications of somatization, and coping strategies among a refugee population. Methods: Semi-structured interviews based on the Cultural Formulation Interview (CFI) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were conducted with Syrian refugees who have residence permission in Germany. The interviews were audio-recorded, transcribed, and analyzed according to the qualitative content analysis of Mayring. The foci of interest were determined on the basis of the predefined interview guideline, and inductive subcategories were extracted from the transcripts. Results: Sixteen refugees participated (50% women; mean age: 35.5 years, SD = 11.2; the mean duration of stay in Germany: 23.3 months, SD = 6.6). War experiences were the most frequently reported subjective perceptions of trauma. Frequently reported complaints included sleeping disturbance, cardiovascular symptoms, rumination, and pain. Among half of the participants, we found indications of somatization. We identified the following coping strategies: Activity, cognitive coping, social coping, religious coping, avoidance, and emotional coping. Conclusions: War-related traumatic events are the most common trauma perceptions among Syrian refugees. The self-reported complaints demonstrate somatoform, depressive, and posttraumatic symptoms. Syrian refugees should be screened for somatization, depression, and posttraumatic stress disorder and should receive targeted interventions that consider and support individual coping resources.
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Affiliation(s)
- Ali Zbidat
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.Z.); (E.G.); (A.B.); (Y.E.)
| | - Ekaterini Georgiadou
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.Z.); (E.G.); (A.B.); (Y.E.)
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University, 90419 Nürnberg, Germany
| | - Andrea Borho
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.Z.); (E.G.); (A.B.); (Y.E.)
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.Z.); (E.G.); (A.B.); (Y.E.)
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.Z.); (E.G.); (A.B.); (Y.E.)
- Correspondence:
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21
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Shelter From the Storm: Psychiatric Diagnosis and Treatment of the Refugee Patient. ADDICTIVE DISORDERS & THEIR TREATMENT 2019. [DOI: 10.1097/adt.0000000000000164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Refugee Students in Spain: The Role of Universities as Sustainable Actors in Institutional Integration. SUSTAINABILITY 2018. [DOI: 10.3390/su10062082] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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