Global evidence for a biopsychosocial understanding of refugee adaptation.

Early research on refugee mental health and adaptation has largely proceeded from a life-events/biomedical framework. That approach has helped elucidate the relationship between life events and psychiatric symptoms, but has been criticized as reductionistic or exclusionary. This article argues that the complexity of the social domain of refugee experience and the causal interactions among biological, psychological and social domains make individual effects difficult to study in isolation. A biopsychosocial approach could complement the more focal research to move the field forward. Evidence in support of this position is marshaled from new analyses conducted on a meta-analytic data set of five decades of the worldwide empirical literature on refugee mental health, reflecting data derived from 67,294 primary study participants (Porter & Haslam, 2005). Results demonstrate the importance of higher-order interactions between distal and proximal social variables, as well as associations among biological, psychological and community-level social functioning in refugees. Interdisciplinary research and novel analytic methods can complement more focal research. The presumed benefits of returning refugees to their country of origin are questioned in light of the important effects of social variables on refugee adaptation.