Relations between trauma experiences and psychological, physical and neuroendocrine functioning among Somali refugees: mediating role of coping with acculturation stressors.

Refugees may be prone to stress-related psychological and physical health disorders, coupled with disturbances of hypothalamic-pituitary-adrenal functioning reflected by cortisol levels. It was suggested that traumatic encounters would directly influence stress-related outcomes, as well as indirectly influence them by undermining refugees' ability to cope with acculturation challenges. Somali refugees to Canada (N = 90) consistently reported encountering trauma, which was related to poorer self-reported outcomes (trauma symptoms, depressive affect, physical health), and these relations were mediated by increased use of emotion-focused (especially avoidant) coping strategies. Trauma symptoms and multiple traumatic experiences were associated with an exaggerated morning cortisol rise, but with a blunted response to stressor reminder cues. This blunted cortisol reactivity among participants encountering prior trauma was mediated by their increased propensity to cope by means of passive resignation. Evidently, refugees were at risk for stress-related dysfunction long after migrating, and the diminished capacity to cope with acculturation challenges was particularly important in this regard.