Dzenana Kartal1,2, Nathan Alkemade3, Maurice Eisenbruch4, David Kissane4. 1. School of Clinical Sciences, Department of Psychiatry, Monash University, Clayton, Australia. dkartal@unimelb.edu.au. 2. Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, Australia. dkartal@unimelb.edu.au. 3. Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, Australia. 4. School of Clinical Sciences, Department of Psychiatry, Monash University, Clayton, Australia.
Abstract
OBJECTIVE: Acculturation studies conducted with refugees have predominantly concentrated on investigating the impact of acculturative stress on mental health, and have neglected to investigate the impact of cultural orientations towards the host and ethnic cultures. Furthermore, exposure to traumas is highly prevalent in refugees and strongly associated with mental health outcomes, however, rarely included in investigations of acculturative process of refugees. METHOD: Using structural equation modelling, this study tested an integrated model of the relationship between traumatic exposure, acculturative stress, host and ethnic cultural orientations and posttraumatic stress disorder (PTSD), depression and anxiety symptoms among 138 Bosnian refugees resettled in Australia and Austria. RESULTS: The model showed an overall good fit and noteworthy amount of variance indicating that traumatic exposure is the strongest direct and indirect predictor of PTSD, depression and anxiety symptoms. Furthermore, acculturative stress was identified as a significant risk factor influencing host cultural orientation, mediating the effect of traumatic exposure on all mental health outcomes. CONCLUSION: Acculturative stress and cultural and social stressors that are related to acculturation need to be addressed alongside provision of effective psychotherapy, especially since they are significant impediments to host cultural orientation and constructive engagement with mental health services in refugees.
OBJECTIVE: Acculturation studies conducted with refugees have predominantly concentrated on investigating the impact of acculturative stress on mental health, and have neglected to investigate the impact of cultural orientations towards the host and ethnic cultures. Furthermore, exposure to traumas is highly prevalent in refugees and strongly associated with mental health outcomes, however, rarely included in investigations of acculturative process of refugees. METHOD: Using structural equation modelling, this study tested an integrated model of the relationship between traumatic exposure, acculturative stress, host and ethnic cultural orientations and posttraumatic stress disorder (PTSD), depression and anxiety symptoms among 138 Bosnian refugees resettled in Australia and Austria. RESULTS: The model showed an overall good fit and noteworthy amount of variance indicating that traumatic exposure is the strongest direct and indirect predictor of PTSD, depression and anxiety symptoms. Furthermore, acculturative stress was identified as a significant risk factor influencing host cultural orientation, mediating the effect of traumatic exposure on all mental health outcomes. CONCLUSION: Acculturative stress and cultural and social stressors that are related to acculturation need to be addressed alongside provision of effective psychotherapy, especially since they are significant impediments to host cultural orientation and constructive engagement with mental health services in refugees.
Authors: Dorthe Varning Poulsen; Anna María Pálsdóttir; Sasja Iza Christensen; Lotta Wilson; Sigurd Wiingaard Uldall Journal: Int J Environ Res Public Health Date: 2020-10-16 Impact factor: 3.390