Rochelle L Frounfelker1, Tej Mishra2, Alexa Carroll3, Robert T Brennan2,4, Bhuwan Gautam5, Eman Abdullahi Alas Ali3, Theresa S Betancourt2. 1. Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Quebec, Canada. 2. Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA, USA. 3. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. 4. Women's Study Research Center, Brandeis University, Waltham, MA, USA. 5. Bhutanese Society of Western Massachusetts, Inc., Springfield, MA, USA.
Abstract
OBJECTIVES: Older displaced persons often receive limited attention from aid organizations, policy-makers and service providers in countries of resettlement. The objective of this study is to identify the relationship between experiencing traumatic events and stressors prior to resettlement, current resettlement stressors, social support, and mental health of older Bhutanese with a refugee life experience. METHOD: Study participants were 190 older Bhutanese with a refugee life experience living in a metropolitan area in New England (US) and Ontario (Canada). We used structural equation modeling to determine the association between traumatic and stressful events in Bhutan and Nepal, current resettlement stressors, and symptoms of anxiety and depression, as measured by the GAD-7 and PHQ-9. We assessed the role of social support as an effect modifier in the relationship between these variables. RESULTS: Surviving torture was associated with anxiety (p=.006), and experiencing threats to physical wellbeing in Nepal was associated with both anxiety (p=.003) and depression (p=.002). The relationship between physical threats in Nepal and current mental health were partially mediated by resettlement stressors. Social support moderated the relationship between trauma, stress, and mental health. CONCLUSION: Both past traumas and current resettlement stressors contribute to the current psychosocial functioning of older Bhutanese with a refugee life experience. Based on our findings, social support is critical in promoting mental health in this population.
OBJECTIVES: Older displaced persons often receive limited attention from aid organizations, policy-makers and service providers in countries of resettlement. The objective of this study is to identify the relationship between experiencing traumatic events and stressors prior to resettlement, current resettlement stressors, social support, and mental health of older Bhutanese with a refugee life experience. METHOD: Study participants were 190 older Bhutanese with a refugee life experience living in a metropolitan area in New England (US) and Ontario (Canada). We used structural equation modeling to determine the association between traumatic and stressful events in Bhutan and Nepal, current resettlement stressors, and symptoms of anxiety and depression, as measured by the GAD-7 and PHQ-9. We assessed the role of social support as an effect modifier in the relationship between these variables. RESULTS: Surviving torture was associated with anxiety (p=.006), and experiencing threats to physical wellbeing in Nepal was associated with both anxiety (p=.003) and depression (p=.002). The relationship between physical threats in Nepal and current mental health were partially mediated by resettlement stressors. Social support moderated the relationship between trauma, stress, and mental health. CONCLUSION: Both past traumas and current resettlement stressors contribute to the current psychosocial functioning of older Bhutanese with a refugee life experience. Based on our findings, social support is critical in promoting mental health in this population.
Authors: Sarah Elizabeth Neville; Kira DiClemente-Bosco; Lila K Chamlagai; Mary Bunn; Jordan Freeman; Jenna M Berent; Bhuwan Gautam; Abdirahman Abdi; Theresa S Betancourt Journal: Int J Environ Res Public Health Date: 2022-09-29 Impact factor: 4.614