Effect of trauma on asylum seekers and refugees receiving a WHO psychological intervention: a mediation model

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Riccardo Serra - , University of Verona, University of Rome La Sapienza (Author)
  • Marianna Purgato - , University of Verona (Author)
  • Federico Tedeschi - , University of Verona (Author)
  • Ceren Acartürk - , Koc University, Istanbul Bilgi University (Author)
  • Eirini Karyotaki - , Vrije Universiteit Amsterdam (VU) (Author)
  • Ersin Uygun - , Koc University, Istanbul Bilgi University (Author)
  • Giulia Turrini - , University of Verona (Author)
  • Hildegard Winkler - , Caritas Community Psychiatric Services Vienna (Author)
  • Irene Pinucci - , University of Rome La Sapienza (Author)
  • Johannes Wancata - , Medical University of Vienna (Author)
  • Lauren Walker - , City, University of London (Author)
  • Mariana Popa - , University of Liverpool (UOL) (Author)
  • Marit Sijbrandij - , Vrije Universiteit Amsterdam (VU) (Author)
  • Maritta Välimäki - , University of Turku, University of Helsinki (Author)
  • Markus Kösters - , Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Ulm University (Author)
  • Michela Nosè - , University of Verona (Author)
  • Minna Anttila - , University of Turku (Author)
  • Rachel Churchill - , University of York (Author)
  • Ross G. White - , Queen's University Belfast (Author)
  • Tella Lantta - , University of Turku, Swinburne University of Technology (Author)
  • Thomas Klein - , Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Ulm University (Author)
  • Thomas Wochele-Thoma - , Caritas Community Psychiatric Services Vienna (Author)
  • Lorenzo Tarsitani - , University of Rome La Sapienza (Author)
  • Corrado Barbui - , University of Verona (Author)

Abstract

Background: Scalable psychological interventions such as the WHO’s Self-Help Plus (SH+) have been developed for clinical and non-clinical populations in need of psychological support. SH+ has been successfully implemented to prevent common mental disorders among asylum seekers and refugees who are growing in number due to increasing levels of forced migration. These populations are often exposed to multiple, severe sources of traumatisation, and evidence of the effect of such events on treatment is insufficient, especially for non-clinical populations. Objective: We aim to study the effect of potentially traumatic experiences (PTEs) and the mediating role of symptoms of posttraumatic stress disorder (PTSD) on the improvement following SH+. Method: Participants allocated to SH+ who received at least three sessions (N = 345) were extracted from two large, randomised, European prevention trials involving asylum seekers and refugees. Measures of distress, depression, functional impairment, and post-traumatic stress symptoms were administered at baseline and 6 months post-intervention, together with measures of well-being and quality of life. Adjusted models were constructed to examine the effect of PTEs on post-intervention improvement. The possible mediating role of PTSD symptoms in this relationship was then tested. Results: Increasing numbers of PTEs decreased the beneficial effect of SH+ for all measures. This relationship was mediated by symptoms of PTSD when analysing measures of well-being and quality of life. However, this did not apply for measures of mental health problems. Conclusions: Exposure to PTEs may largely reduce benefits from SH+. PTSD symptomatology plays a specific, mediating role on psychological well-being and quality of life of participants who experienced PTE. Healthcare professionals and researchers should consider the role of PTEs and PTSD symptoms in the treatment of migrants and refugees and explore possible feasible add-on solutions for cases exposed to multiple PTEs.

Details

Original languageEnglish
Article number2355828
JournalEuropean Journal of Psychotraumatology
Volume15
Issue number1
Publication statusPublished - 2024
Peer-reviewedYes

External IDs

PubMed 38828909
ORCID /0000-0001-7018-6021/work/168207937

Keywords

ASJC Scopus subject areas

Keywords

  • asylum seekers and refugees, mediation, migrants, Post-traumatic stress, psychological intervention, scalable interventions, self-help plus