A1 Refereed original research article in a scientific journal

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




AuthorsSerra, Riccardo; Purgato, Marianna; Tedeschi, Federico; Acartürk, Ceren; Karyotaki, Eirini; Uygun, Ersin; Turrini, Giulia; Winkler, Hildegard; Pinucci, Irene; Wancata, Johannes; Walker, Lauren; Popa, Mariana; Sijbrandij, Marit; Välimäki, Maritta; Kösters, Markus; Nosè, Michela; Anttila, Minna; Churchill, Rachel; White, Ross G.; Lantta, Tella; Klein, Thomas; Wochele-Thoma, Thomas; Tarsitani, Lorenzo; Barbui, Corrado

PublisherTaylor & Francis

Publication year2024

JournalEuropean journal of psychotraumatology

Journal name in sourceEuropean journal of psychotraumatology

Journal acronymEur J Psychotraumatol

Article number2355828

Volume15

Issue1

eISSN2000-8066

DOIhttps://doi.org/10.1080/20008066.2024.2355828

Web address https://www.tandfonline.com/doi/full/10.1080/20008066.2024.2355828

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/454796433


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.


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Funding information in the publication
This work was supported by the European Commission, grant agreement n. 779255 ‘RE-DEFINE: Refugee Emergency: DEFining and Implementing Novel Evidence-based psychosocial interventions’. The funder had no role in study designing, and no role in data management, analysis, interpretation, as well as in writing the report and the decision to submit the report for publication, nor ultimate authority over any of the listed activities.


Last updated on 2025-27-01 at 19:27