TY - JOUR
T1 - Effect of trauma on asylum seekers and refugees receiving a WHO psychological intervention
T2 - a mediation model
AU - Serra, Riccardo
AU - Purgato, Marianna
AU - Tedeschi, Federico
AU - Acartürk, Ceren
AU - Karyotaki, Eirini
AU - Uygun, Ersin
AU - Turrini, Giulia
AU - Winkler, Hildegard
AU - Pinucci, Irene
AU - Wancata, Johannes
AU - Walker, Lauren
AU - Popa, Mariana
AU - Sijbrandij, Marit
AU - Välimäki, Maritta
AU - Kösters, Markus
AU - Nosè, Michela
AU - Anttila, Minna
AU - Churchill, Rachel
AU - White, Ross G.
AU - Lantta, Tella
AU - Klein, Thomas
AU - Wochele-Thoma, Thomas
AU - Tarsitani, Lorenzo
AU - Barbui, Corrado
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2024/6/3
Y1 - 2024/6/3
N2 - 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.
AB - 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.
KW - asylum seekers and refugees
KW - mediation
KW - migrants
KW - Post-traumatic stress
KW - psychological intervention
KW - scalable interventions
KW - self-help plus
UR - http://www.scopus.com/inward/record.url?scp=85195012067&partnerID=8YFLogxK
U2 - 10.1080/20008066.2024.2355828
DO - 10.1080/20008066.2024.2355828
M3 - Article
C2 - 38828909
AN - SCOPUS:85195012067
SN - 2000-8066
VL - 15
JO - European Journal of Psychotraumatology
JF - European Journal of Psychotraumatology
IS - 1
M1 - 2355828
ER -