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

IF 4.2 2区 医学 Q1 PSYCHIATRY European Journal of Psychotraumatology Pub Date : 2024-01-01 Epub Date: 2024-06-03 DOI:10.1080/20008066.2024.2355828
Riccardo Serra, Marianna Purgato, Federico Tedeschi, Ceren Acartürk, Eirini Karyotaki, Ersin Uygun, Giulia Turrini, Hildegard Winkler, Irene Pinucci, Johannes Wancata, Lauren Walker, Mariana Popa, Marit Sijbrandij, Maritta Välimäki, Markus Kösters, Michela Nosè, Minna Anttila, Rachel Churchill, Ross G White, Tella Lantta, Thomas Klein, Thomas Wochele-Thoma, Lorenzo Tarsitani, Corrado Barbui
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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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创伤对接受世界卫生组织心理干预的寻求庇护者和难民的影响:中介模型。
背景:针对需要心理支持的临床和非临床人群开发了可推广的心理干预措施,如世界卫生组织的自助加(SH+)。SH+ 已成功用于预防寻求庇护者和难民中常见的精神障碍,由于被迫移民的人数不断增加,这些人的数量也在不断增加。这些人群通常会遭受多重、严重的心理创伤,而有关此类事件对治疗影响的证据并不充分,尤其是对非临床人群而言:我们旨在研究潜在创伤经历(PTEs)的影响,以及创伤后应激障碍(PTSD)症状对 SH+ 后病情改善的中介作用:方法:从两项涉及寻求庇护者和难民的大型欧洲随机预防试验中抽取了至少接受过三次 SH+ 治疗的参与者(N = 345)。在基线和干预后 6 个月,对苦恼、抑郁、功能障碍和创伤后应激症状进行了测量,同时还对幸福感和生活质量进行了测量。建立了调整模型,以检验创伤后应激症状对干预后改善的影响。然后检验了创伤后应激障碍症状在这种关系中可能起到的中介作用:结果:PTEs 数量的增加降低了 SH+ 对所有测量指标的有益影响。在分析幸福感和生活质量时,创伤后应激障碍症状对这种关系起到了中介作用。然而,这并不适用于精神健康问题的测量:结论:暴露于 PTEs 可能会在很大程度上减少 SH+ 的益处。创伤后应激障碍症状对经历过 PTE 的参与者的心理健康和生活质量起着特殊的调节作用。医疗保健专业人员和研究人员应考虑 PTEs 和创伤后应激障碍症状在移民和难民治疗中的作用,并为暴露于多种 PTEs 的病例探索可行的附加解决方案。
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来源期刊
CiteScore
7.60
自引率
12.00%
发文量
153
审稿时长
18 weeks
期刊介绍: The European Journal of Psychotraumatology (EJPT) is a peer-reviewed open access interdisciplinary journal owned by the European Society of Traumatic Stress Studies (ESTSS). The European Journal of Psychotraumatology (EJPT) aims to engage scholars, clinicians and researchers in the vital issues of how to understand, prevent and treat the consequences of stress and trauma, including but not limited to, posttraumatic stress disorder (PTSD), depressive disorders, substance abuse, burnout, and neurobiological or physical consequences, using the latest research or clinical experience in these areas. The journal shares ESTSS’ mission to advance and disseminate scientific knowledge about traumatic stress. Papers may address individual events, repeated or chronic (complex) trauma, large scale disasters, or violence. Being open access, the European Journal of Psychotraumatology is also evidence of ESTSS’ stand on free accessibility of research publications to a wider community via the web. The European Journal of Psychotraumatology seeks to attract contributions from academics and practitioners from diverse professional backgrounds, including, but not restricted to, those in mental health, social sciences, and health and welfare services. Contributions from outside Europe are welcome. The journal welcomes original basic and clinical research articles that consolidate and expand the theoretical and professional basis of the field of traumatic stress; Review articles including meta-analyses; short communications presenting new ideas or early-stage promising research; study protocols that describe proposed or ongoing research; case reports examining a single individual or event in a real‑life context; clinical practice papers sharing experience from the clinic; letters to the Editor debating articles already published in the Journal; inaugural Lectures; conference abstracts and book reviews. Both quantitative and qualitative research is welcome.
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