Impairments in psychological functioning in refugees and asylum seekers

Josef S Baumgartner; Antonia Renner; Thomas Wochele-Thoma; Peter Wehle; Corrado Barbui; Marianna Purgato; Federico Tedeschi; Lorenzo Tarsitani; Valentina Roselli; Ceren Acartürk; Ersin Uygun; Minna Anttila; Tella Lantta; Maritta Välimäki; Rachel Churchill; Lauren Walker; Marit Sijbrandij; Pim Cuijpers; Markus Koesters; Thomas Klein; Ross G White; Marion C Aichberger; Johannes Wancata

doi:10.3389/fpsyg.2023.1295031

Impairments in psychological functioning in refugees and asylum seekers

Front Psychol. 2024 Jan 8:14:1295031. doi: 10.3389/fpsyg.2023.1295031. eCollection 2023.

Authors

Josef S Baumgartner¹, Antonia Renner¹, Thomas Wochele-Thoma², Peter Wehle^{1

3}, Corrado Barbui⁴, Marianna Purgato⁴, Federico Tedeschi⁴, Lorenzo Tarsitani⁵, Valentina Roselli⁵, Ceren Acartürk⁶, Ersin Uygun⁷, Minna Anttila⁸, Tella Lantta⁸, Maritta Välimäki^{8

9}, Rachel Churchill¹⁰, Lauren Walker^{10

11}, Marit Sijbrandij^{12

13}, Pim Cuijpers^{12

13}, Markus Koesters^{14

15}, Thomas Klein^{14

15}, Ross G White¹⁶, Marion C Aichberger¹, Johannes Wancata¹

Affiliations

¹ Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
² LBI Digital Health and Patient Safety, Vienna, Austria.
³ Psychosocial Services in Vienna, Vienna, Austria.
⁴ WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.
⁵ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
⁶ Department of Psychology, College of Social Sciences and Humanities, Koc University, Istanbul, Türkiye.
⁷ Emergency and Disaster Management, Vocational School of Health Services, Bilgi University, Istanbul, Türkiye.
⁸ Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.
⁹ Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
¹⁰ Centre for Reviews and Dissemination, Faculty of Social Sciences, University of York, York, United Kingdom.
¹¹ School of Health and Social Work, University of Hertfordshire, Hatfield, United Kingdom.
¹² Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
¹³ WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
¹⁴ Department of Psychiatry and Psychotherapy ll, District Hospital Guenzburg, Ulm University, Ulm, Germany.
¹⁵ Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, Technische Universität, Dresden, Germany.
¹⁶ Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom.

Abstract

Refugees are at increased risk for developing psychological impairments due to stressors in the pre-, peri- and post-migration periods. There is limited knowledge on how everyday functioning is affected by migration experience. In a secondary analysis of a study in a sample of refugees and asylum seekers, it was examined how aspects of psychological functioning were differentially affected. 1,101 eligible refugees and asylum seekers in Europe and Türkiye were included in a cross-sectional analysis. Gender, age, education, number of relatives and children living nearby, as well as indicators for depressive and posttraumatic symptoms, quality of life, psychological well-being and functioning, and lifetime potentially traumatic events were assessed. Correlations and multiple regression models with World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item version's total and six subdomains' scores ('mobility', 'life activities', 'cognition', 'participation', 'self-care', 'getting along') as dependent variables were calculated. Tests for multicollinearity and Bonferroni correction were applied. Participants reported highest levels of impairment in 'mobility' and 'participation', followed by 'life activities' and 'cognition'. Depression and posttraumatic symptoms were independently associated with overall psychological functioning and all subdomains. History of violence and abuse seemed to predict higher impairment in 'participation', while past events of being close to death were associated with fewer issues with 'self-care'. Impairment in psychological functioning in asylum seekers and refugees was related to current psychological symptoms. Mobility and participation issues may explain difficulties arising after resettlement in integration and exchange with host communities in new contexts.

Keywords: WHODAS 2.0; participation; post-migration stressors; psychological functioning; refugee mental health; trauma.

Copyright © 2024 Baumgartner, Renner, Wochele-Thoma, Wehle, Barbui, Purgato, Tedeschi, Tarsitani, Roselli, Acartürk, Uygun, Anttila, Lantta, Välimäki, Churchill, Walker, Sijbrandij, Cuijpers, Koesters, Klein, White, Aichberger and Wancata.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the European Commission, grant agreement n. 779255 (“RE-DEFINE: Refugee Emergency: DEFining and Implementing Novel Evidence-based psychosocial interventions”).