Mölsä Mulki, Kuittinen Saija, Tiilikainen Marja, Honkasalo Marja-Liisa, Punamäki Raija-Leena
a Department of Public Health , University of Helsinki , Helsinki , Finland.
b Department of Health and Welfare Inequalities Unit , National Institute for Health and Welfare , Helsinki , Finland.
Aging Ment Health. 2017 Aug;21(8):829-837. doi: 10.1080/13607863.2016.1165183. Epub 2016 Apr 15.
The aim of this study was to examine, first, how past traumatic stress and present acculturation indices, and discrimination are associated with mental health; and, second, whether religiousness can buffer the mental health from negative impacts of war trauma.
Participants were 128 older (50-80 years) Somali refugees living in Finland. They reported experiences of war trauma and childhood adversities, and filled-in questionnaires of perceived ethnic discrimination, religiousness (beliefs, attendance, and observance of Islamic faith), and symptoms of posttraumatic stress disorder (PTSD), depressive (BDI-21), psychological distress (GHQ-12), and somatization (SCL-90).
Symptom-specific regression models showed that newly arrived refugees with non-permanent legal status and severe exposures to war trauma, childhood adversity, and discrimination endorsed greater PTSD symptoms, while only war trauma and discrimination were associated with depressive symptoms. Results confirmed that high religiousness could play a buffering role among older Somalis, as exposure to severe war trauma was not associated with high levels of PTSD or somatization symptoms among highly religious refugees.
Health care should consider both unique past and present vulnerabilities and resources when treating refugees, and everyday discrimination and racism should be regarded as health risks.
本研究的目的,其一,是考察过去的创伤应激、当前的文化适应指标以及歧视如何与心理健康相关联;其二,是考察宗教信仰能否缓冲战争创伤对心理健康的负面影响。
研究对象为128名居住在芬兰的年长(50 - 80岁)索马里难民。他们报告了战争创伤和童年逆境的经历,并填写了关于感知到的种族歧视、宗教信仰(对伊斯兰教的信仰、参与度和遵守情况)以及创伤后应激障碍(PTSD)症状、抑郁(BDI - 21)、心理困扰(GHQ - 12)和躯体化(SCL - 90)的问卷。
特定症状回归模型显示,具有非永久合法身份且严重暴露于战争创伤、童年逆境和歧视的新抵达难民表现出更严重的PTSD症状,而只有战争创伤和歧视与抑郁症状相关。结果证实,高度的宗教信仰在年长的索马里人中可能起到缓冲作用,因为在高度虔诚的难民中,暴露于严重战争创伤与高水平的PTSD或躯体化症状无关。
在为难民提供治疗时,医疗保健应考虑到他们过去和当前独特的脆弱性及资源,日常的歧视和种族主义应被视为健康风险。