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探索英国寻求庇护者和被拒庇护者迁徙后压力源与心理健康之间的关系。

Exploring the relationship between postmigratory stressors and mental health for asylum seekers and refused asylum seekers in the UK.

作者信息

Morgan Gareth, Melluish Steve, Welham Alice

机构信息

University of Leicester, Derbyshire Healthcare NHS Foundation Trust.

University of Leicester.

出版信息

Transcult Psychiatry. 2017 Oct-Dec;54(5-6):653-674. doi: 10.1177/1363461517737188. Epub 2017 Nov 14.

Abstract

Numerous studies have linked the high rates of traumatic events experienced by refugees to the elevated rate of mental health problems in these populations. A growing body of evidence has also highlighted the importance of considering postmigratory stressors when making sense of displaced person distress. This study explored the relationship between mental health and postmigratory stress for asylum seekers and refused asylum seekers in Britain. The study further examined if those refused asylum experienced elevated distress and postmigratory stress compared to those awaiting the outcome of asylum applications. Results indicated that participants ( N = 97) had endured a range of pre- and postmigratory stressors and had high scores on measures of anxiety, depression, and PTSD. A postmigratory factor comprising items associated with isolation, restrictive policies, and stressors associated with having an insecure immigration status, was significantly associated with PTSD scores. This relationship remained when controlling for the variance accounted for by premigratory trauma predictors. Being refused asylum was the strongest predictor of depression and anxiety. Those refused asylum scored higher on a factor associated with barriers to accessing services. Social materialist theories of distress are drawn upon to contextualise the heightened vulnerability of those refused asylum. The paper concludes by emphasising the problems associated with taking an exclusively trauma-focussed approach when working with asylum seekers and argues for community orientated interventions to support displaced people to cope with the various stressors endured in exile.

摘要

众多研究已将难民经历的高创伤事件发生率与这些人群中较高的心理健康问题发生率联系起来。越来越多的证据也凸显了在理解流离失所者的痛苦时考虑迁移后应激源的重要性。本研究探讨了英国寻求庇护者和被拒难民的心理健康与迁移后应激之间的关系。该研究进一步考察了与等待庇护申请结果的人相比,那些被拒难民是否经历了更高程度的痛苦和迁移后应激。结果表明,参与者(N = 97)经历了一系列迁移前和迁移后的应激源,在焦虑、抑郁和创伤后应激障碍测量中得分较高。一个由与孤立、限制性政策以及与不安全移民身份相关的应激源相关项目组成的迁移后因素,与创伤后应激障碍得分显著相关。在控制了迁移前创伤预测因素所解释的方差后,这种关系依然存在。被拒难民身份是抑郁和焦虑的最强预测因素。那些被拒难民在与获得服务的障碍相关的一个因素上得分更高。本文借鉴社会唯物主义痛苦理论来解释那些被拒难民更高的脆弱性。文章最后强调了在为难民提供服务时仅采用专注于创伤的方法所带来的问题,并主张采取以社区为导向的干预措施来支持流离失所者应对流亡期间所遭受的各种应激源。

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