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创伤暴露、文化适应压力和文化取向:对难民创伤后应激障碍、抑郁和焦虑症状的影响。

Traumatic exposure, acculturative stress and cultural orientation: the influence on PTSD, depressive and anxiety symptoms among refugees.

机构信息

School of Clinical Sciences, Department of Psychiatry, Monash University, Clayton, Australia.

Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, Australia.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2018 Sep;53(9):931-941. doi: 10.1007/s00127-018-1532-z. Epub 2018 Jun 21.

Abstract

OBJECTIVE

Acculturation studies conducted with refugees have predominantly concentrated on investigating the impact of acculturative stress on mental health, and have neglected to investigate the impact of cultural orientations towards the host and ethnic cultures. Furthermore, exposure to traumas is highly prevalent in refugees and strongly associated with mental health outcomes, however, rarely included in investigations of acculturative process of refugees.

METHOD

Using structural equation modelling, this study tested an integrated model of the relationship between traumatic exposure, acculturative stress, host and ethnic cultural orientations and posttraumatic stress disorder (PTSD), depression and anxiety symptoms among 138 Bosnian refugees resettled in Australia and Austria.

RESULTS

The model showed an overall good fit and noteworthy amount of variance indicating that traumatic exposure is the strongest direct and indirect predictor of PTSD, depression and anxiety symptoms. Furthermore, acculturative stress was identified as a significant risk factor influencing host cultural orientation, mediating the effect of traumatic exposure on all mental health outcomes.

CONCLUSION

Acculturative stress and cultural and social stressors that are related to acculturation need to be addressed alongside provision of effective psychotherapy, especially since they are significant impediments to host cultural orientation and constructive engagement with mental health services in refugees.

摘要

目的

针对难民的文化适应研究主要集中在调查文化适应压力对心理健康的影响,而忽略了对其对东道国和本族文化的文化取向的影响的研究。此外,创伤暴露在难民中非常普遍,并且与心理健康结果密切相关,但在难民文化适应过程的研究中很少被包括。

方法

本研究采用结构方程模型,测试了创伤暴露、文化适应压力、对东道国和本族文化的文化取向与创伤后应激障碍(PTSD)、抑郁和焦虑症状之间关系的综合模型,该模型共纳入了 138 名在澳大利亚和奥地利重新安置的波斯尼亚难民。

结果

该模型显示出整体良好的拟合度和显著的方差量,表明创伤暴露是 PTSD、抑郁和焦虑症状的最强直接和间接预测因素。此外,文化适应压力被确定为影响对东道国文化取向的重要危险因素,中介了创伤暴露对所有心理健康结果的影响。

结论

需要解决文化适应压力和与文化适应相关的文化和社会压力源问题,同时提供有效的心理治疗,特别是因为它们是难民对东道国文化取向和建设性利用精神卫生服务的重要障碍。

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