Mack Center on Mental Health & Social Conflict, School of Social Welfare, University of California Berkeley, Berkeley, California, USA.
J Glob Health. 2019 Dec;9(2):020407. doi: 10.7189/jogh.09.020407.
Syrians seeking refuge have been exposed to atrocities and trauma beyond comprehension. This study examines how personal, interpersonal, displacement and war-related factors have impacted married refugees' intimate lives.
Data included 158 married Syrian refugee individuals who live in the host communities of Jordan. Refugees reported on their personal, interpersonal, current-displacement and past-war related experiences. Traumatic impacts were assessed using the Harvard Trauma Questionnaire (HTQ), K6 screening scale for serious mental illness (SMI), The War Events Questionnaire (WEQ), and Personal Assessment of Intimacy in Relationships (PAIR). Stepwise multiple regressions were used to determine the factors associated with refugees' intimacy-total score and its six dimensions.
Most refugees (94.2%) experienced war events, and 34% screened positive on the PTSD-HTQ scale. Overall intimacy scores were low, scoring M (±standard deviation) = 2.4 (±1.1) of a possible five on average. Intimacy scores were lower for refugees who screened positive on the PTSD-HTQ (M = 1.95 ± 65) compared to the ones screening negative, respectively (M = 2.23 ± 66). Furthermore, the higher the PTSD symptoms reported, the lower the couples' intimacy. PTSD and forced marriage were the strongest factors to predict decreased total-intimacy scores (β = -0.23, = 0.002; β = -0.32, < 0.001), and decreased scores on four dimensions of intimacy (emotional, sexual, intellectual and recreational). Whereas gender was the second strongest factor associated with decreased total-intimacy scores (β = -0.29, < 0.001), and decreased scores on three dimensions of intimacy (emotional, social and anger), meaning that women reported suffering more than men from deteriorated intimacy in their marital relationships. Other displacement and war-related factors associated with intimacy were: decreased sexual intimacy associated with having been raped; increased intellectual intimacy associated with escaped from Syria with one's spouse; decreased recreational intimacy associated with the number of family members lived with; decreased sexual, emotional and total-intimacy scores associated with number of children; and years of education as a seemingly personal protective factor associated with increased intellectual and recreational intimacy.
Addressing Syrian refugees' intimacy issues in interventions is essential, as well as raising the awareness of stakeholders and community leaders to the negative impacts of PTSD, forced marriage, rape, and displacement difficulties endured by the already challenged and distressed married refugees.
寻求避难的叙利亚人遭受了难以理解的暴行和创伤。本研究探讨了个人、人际、流离失所和战争相关因素如何影响已婚难民的亲密生活。
数据包括 158 名居住在约旦收容社区的已婚叙利亚难民。难民报告了他们的个人、人际、当前流离失所和过去战争相关经历。使用哈佛创伤问卷（HTQ）、严重精神疾病（SMI）的 K6 筛查量表、战争事件问卷（WEQ）和人际关系亲密程度个人评估（PAIR）评估创伤影响。逐步多元回归用于确定与难民亲密关系总分及其六个维度相关的因素。
大多数难民（94.2%）经历过战争事件，34%的人在 PTSD-HTQ 量表上呈阳性。总体亲密关系评分较低，平均得分为可能得分为五分的 2.4（±1.1）。在 PTSD-HTQ 呈阳性的难民中，亲密关系评分较低（M=1.95±65），而阴性评分（M=2.23±66）则较高。此外，报告的 PTSD 症状越高，夫妻之间的亲密关系越低。PTSD 和强迫婚姻是预测总亲密关系评分下降的最强因素（β=-0.23，=0.002；β=-0.32，<0.001），以及亲密关系的四个维度评分下降（情感、性、智力和娱乐）。而性别是与总亲密关系评分下降相关的第二强因素（β=-0.29，<0.001），以及亲密关系的三个维度评分下降（情感、社交和愤怒），这意味着女性在婚姻关系中遭受的亲密关系恶化比男性更严重。与亲密关系相关的其他流离失所和战争相关因素包括：与被强奸有关的性亲密关系下降；与与配偶一起逃离叙利亚有关的智力亲密关系增加；与与一起生活的家庭成员数量有关的娱乐亲密关系下降；与儿童数量有关的性、情感和总亲密关系评分下降；以及作为与智力和娱乐亲密关系增加相关的个人保护因素的教育年限。
在干预措施中解决叙利亚难民的亲密关系问题至关重要，同时提高利益相关者和社区领导人对 PTSD、强迫婚姻、强奸和流离失所困难对已经面临挑战和困扰的已婚难民的负面影响的认识。
