Department of Health Sciences, The Swedish Red Cross University College, PO Box 1059, SE-141 21, Huddinge, Sweden.
Clinical Psychology in Health Care, Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden.
BMC Int Health Hum Rights. 2019 Sep 5;19(1):28. doi: 10.1186/s12914-019-0214-6.
The aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and PTSD; (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender.
Data from a cross-sectional and population-based study of a random sample of Syrian refugees (n = 1215) resettled in Sweden 2011-2013 was analyzed within a Structural Equation Modeling (SEM) framework.
Our results indicate adequate fit and gender invariance for a unidimensional model of ESSI. Exposure to torture was associated with lower social support (B = -0.22, p < 0.01) and with higher odds ratio (OR) for PTSD (OR 2.52, 95% Confidence interval (CI) 1.83-3.40). Furthermore, higher social support was associated with less likelihood for PTSD (B = -0.56, p < 0.001). Social support partially mediated the effect of torture exposure on PTSD (OR 1.13, 95% bias corrected bootstrap CI 1.06-1.26). Gender did not moderate this pattern.
The results indicate that social support attenuates the link between torture exposure and PTSD, and may function as a protective factor for PTSD among both torture-exposed refugee men and women.
本研究旨在实现三个目标：（一）首次在定居于瑞典的叙利亚难民群体中应用强化生活经历问卷（ENRICHD Social Support Inventory，ESSI），对其进行心理计量学特性评估并验证其性别不变性；（二）评估社会支持与酷刑暴露对 PTSD 的影响是否存在性别差异；（三）评估社会支持是否在酷刑暴露与 PTSD 之间起中介作用，以及这种中介作用是否受到性别影响。
本研究采用横断面研究设计，基于 2011-2013 年定居于瑞典的叙利亚难民的随机样本数据（n=1215），在结构方程模型（Structural Equation Modeling，SEM）框架内进行分析。
我们的研究结果表明，ESSI 的单维模型具有良好的适配度和性别不变性。酷刑暴露与社会支持水平降低（B=-0.22，p<0.01）和 PTSD 患病风险增加（OR=2.52，95%置信区间（Confidence interval，CI）为 1.83-3.40）有关。此外，较高的社会支持与 PTSD 发生的可能性降低有关（B=-0.56，p<0.001）。社会支持在一定程度上中介了酷刑暴露对 PTSD 的影响（OR=1.13，95%偏倚校正的自举置信区间（Bias-corrected bootstrap confidence interval，BCBCI）为 1.06-1.26）。性别未对这一模式产生调节作用。
研究结果表明，社会支持减弱了酷刑暴露与 PTSD 之间的联系，并且可能是处于酷刑暴露下的男性和女性难民 PTSD 的保护因素。
