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受冲突影响的被迫移民的日常生活经历与心理健康:一项元分析。

Everyday life experiences and mental health among conflict-affected forced migrants: A meta-analysis.

机构信息

Laboratory of Psychology and Ecology of Stress (LoPES), Department of Psychology, Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, NT, Hong Kong, China.

Laboratory of Psychology and Ecology of Stress (LoPES), Department of Psychology, Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, NT, Hong Kong, China.

出版信息

J Affect Disord. 2020 Mar 1;264:50-68. doi: 10.1016/j.jad.2019.11.165. Epub 2019 Dec 5.

Abstract

BACKGROUND

There are a growing number of forced migrants worldwide. Early detection of poor adjustment and interventions to facilitate positive adaptation within these communities is a critical global public health priority. A growing literature points to challenges within the post-migration context as key determents of poor mental health.

AIMS

The current meta-analysis evaluated the association between daily stressors and poor mental health among these populations.

METHOD

A systematic search in PsycINFO, PubMed, and Web of Science identified relevant studies from inception until the end of 2018. Effect sizes (correlation coefficients) were pooled using Fisher's Z transformation and reported with 95% confidence intervals. Moderator and mediator analyses were conducted. The protocol is available in PROSPERO [CRD42018081207].

RESULTS

Analysis of 59 eligible studies (n = 17,763) revealed that daily stressors were associated with higher psychiatric symptoms (Zr=0.126-0.199, 95% CI=0.084-0.168, 0.151-0.247, p<0.001) and general distress (Zr=0.542, 95% CI=0.332-0.752, p<0.001). Stronger effect sizes were observed for mixed daily stressors relative to subjective, interpersonal, and material daily stressors, and for general distress relative to posttraumatic stress symptoms and general well-being. Effect sizes were also stronger for children and adolescents relative to adults. Daily stressors fully mediated the associations of prior trauma with post-migration anxiety, depressive, and post-traumatic stress disorder symptoms.

CONCLUSIONS

This meta-analysis provides a synthesis of existing research on the role of unfavorable everyday life experiences and their associations with poor mental health among conflict-affected forced migrants. Routine assessment and intervention to reduce daily stressors can prevent and reduce psychiatric morbidity in these populations.

摘要

背景

全球被迫移民的人数不断增加。早期发现这些社区适应不良,并采取干预措施促进积极适应,是全球公共卫生的当务之急。越来越多的文献指出,移民后的环境挑战是导致心理健康状况不佳的关键因素。

目的

本项荟萃分析评估了日常生活压力源与这些人群的心理健康不良之间的关联。

方法

通过在 PsycINFO、PubMed 和 Web of Science 中进行系统检索,从研究开始到 2018 年底确定了相关研究。使用 Fisher's Z 变换对效应量(相关系数)进行汇总,并报告 95%置信区间。进行了调节和中介分析。该方案可在 PROSPERO [CRD42018081207] 中查阅。

结果

对 59 项符合条件的研究(n=17763)进行分析后发现,日常生活压力源与更高的精神症状(Zr=0.126-0.199,95%CI=0.084-0.168,0.151-0.247,p<0.001)和一般困扰(Zr=0.542,95%CI=0.332-0.752,p<0.001)相关。与主观、人际和物质性日常压力源相比,混合性日常压力源的效应量更大;与创伤后应激症状和总体幸福感相比,一般困扰的效应量更大。与成年人相比,儿童和青少年的效应量更大。日常生活压力源完全中介了先前创伤与移民后焦虑、抑郁和创伤后应激障碍症状之间的关联。

结论

本荟萃分析综合了现有研究,探讨了不利的日常生活经历及其与受冲突影响的被迫移民心理健康不良之间的关联。对日常生活压力源的常规评估和干预可以预防和减少这些人群的精神疾病发病率。

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