Alpay Emre Han, Kira Ibrahim Aref
Department of Psychology, Mersin University, Mersin, Türkiye.
Center for Stress, Trauma, and Resilience, Georgia State University, Atlanta, Georgia, USA.
Clin Psychol Psychother. 2025 Jul-Aug;32(4):e70133. doi: 10.1002/cpp.70133.
This study aimed to examine the relationships among continuous traumatic stressors (CTS), posttraumatic stress disorder (PTSD), somatic symptoms, and chronic pain in a sample of Syrian refugees. Specifically, we hypothesized that PTSD would mediate the association between discrimination-based CTS and chronic pain and that somatic symptoms would moderate the link between PTSD and chronic pain-such that higher somatic symptom levels would amplify this association.
A total of 669 Syrian refugees residing in Türkiye participated in the study. Data were collected through face-to-face interviews using validated self-report instruments, including the Patient Health Questionnaire-15 (PHQ-15), the PTSD Checklist for DSM-5 (PCL-5), the Short-Form McGill Pain Questionnaire (SF-MPQ) and the Cumulative Trauma Scale.
PTSD symptoms mediated the relationship between discrimination-based CTS and chronic pain. Additionally, somatic symptoms significantly moderated the association between PTSD and chronic pain, such that individuals with higher levels of somatic symptoms exhibited a stronger link between PTSD symptoms and chronic pain severity.
These findings emphasize the relationship between discrimination-based CTS, psychological distress, and physical complaints among Syrian refugees in Türkiye. While the results provide important insights into trauma-related health outcomes in this group, caution should be exercised in generalizing the findings to all displaced populations. The results highlight the profound impact of prolonged traumatic stress on both psychological and physical health and emphasize the need for trauma-informed, culturally sensitive clinical interventions for displaced individuals.
本研究旨在探讨叙利亚难民样本中持续性创伤应激源（CTS）、创伤后应激障碍（PTSD）、躯体症状和慢性疼痛之间的关系。具体而言，我们假设PTSD将介导基于歧视的CTS与慢性疼痛之间的关联，并且躯体症状将调节PTSD与慢性疼痛之间的联系——即更高的躯体症状水平会增强这种关联。
共有669名居住在土耳其的叙利亚难民参与了本研究。通过面对面访谈，使用经过验证的自我报告工具收集数据，包括患者健康问卷-15（PHQ-15）、DSM-5创伤后应激障碍检查表（PCL-5）、简短麦吉尔疼痛问卷（SF-MPQ）和累积创伤量表。
PTSD症状介导了基于歧视的CTS与慢性疼痛之间的关系。此外，躯体症状显著调节了PTSD与慢性疼痛之间的关联，即躯体症状水平较高的个体在PTSD症状与慢性疼痛严重程度之间表现出更强的联系。
这些发现强调了土耳其叙利亚难民中基于歧视的CTS、心理困扰和身体不适之间的关系。虽然研究结果为该群体中与创伤相关的健康结果提供了重要见解，但在将这些发现推广到所有流离失所人群时应谨慎。研究结果突出了长期创伤应激对心理和身体健康的深远影响，并强调了为流离失所者提供具有创伤知情、文化敏感性的临床干预措施的必要性。
