The longitudinal relationship between economic and social stressors, emotion dysregulation and mental health among refugees in protracted displacement.

AIMS: Trauma-related psychopathology is markedly elevated among refugee populations, particularly those living in sustained displacement. While economic, social and psychological factors have been linked to the deterioration of mental health following trauma and displacement, these factors have rarely been investigated concurrently and longitudinally. Consequently, there is little information on the potential longitudinal mechanisms driving mental ill-health in displacement settings. This study explored the temporal association between economic stressors, social stressors, emotion dysregulation and psychopathology in 1,235 refugees displaced in Indonesia.

METHODS

Refugee participants from Farsi, Dari, Arabic, Somali and English-speaking backgrounds completed an online survey at four timepoints, 6 months apart. Factors of interest were measured using validated instruments including the Patient Health Questionnaire (to assess depressive symptoms), Posttraumatic Diagnostic Scale (to assess posttraumatic stress [PTS] symptoms), Post-Migration Living Difficulties Checklist (to index economic and social stressors) and Difficulties in Emotion Regulation Scale (to assess emotion dysregulation).

RESULTS

Random-intercept cross-lagged panel analysis revealed that economic stressors and emotion dysregulation were central to the longitudinal course of trauma-related psychopathology. Specifically, economic stressors were associated with subsequent increases in PTS symptoms (B = 0.07, p = 0.047), depressive symptoms (B = 0.17, p < .001) and social stressors (B = 0.28, p < .001), while emotion dysregulation was antecedent to increases in PTS (B = 0.16, p < .001), depression symptoms (B = 0.13, p < .001), and social stressors (B = 0.10, p = .017). Additionally, depression was associated with subsequent increases in economic stressors (B = 0.18, p = .001) and social stressors were associated with subsequent increases in economic stressors (B = 0.12, p = .037).

CONCLUSIONS

The current study identified both economic stressors and emotion dysregulation as the main drivers of psychopathology for refugees. This indicates that both the structural barriers encountered in the environment and one's internal capacity have a substantial impact on wellbeing. These findings highlight that alongside psychological interventions, policy changes that facilitate economic empowerment are critically, and equally, important.