Predicting general mental health and exhaustion : the role of emotion and cognition components of personal and collective work-identity.

The aim of this study was to investigate relationships between emotion and cognition components of personal and collective work-identity and self-reported general mental health and exhaustion, in Swedish teachers (N = 768). In line with our predictions, we showed that the emotion component of personal work-identity and the cognition component of collective work-identity associated positively with general mental health and negatively with exhaustion. The reverse result was found, however, for the cognition component of personal work-identity and emotion component of collective work-identity. In general, all this indicates that person-work bonding might, to some degree, account for general mental health and exhaustion in employees. In particular, the findings suggest that general mental health and exhaustion may vary symmetrically across the: (1) Type of person-work bonding (personal vs. collective work-identity); and (2) Type of psychological component (emotion vs. cognition) involved in personal- and collective work-identity

Post-migration stressors, mental health and well-being in resettled refugees from Syria: Do individuals’ coping strategies matter?

Abstract Background The evidence is mixed as to whether individuals’ coping strategies may mitigate the adverse mental health effects of post-displacement stressors in refugee populations, with some indications that the buffering effects of coping strategies are context dependent. The present study examined if problem-solving and acceptance coping strategies were effect modifiers between post-migration stressors and mental health in adult refugees from Syria resettled in Sweden. Methods Study aims were investigated using cross-sectional survey data from a nationwide, randomly sampled group of adult refugees from Syria granted permanent residency in Sweden between 2011 and 2013 (Nsample = 4000, nrespondents = 1215, response rate 30.4%). Post-migration stressors examined included: financial strain, social strain, host-country competency strain and discrimination. Two mental health outcomes were used: anxiety/depression, measured with the Hopkins Symptom Checklist-25; and well-being, measured with the WHO-5 Well-being Index. Both outcomes were modelled continuously. Coping strategies were measured using the BRIEF Cope scale. Interactions between coping strategies and post-migration stressors were tested in fully adjusted linear regression models using Wald test for interaction, corrected for multiple testing using the Benjamini–Hochberg procedure. Results Both problem-solving and acceptance coping strategies buffered the adverse association between financial strain and symptoms of anxiety/depression, and problem-solving coping strategies buffered the adverse association between host-country competency strain and anxiety/depression. Conclusions The study suggests that individuals’ coping strategies may to some degree buffer the adverse mental health effects of financial strain and host-country competency strain experienced by refugees in the resettlement phase. Although this pattern was only found in regard to anxiety/depression and not subjective well-being, the findings show that individual-level coping skills among refugees may contribute to adaptation in the face of post-settlement adversities. Notwithstanding the importance of attending to refugees’ psychosocial conditions, refugees residing in refugee camps and newly resettled refugees might benefit from interventions aiming at enhancing individual coping resources and skills. The potential effect of increased controllability and decreased conflict-proximity also warrants further exploration in future studies

Social support attenuates the link between torture exposure and post-traumatic stress disorder among male and female Syrian refugees in Sweden

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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

The role of personal standards in clinically significant perfectionism. A person-oriented approach to the study of patterns of perfectionism

Clinically significant perfectionism is defined as patterns of perfectionism which are over-represented in clinical samples and under-represented in non-clinical samples. The present study contrasted two hypotheses about what characterizes clinically significant perfectionism: the two-factor theory and perfectionism/acceptance theory. First, a person-oriented approach by means of cluster analysis was used to identify typical patterns of perfectionism. These clusters were then cross-tabulated with two clinical samples (patients with social phobia and patients with panic disorder) and a non-clinical sample. The results showed that patterns of clinically significant perfectionism combined high Concern over Mistakes (CM) and Doubts about Action (DA) with high Personal Standards (PS) (and to a lesser extent also high Organization)--which is consistent with perfectionism/acceptance theory, but at odds with the two-factor theory. The results illustrate the value of a person-oriented methodological approach as a complement to the traditional variable-oriented approach

Exploring Social and Financial Hardship, Mental Health Problems and the Role of Social Support in Asylum Seekers Using Structural Equation Modelling

Asylum seekers are exposed to a range of social and financial difficulties suggested to adversely impact mental health. Uprooted social networks and living conditions during the asylum seeking process potentially predispose this population to low access to social support. The aim of this study was to examine the relationship between social and financial hardship and mental health problems, and assess the potential mediating role of social support among asylum seekers. Cross sectional survey data from a cohort of asylum seekers in Sweden (N = 455) were subjected to structural equation modelling for examining hypothesized pathways between social and financial hardship, common mental health problems (CMHPs) and social support. Fit indices showed adequate to excellent fit of the examined models with CMHPs as the outcome (all CFI ≥ 0.951, RMSEA < 0.05, SRMR < 0.056). CMHPs were positively regressed on social and financial hardship (B = 0.786, S = 0.102, p < 0.001) and negatively regressed on social support (B = -0.103, SE = 0.032, p = 0.001). Social support mediated the association between social and financial hardship and CMHPs (effect estimate = 0.075, 95% CI = 0.032-0.136). The results point to the importance of social and living conditions of asylum seekers and indicate that social support is both socially patterned and may act as a mitigating resource to inform interventions and policies

Prevalence of torture and other war-related traumatic events in forced migrants : A systematic review

Aim: To describe and appraise the research literature reporting prevalence of torture and/or war-related potentially traumatic experiences (PTEs) in adult forced migrants living in high-income countries. Methods: A search for peer-reviewed articles in English was conducted in PubMed, Web of Science, PILOTS, key journals, and reference lists. Studies based on clinical samples and samples where less than half of participants were forced migrants were excluded. Data was extracted and a methodological quality appraisal was performed. Results: A total of 3,470 titles and abstracts were retrieved and screened. Of these, 198 were retrieved in full-text. Forty-one articles fulfilled inclusion criteria and the total number of study participants was 12,020 (median 170). A majority focused on specific ethnic groups or nationalities, Southeast Asian, Middle Eastern and Balkan being the most frequent. Reported prevalence rates of torture ranged between one and 76 % (median 27 %). Almost all participants across all studies had experienced some kind of war-related PTE. Conclusions: Reported prevalence rates of torture and war-related PTEs vary between groups of forced migrants. Trauma history was often studied as a background variable in relation to mental health. The heterogeneity of data, as well as the methodological challenges in reaching forced migrants and defining and measuring traumatic experiences, prevent generalisation concerning trauma history across groups

Health-related quality of life among Syrian refugees resettled in Sweden

Purpose The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population. Methods This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis. Results Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score. Conclusions Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support

Teachers' Personal and Collective Work-Identity Predicts Exhaustion and Work Motivation : Mediating Roles of Psychological Job Demands and Resources

The aim of this study was to investigate the mediating roles of teachers' psychological job demands and resources regarding personal and collective work-identity, respectively, and exhaustion and self-determined work motivation, respectively. A total of 2,905 members of a Swedish teacher's trade union received an online questionnaire by e-mail; 768 individuals answered the questionnaire and so participated in this study. The data were obtained by self-reported measures (e.g., emotional and cognitive components of work-identity, psychological job demands and resources, exhaustion and work motivation) and analyzed by mediation regression analyses. The results showed that teachers' psychological job demands (prosocial extra-role performance) mediated relationships between cognitive personal work-identity and emotional collective work-identity, respectively, and exhaustion. Teachers' psychological job resources (educational inspiration) mediated relationships between emotional personal work-identity and cognitive collective work-identity, respectively, and self-determined work motivation. Thus, teachers might be disadvantaged by stronger personal work-related thinking and collective work-related feeling when related to exhaustion, to some extent accounted for by psychological job demands, and they might find advantage in stronger personal work-related feeling and collective work-related thinking when related to work motivation, to some extent accounted for by psychological job resources

Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden : a cross-sectional study

Background: Forced migrant populations have high rates of trauma-related ill health, including post-traumatic stress disorder (PTSD). Physical activity (PA) is well-established as an effective stress reliever, while insufficient PA is associated with adverse effects on both mental and physical health. The aim of this study was to examine the prevalence of different levels of PA and its association with PTSD symptom severity, controlled for exposure to torture, among asylum seekers in Sweden. Methods: A cross-sectional survey study, with data from 455 asylum seekers, originating from Afghanistan, Eritrea, Iraq, Somalia, and Syria, residing at large housing facilities across Sweden. Level of PA was assessed by the Exercise Vital Sign and categorized as; Inactive, Insufficient PA, and Sufficient PA. Prevalence estimates for proportions of different levels of PA were calculated. Analysis of variance were conducted to determine the association between levels of PA and PTSD symptom severity, measured by the Harvard Trauma Questionnaire. Multivariable logistic regression analysis was performed to determine the contribution of PA on PTSD beyond sex, age, and exposure to torture. Results: About half of the participants (53.3, 95% CI: 48.6-58.1) met the recommendations for Sufficient PA. One third of the participants (33.3, 95% CI: 28.7-37.8) were insufficiently engaged in PA, and 13.4% (95% CI: 10.1-16.7) were inactive. There was a significant difference in PTSD symptom severity between groups of asylum seekers with different levels of PA (F-(2,F- 316) = 23.15, p < .001). When controlling for sex, age, and exposure to torture, Sufficient PA was found to be associated with less PTSD symptom severity compared to both Insufficient PA (B = 0.297, SE = 0.086, p < .001) and Inactive (B = 0.789, SE = 0.104, p < .001). Conclusions: Insufficient PA was common among the asylum seekers and our findings suggest that more PA is highly associated with lower PTSD symptom severity. An increased focus on assessment and promotion of PA is justified and discussed as particularly pertinent considering the much extended time of asylum-seeking processes. The results support previous evidence of PA as a potentially important factor in the context of PTSD and forced migrants' health