Journeys in meaning : Psychological adjustment to trauma in resettled syrian refugees

Dissertation submitted in partial fulfillment of the requirements for degree of Doctor in Philosophy, specialty in Clinical Psychology, to ISPA – Instituto Universitário, in 2022, with the supervision of Isabel Maria Pereira Leal, Crystal L. Park and Monica J. Indart. The present work was sponsored by a doctoral grant from the Portuguese Foundation for Science and Technology (ref.: SFRH/BD/129602/2017).The ability to make meaning of extreme events is a key determinant of psychological adjustment to trauma. Guided by Park’s (2010) integrated meaning-making model, the principal aim of this dissertation was to investigate the meaning-making experiences of resettled Syrian refugees and the impact of those experiences on posttraumatic adjustment. To this end, we conducted a mixed-methods cross-sectional study, with two phases of data collection and two independent samples. A total of 44 Syrian war-exposed adults living in urban communities across continental Portugal participated in Phase 1 Focus Groups (n = 2; 5 participants) and Phase 2 individual interviews (n = 39). Empirical results are described in Chapters 3 to 7. Key results identified: (1) exposure to significant meaning-shattering events pre-, during, and post-flight; (2) the centrality of pre-war global meanings related to identity, justice, control, God, expectations of normality, intact family and country, and peace to appraise the war and forced displacement; (3) situational appraisals as both intra- and interpersonal processes subject to revisiting with new trauma, new information, time, and context; (4) cognitive-specific, as well as immediate and gradual meaning violations; (5) determinants of search for meaning including cumulative stressors, availability of cognitive resources, stage of displacement, social support, coping strategies, and developmental age; (6) negative, positive, ambivalent, and unresolved meanings-made of trauma; and (7) psychological adjustment to refugee trauma as a continuum of responses, from distress to perceptions of growth. Findings suggest that meaning-making of refugee trauma entails a set of concurrent, dynamic, cognitive-specific trajectories that are informed by place and sociopolitical context, and thus prone to be repeatedly revisited. Findings further challenge the concept of successful psychological adjustment to trauma as an end-state. This work highlights the need to promote adaptive meaning-making as an integrated experience that prioritizes repairing the meanings most severely challenged by war, including sense of justice, belonging, control, as well as the possibility of a peaceful and safe future.O processo de atribuição de sentido a acontecimentos extremos é um determinante-chave do ajustamento psicológico ao trauma. Tendo por base o modelo teórico integrado de atribuição de sentido (Park, 2010), este trabalho teve como principal objetivo investigar os processos de atribuição de sentido em refugiados sírios reinstalados, bem como o impacto desses processos no ajustamento pós-traumático. Para tal, foi realizado um estudo transversal, de métodos mistos, com duas fases de recolha de dados e duas amostras independentes. Um total de 44 sobreviventes de guerra sírios, adultos, reinstalados em diferentes cidades portuguesas, participaram em Grupos Focais (Fase 1; n = 2, 5 participantes) e em entrevistas individuais (Fase 2; n = 39). Os Capítulos 3 a 7 descrevem os resultados empíricos. Os principais resultados identificaram: (1) exposição a números significativos de acontecimentos potencialmente traumáticos antes, durante e após a fuga; (2) centralidade de sentidos globais (i.e., global meanings) relativos a identidade, justiça, controlo, Deus, expectativas de normalidade, família e país intactos, e paz, na avaliação das experiências de guerra e migração forçada; (3) avaliações situacionais (i.e., situational meanings) enquanto processos tanto intrínsecos como extrínsecos, reavaliados com exposição a novos traumas, a nova informação, com o tempo e contexto; (4) violações de sentido (i.e., meaning violations) tanto imediatas como progressivas e que afetam cognições específicas; (5) determinantes de procura de sentido, incluindo stressores cumulativos, disponibilidade de recursos cognitivos, período migratório, suporte social, estratégias de evitamento e idade; (6) sentidos atribuídos ao trauma (i.e., meanings-made) negativos, positivos, ambivalentes e incompletos; e (7) ajustamento psicológico ao trauma associado à experiência de refúgio como um continuum de respostas, que vão do distress a perceções de crescimento psicológico. Os resultados sugerem que a atribuição de sentido ao trauma associado à experiência de refúgio inclui um conjunto de trajetórias paralelas, dinâmicas e relativas a cognições específicas, que são informadas pelo contexto sociopolítico e lugar e, como tal, propensas a serem repetidamente reavaliadas. Por outro lado, os resultados desafiam conceitos de ajustamento psicológico positivo enquanto processo com um fim definido. Este estudo destaca a necessidade de promover processos adaptativos de atribuição de sentido enquanto experiência integrada, que priorize a reparação das estruturas cognitivas mais severamente danificadas pelo trauma, incluindo sentido de justiça, pertença, controlo, bem como a expectativa de um futuro em paz e segurança

ADAPTAÇÃO DA GLOBAL MEANING VIOLATION SCALE PARA REFUGIADOS DE LÍNGUA ÁRABE

Refugees are survivors of extreme, cumulative potentially-traumatic events (PTEs), which can violate their goals, beliefs and sense of purpose (i.e. global meaning) and cause significant psychological distress. Despite being disproportionately affected by PTEs, there are few psychological instruments available in refugees’ native languages, and which consider their cultural and traumatic diversity. Our aim is to describe the process of cross-cultural adaption of the Global Meaning Violation Scale (GMVS) for use with Arabic-speaking refugees in resettlement. Methods: Following the ITC Guidelines for Translating and Adapting Tests, we engaged the assistance of psychometry, language, cultural and content experts to translate and adapt the GMVS to Arabic. Results: Experts based in Portugal, Jordan, US and Germany participated in the translation and adaptation process. The scale was considered straightforward and overall cohesive and, by addressing feelings rather than mental health issues, culturally-appropriate. Potential problems related to the complexity of the construct, cultural appropriateness of the “Intimacy (emotional closeness)” item, and use of a Likert Scale. Discussion: The overall process of translating and adapting the GMVS to Arabic was lengthy and resource-intensive. Researchers should carefully consider availability of resources when planning research with culturally diverse populations.info:eu-repo/semantics/publishedVersio

“It’s the God factor”: A qualitative study of Syrian Muslims’ post-war religious meaning-making

Objective: Religious meaning-making may facilitate psychological adjustment to even the most extreme traumatic stressors, including war and forced displacement. Yet few studies have examined the religious meaning-making trajectories of refugees and none from an Islamic perspective. Method: This qualitative cross-sectional study investigated Syrian Muslims’ post-war meaning-making experiences, guided by Park’s (2010) meaning-making model. Results: Thirty-three Syrian Muslim refugees living in Portugal were interviewed eight years after the onset of the war. Thematic analysis was used to explore cognitive reappraisal processes informed by Islam. Key results suggest: the recurrent nature of meaning-making throughout refugees’ displacement trajectories; religious struggles as a key determinant of religious meaning-making; meaning-making as dynamic trajectories with no clear end; place of settlement as a source of meaning; and the ability of Islam to withstand extreme challenges and provide a last-resort narrative, even for those individuals with severely eroded beliefs. Findings highlight the need for practitioners in host countries to incorporate faith and religious traditions in the provision of care.info:eu-repo/semantics/submittedVersio

‘The War Made Me a Better Person’: Syrian Refugees’ Meaning-Making Trajectories in the Aftermath of Collective Trauma

first_pagesettings Open AccessArticle ‘The War Made Me a Better Person’: Syrian Refugees’ Meaning-Making Trajectories in the Aftermath of Collective Trauma by Lisa Matos 1,*ORCID,Pedro A. Costa 1ORCID,Crystal L. Park 2ORCID,Monica J. Indart 3 andIsabel Leal 1 1 William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisbon, Portugal 2 Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA 3 Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ 08901, USA * Author to whom correspondence should be addressed. Academic Editors: Alessandra Talamo and Camilla Modesti Int. J. Environ. Res. Public Health 2021, 18(16), 8481; https://doi.org/10.3390/ijerph18168481 Received: 6 July 2021 / Revised: 3 August 2021 / Accepted: 6 August 2021 / Published: 11 August 2021 (This article belongs to the Special Issue Refugees across Communities: Health and Place Attachment in Resettlement) Download PDF Browse Figure Citation Export Abstract The centrality of the collective to Syrian identity and the ability of war to disrupt community ties have led to significant violations of Syrians’ pre-war assumptions about themselves, the world, and their place in the world. Guided by the integrated meaning-making model, this qualitative cross-sectional study assessed Syrian refugees’ meaning trajectories through their reappraisals of the war, attempts to repair community-informed shattered meanings, and those processes’ outputs (i.e., meanings-made) and outcomes (i.e., perceived psychological adjustment). We conducted semi-structured cognitive interviews with 39 Syrian war-exposed adults living in urban communities across Portugal, most of whom were beneficiaries of higher education programs for refugees. Interviews were analyzed through thematic analysis. Results suggest that the war severely disrupted Syrians’ sense of collective self, and that they repeatedly engaged in search for meaning, appraisals of the war, and reappraisals of shattered beliefs, life goals, and sense of purpose, both during wartime and in resettlement. In Portugal, despite persistent negative beliefs about the collective and ongoing and distressing searches for meaning, participants’ lived experiences concomitantly informed positive meaning reappraisals, including progressive restoration of worldviews, new opportunities for self-realization, and newly-found purpose, leading to perceived psychological benefits and growth. These findings suggest that meaning-making is both a trajectory and a dynamic process, informed by place and sociopolitical context. Clinical work to facilitate adaptive meaning-making and meaning-informed psychosocial interventions that help restore refugees’ shattered beliefs about safety, predictability, trust, and belonging, may be helpful directions to promote positive psychological adjustment and improve long-term integration prospects in refugees.Fundação para a Ciência e Tecnologia - FCTinfo:eu-repo/semantics/publishedVersio

Assessing meaning violations in Syrian refugees: A mixed‐methods cross‐cultural adaptation of the Global Meaning Violations Scale–ArabV

Refugees are disproportionately affected by extreme traumatic events that can violate core beliefs and life goals (i.e., global meaning) and cause significant distress. This mixed-methods study used an exploratory sequential design to assess meaning violations in a sample of Syrian refugees living in Portugal. For this purpose, we cross-culturally adapted the Global Meaning Violations Scale (GMVS) for use with Arabic-speaking refugees. In total, 43 war-affected Syrian adults participated in the two-phase study. Participants completed measures of trauma and narrated violations as they filled out the newly adapted GMVSArabV. GMVS-ArabV validity evidence based on response processes was investigated through Phase 1 focus groups (FGs; n = 2), whereas data from Phase 2 cognitive interviews (n = 38) were used to preliminarily explore the measure’s internal structure through descriptive statistics as well as culture- and traumainformed content evidence through thematic analysis. The results suggested highest goal (M = 3.51, SD = 1.46) and lowest belief (M = 2.38, SD = 1.59) violations of educational goals and religious beliefs, respectively. Themes related to stressors, item formulation, response scale, and the global meaning construct suggested that (a) beliefs and goals can be differentially violated by different stressors; (b) much like war trauma, including torture, daily stressors can additionally shatter pretrauma global meaning; and (c) refugees reappraise meaning and suffer violations anew throughout their migration journeys. The GMVSArabV offers a promising tool for exploring shattered cognitions in refugees and informs evidence-based approaches to trauma recovery and psychological adjustment in postmigration settings (the Arabic abstract and keywords are available in the Supplementary Materials).Fundação para a Ciência e Tecnologia - FCTinfo:eu-repo/semantics/publishedVersio

Outcome of radioiodine therapy for feline hyperthyroidism: Fixed dose versus individualized dose based on a clinical scoring system.

Background Hyperthyroidism is the most frequent endocrinopathy in older cats. To date, there is no consensus on how to best calculate the dose of radioiodine to administer to hyperthyroid cats. Aim The goals of this study were to compare thyroid function, renal function, and survival time between hyperthyroid cats receiving a fixed dose of radioiodine and those receiving an individualized dose calculated using a clinical scoring system. Methods Medical records of 110 cats treated with radioiodine therapy at the University of Bern between 2010 and 2020 were reviewed. Thyroid function, renal function, and survival of cats treated with a fixed dose of radioiodine (2010-2015; n = 50) were compared to those of cats treated with an individualized dose (2015-2020; n = 60) at different time points after therapy. Results Treatment with a fixed dose of radioiodine (mean = 168 ± 26 MBq) was associated with 69% of euthyroidism, 19% persistent hyperthyroidism, and 12% hypothyroidism, whereas treatment with an individualized dose (mean = 120 ± 30 MBq) led to 54% euthyroidism, 23% hyperthyroidism, and 23% hypothyroidism (p = 0.73). More than 12 months after treatment, the incidence of azotemia was comparable between cats treated with a fixed dose (37%) and those treated with an individualized dose (31%) (p = 0.77). No factors were found to be predictive of treatment failure (hypothyroidism or hyperthyroidism) after therapy. Median survival time after radioiodine therapy was 44 months. In a multivariate analysis, persistent hyperthyroidism was the only variable independently associated with a shorter survival time (HR = 6.24, p = 0.002). Conclusion The method of calculating the dose of radioiodine (fixed vs. individualized) to treat feline hyperthyroidism does not appear to be decisive for posttreatment thyroid function, renal function, or survival

Meaning-making and psychological adjustment following refugee trauma

Inexistente.info:eu-repo/semantics/publishedVersio

Meaning-making and psychological adjustment following refugee trauma

Inexistente.info:eu-repo/semantics/publishedVersio

Direct frequency-comb spectroscopy of a dipole-forbidden clock transition in trapped 40Ca+ ions

We demonstrate direct frequency-comb (FC) spectroscopy of the dipole-forbidden 4

Characterizing rTg4510 Mice Model of Alzheimer's Disease on Adult Neurogenesis and Cognitive Function

Alzheimer’s Disease (AD) is a debilitating illness that affects millions of Americans each year. While there is not one definitive hypothesis that exists regarding how the disease develops, some hypotheses include the cholinergic model, the amyloid beta hypothesis, and the tau pathology model. The rTg4510 (Tg) mouse is a model of AD that over-expresses inducible human mutant tau (P301L), a pathological hallmark of AD. This study characterizes the Tg mouse through analysis of adult neurogenesis in the olfactory system, due to the fact that the olfactory system is one of the first sensory systems of the brain to be affected by AD. For this, we examined the behavioral changes in different age groups, specifically 2 and 7 months. Adult neurogenesis within the granule cell layers and glomerular layers in the main and accessory olfactory bulb was analyzed by methods of immunohistochemistry using appropriate antibodies and cell counting with confocal microscopy. Several behavioral paradigms, such as habituation/dishabituation, odor detection threshold, and novel object recognition, were executed to assess cognitive function of these mice, especially in relation to markers of olfactory behavior. Our data suggest that there is an age-dependent cognitive impairment but an age-dependent increase in neurogenesis. Further study is required to identify the effects of inducing the mutant tau on neurogenesis in the olfactory bulb (OB) and whether the overexpression of tau directly impacts cognitive decline