War can harm intimacy: consequences for refugees who escaped Syria.

BackgroundSyrians seeking refuge have been exposed to atrocities and trauma beyond comprehension. This study examines how personal, interpersonal, displacement and war-related factors have impacted married refugees' intimate lives.MethodsData included 158 married Syrian refugee individuals who live in the host communities of Jordan. Refugees reported on their personal, interpersonal, current-displacement and past-war related experiences. Traumatic impacts were assessed using the Harvard Trauma Questionnaire (HTQ), K6 screening scale for serious mental illness (SMI), The War Events Questionnaire (WEQ), and Personal Assessment of Intimacy in Relationships (PAIR). Stepwise multiple regressions were used to determine the factors associated with refugees' intimacy-total score and its six dimensions.ResultsMost refugees (94.2%) experienced war events, and 34% screened positive on the PTSD-HTQ scale. Overall intimacy scores were low, scoring M (±standard deviation) = 2.4 (±1.1) of a possible five on average. Intimacy scores were lower for refugees who screened positive on the PTSD-HTQ (M = 1.95 ± 65) compared to the ones screening negative, respectively (M = 2.23 ± 66). Furthermore, the higher the PTSD symptoms reported, the lower the couples' intimacy. PTSD and forced marriage were the strongest factors to predict decreased total-intimacy scores (β = -0.23, P = 0.002; β = -0.32, P < 0.001), and decreased scores on four dimensions of intimacy (emotional, sexual, intellectual and recreational). Whereas gender was the second strongest factor associated with decreased total-intimacy scores (β = -0.29, P < 0.001), and decreased scores on three dimensions of intimacy (emotional, social and anger), meaning that women reported suffering more than men from deteriorated intimacy in their marital relationships. Other displacement and war-related factors associated with intimacy were: decreased sexual intimacy associated with having been raped; increased intellectual intimacy associated with escaped from Syria with one's spouse; decreased recreational intimacy associated with the number of family members lived with; decreased sexual, emotional and total-intimacy scores associated with number of children; and years of education as a seemingly personal protective factor associated with increased intellectual and recreational intimacy.ConclusionsAddressing Syrian refugees' intimacy issues in interventions is essential, as well as raising the awareness of stakeholders and community leaders to the negative impacts of PTSD, forced marriage, rape, and displacement difficulties endured by the already challenged and distressed married refugees

Trauma during humanitarian work: the effects on intimacy, wellbeing and PTSD-symptoms.

Background: Organizations assisting refugees are over burdened with the Syrian humanitarian catastrophe and encounter diverse difficulties facing the consequences of this massive displacement. Aid-workers experience the horrors of war through their efforts to alleviate suffering of Syrian refugees. Objective: This study of Syrian refugee aid-workers in Jordan examined work-stressors identified as secondary traumatic stress (STS), number of refugees assisted, worker feelings towards the organization, and their associations to PTSD-symptoms, wellbeing and intimacy. It also examined whether self-differentiation, physical health, and physical pain were associated with these variables. Method: Syrian refugee aid-workers (N = 317) in Jordans NGOs were surveyed. Univariate statistics and structural equation modeling (SEM) were utilized to test study hypotheses. Results: Increased STS was associated with lower self-differentiation, decreased physical health and increased physical pain, as well as elevated PTSD-symptoms and decreased intimacy. Decreased connection to the NGO was associated with lower self-differentiation, decreased physical health, increased physical pain, and with decreased intimacy and wellbeing. Lower self-differentiation was associated with increased PTSD-symptoms, decreased wellbeing and intimacy. Elevated physical pain was associated with increased PTSD-symptoms, and decreased wellbeing. Diverse mediation effects of physical health, physical pain and self-differentiation were found among the studys variables. Conclusions: Aid-workers who assist refugees were at risk of physical and mental sequelae as well as suffering from degraded self-differentiation, intimacy and wellbeing. Organizations need to develop prevention policies and tailor interventions to better support their aid-workers while operating in such stressful fieldwork

Differentiation of the self, couples’ intimacy and marital satisfaction: A similar model for Palestinian and Jewish married couples in Israel.

This study compares Palestinian and Jewish married couples in Israel on theimportance of differentiation of the self (DS) and couples’ intimacy to maritalsatisfaction. A comparison of both societies’ cultures was conducted on thecontinuum of individualism and collectivism. Data collection was unique dueto the participation of both married partners. The sample included 167married couples from central and northern Israel. Data analysis was guided bytwo interlocking strategies: analysis of each spouse separately and dyadicanalysis (actor-partner interdependence model, APIM) of the couples as units.The findings situate the diversely perceived intimacy of couples and DS asmore important to marital satisfaction than social-cultural variables. Eventhough Palestinian and Jewish married couples were rated differently on bothscales of DS and couples’ intimacy, their scores on marital satisfaction weresimilar. In addition, Palestinian and Jewish couples held different tendenciesof both traits of individualism and collectivism, but these tendencies interactedsimilarly with other study variables, making the model similar for both(i.e., correlations were in the same direction).Our analysis differs from studies conducted elsewhere in the world withcouples and supports Bowen’s theory concerning DS as universal. Theseresults have several implications that may contribute to the edification ofclinical therapists, improved development of services, and the practice ofculturally sensitive therapy in the treatment of Palestinian and Jewish couples.This research may also help Western-oriented therapists for couples andfamilies to better tailor their methodologies to the distinct characteristics ofthese national groups. Furthermore, the findings may shed new light on Eastern- and Western-oriented populations in Israel and elsewhere in theworld, encouraging further studies of the challenges that contemporarymarried couples face.

Refugee trauma work: Effects on intimate relationships and vicarious posttraumatic growth

BackgroundBearing witness to Syrian refugee atrocities may result in aid-workers' vicarious traumatization (VT). This study examined work stressors and organizational support and their associations with vicarious posttraumatic growth (VPTG) and intimate relationships. It also examined the potential mediating effects of differentiation of the self and finding meaning in trauma-work.MethodsAid-workers (N = 317) from organizations in Jordan were surveyed. Univariate statistics and structural equation modeling (SEM) were utilized to test hypothesized relationships.ResultsIncreased VT was associated with increased VPTG, decreased intimacy and decreased differentiation. Increased needs addressed by NGOs was associated with increased VPTG, differentiation, and finding meaning. Increased trauma-exposure was associated with increased finding meaning. Increased co-workers support was associated with increased intimacy and finding meaning. Higher differentiation was associated with decreased VPTG, and increased intimacy. Whereas, increased finding meaning was associated with increased VPTG and intimacy. Differentiation partially mediated the associations between VT, and both VPTG and intimacy, and between needs at work and VPTG. Differentiation fully mediated the association between needs at work and intimacy. Finding meaning fully mediated the associations between extent of trauma-exposure, and both VPTG and intimacy, and between co-workers support and VPTG; needs at work and intimacy. It partially mediated the associations between needs at work and VPTG; co-workers support and intimacy.LimitationsThe study is cross-sectional and generalization is limited to aid-workers who provide services to Syrian refugees in Jordan.ConclusionsOrganizational support is crucial in mitigating the negative impacts of trauma-work, and in enabling a nurturing space for potential growth

Trauma during humanitarian work: the effects on intimacy, wellbeing and PTSD-symptoms

Background: Organizations assisting refugees are over burdened with the Syrian humanitarian catastrophe and encounter diverse difficulties facing the consequences of this massive displacement. Aid-workers experience the horrors of war through their efforts to alleviate suffering of Syrian refugees.Objective: This study of Syrian refugee aid-workers in Jordan examined work-stressors identified as secondary traumatic stress (STS), number of refugees assisted, worker feelings towards the organization, and their associations to PTSD-symptoms, wellbeing and intimacy. It also examined whether self-differentiation, physical health, and physical pain were associated with these variables.Method: Syrian refugee aid-workers (N = 317) in Jordan’s NGOs were surveyed. Univariate statistics and structural equation modeling (SEM) were utilized to test study hypotheses.Results: Increased STS was associated with lower self-differentiation, decreased physical health and increased physical pain, as well as elevated PTSD-symptoms and decreased intimacy. Decreased connection to the NGO was associated with lower self-differentiation, decreased physical health, increased physical pain, and with decreased intimacy and wellbeing. Lower self-differentiation was associated with increased PTSD-symptoms, decreased wellbeing and intimacy. Elevated physical pain was associated with increased PTSD-symptoms, and decreased wellbeing. Diverse mediation effects of physical health, physical pain and self-differentiation were found among the study’s variables.Conclusions: Aid-workers who assist refugees were at risk of physical and mental sequelae as well as suffering from degraded self-differentiation, intimacy and wellbeing. Organizations need to develop prevention policies and tailor interventions to better support their aid-workers while operating in such stressful fieldwork