Details

Autor(en) / Beteiligte

• Choe, Ryeora
• Lardier, David T.
• Hess, Julia Meredith
• Blackwell, Meredith A.
• Amer, Suha
• Ndayisenga, Martin
• Deewa, Sara
• Isakson, Brian
• Goodkind, Jessica R.
• Kilmer, Ryan P
• Coker, Kendell L

Titel

Measuring Culturally and Contextually Specific Distress Among Afghan, Iraqi, and Great Lakes African Refugees

Ist Teil von

• American journal of orthopsychiatry, 2024, Vol.94 (3), p.246-261

Ort / Verlag

United States: Educational Publishing Foundation

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Culturally and contextually valid measurement of psychological distress is critical, given the increasing numbers of forcibly displaced people and transnational migration. This study replicates an inductive process that elicited culturally specific expressions, understandings, and idioms of distress among Afghans to develop culturally specific measures of distress for Great Lakes Africans and Iraqis and expands this methodology to include a focus on the contexts of refugees resettled in the United States. To create the measures, we adapted Miller et al.'s (2006) model for the Afghan Symptom Checklist (ASCL) and conducted 18 semistructured qualitative interviews that attended to refugees' multiple settings; the impact of potentially traumatic events initially and postresettlement; and the experiences and impact of resettlement stressors. We tested the newly developed measures and existing ASCL with 280 recently resettled refugees (<3 years) from Afghanistan, the Great Lakes region of Africa, and Iraq to assess factor structure, reliability, and construct validity. We successfully replicated and adapted a process for creating culturally specific measures of distress to create reliable and valid scales that consider culturally and contextually specific distress among several groups of forcibly displaced people. Our results highlight the salience of individuals' social contexts and how they are manifested as idioms of distress, bringing together two key areas of research: the social construction of mental health and social determinants of mental health. These findings have implications for improving measurement of psychological distress and for developing multilevel interventions that are culturally resonant and address factors beyond the individual level. Public Policy Relevance Statement Addressing the mental health of the rapidly increasing numbers of forcibly displaced people is urgently needed, and effective interventions require an accurate understanding of the sources and experiences of psychological distress. This study highlights a process for assessing culturally and contextually specific distress among three refugee groups and provides measures that can be used with Afghan, Great Lakes African, and Iraqi refugees in the United States. The symptoms of distress revealed in the newly created measures demonstrate the relevance of including contextually specific items that measure postresettlement stressors and the importance of multilevel and structural interventions that attend to social isolation, family separation, language barriers, and resource access.