BackgroundSince the Syrian civil war began in March 2011, more than half of the Syrian population was forced to escape from their homes, and more than 5 million of them fled their country. The aim of the present study is to estimate the psychological consequences of this conflict among the refugee population who fled to Iraq.MethodIn 2017, a team of locally trained psychologists and social workers interviewed 494 married couples (988 individuals) who were Syrian Kurdish refugees in the Kurdistan Region of Iraq. Validated Kurdish Kurmanji and Arabic versions of post-traumatic stress disorder (PTSD) Checklist for DSM-5 and depression section of Hopkins Symptom Checklist-25 were used for assessing PTSD and depression symptoms.ResultsAlmost all of the participants (98.5%) had experienced at least one traumatic event and 86.3% of them experienced three or more traumatic event types. The prevalence of probable PTSD was about 60%. Gender, length of time in the camp, area in which participants were grown up, and the number of traumatic event types were significant predictors for the presence of PTSD symptoms. Approximately the same rate of participants (59.4%) experienced probable depression, which was associated with gender, age, time spent in the camp, and the number of traumatic event types.ConclusionPTSD and depression are prevalent among refugees exposed to traumatic events, and various variables play important roles. The pattern of risk factors in this population is consistent with findings from war-affected populations in other regions and should be considered for intervention within this population and more broadly.

Most current research investigating traumatic stress is focused on its effects at the individual level, utilizing the implicit assumption that trauma-related disorders are mutually independent within families and communities. However, there is reason to assume that trauma-related symptoms within couples are influenced by each partner's risk factors and symptoms. Using the actor-partner interdependence model, this study aimed to test whether symptoms of posttraumatic stress disorder (PTSD) and depression were predicted by participants' partner's exposure to traumatic events over and above the influence of the participant's own experiences. For this purpose, we interviewed 687 heterosexual, married Iraqi and Syrian couples in Iraq's Kurdistan region who had been forcefully displaced. We assessed symptoms of PTSD and depression using locally validated scales.Nearly all participants (98.8%) reported exposure to at least one traumatic event, with husbands reporting exposure to a higher number of traumatic events than wives, d = 0.48, p < .001. More than half of the participants met the criteria for a probable PTSD (61.1%) or major depressive disorder diagnosis (60.4%). Within couples, significant actor effects of experienced trauma exposure on personal PTSD and depressive symptoms were observed for both husbands and wives. Further, there were significant partner effects of wives' traumatic experiences on husbands' PTSD and depressive symptoms as well as of husbands' traumatic experiences on wives' PTSD and depressive symptoms. The findings argue for the interdependence of trauma-related symptoms within dyads in a dual-trauma context, suggesting the presence of intracouple transmission of trauma-related symptoms.Forced migration has been one of the most consistent, prominent characteristics of humanitarian crises (Kaya et al., 2019). According to the United Nations High Commissioner for Refugees (UNHCR), by the end of 2019, the number of individuals forcibly displaced due to war and conflict reached more than 79,500,000 million worldwide (UNHCR, 2020). There are many ways war negativelyThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

The findings of longitudinal studies on traumatized refugees have shown that factors related to premigration, migration, and post-migration experiences determine changes in mental health over time. The primary aim of this follow-up study was to examine the potential change in the prevalence rates of probable PTSD and depression among Syrian refugees in Iraq. An unselected group of N = 92 Syrian adult refugees was recruited from Arbat camps in Sulaymaniyah Governorate in Iraq’s Kurdistan Region, and then interviewed at two different time points between July 2017 and January 2019. Locally validated instruments were used to assess traumatic events and mental health symptoms. The primary results showed no significant change in the mean scores of PTSD and depression symptoms from the first measurement to the second measurement over the course of 18 months. On the individual level, no reliable change was found for either PTSD or depression symptoms in more than three-quarters of the participants (78.3% and 77.2%, respectively). New adversities and traumatic events that occurred over the 18 months between the interviews were a significant predictor of increasing trauma-related symptoms. After the flight from conflict settings, trauma-related disorders seem to be chronic for the majority of Syrian refugees. Further longitudinal studies are needed in order to identify specific risk factors that lead to maintaining or worsening mental health symptoms over time, and to explore effective therapeutic intervention methods for this traumatized population.