Posttraumatic growth, depressive symptoms, posttraumatic stress symptoms, post-migration stressors and quality of life in multi-traumatized psychiatric outpatients with a refugee background in Norway

Abstract

BackgroundPsychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway.MethodsFifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI), and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref) as well as measures of social integration, social network and employment status.ResultsAll patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the’life satisfaction’ standard proposed by Cummins.A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with posttraumatic growth and quality of life, and positively correlated with psychopathological symptoms. Sixty percent of the outpatients were unemployed.ConclusionsMulti-traumatized refugees in outpatient clinics reported both symptoms of psychopathology and posttraumatic growth after exposure to multiple traumatic events. Symptoms of psychopathology were negatively related to the quality of life, and positively related to post-migration stressors such as unemployment, weak social network and poor social integration. Posttraumatic growth was positively associated with quality of life, and negatively associated with post-migration stressors. Hierarchical regression modeling showed that posttraumatic growth explained more of the variance in quality of life than did posttraumatic stress symptoms, depressive symptoms or unemployment. It may therefore be necessary to address both positive changes and psychopathological symptoms when assessing and treating multi-traumatized outpatients with a refugee background.

Relationship of Religiousness and Religious Coping With Quality of Life Among War Trauma Survivors

“…Posttraumatic growth significantly predicted QOL in a manner that people who displayed more personal growth reported higher QOL. These findings are consistent with the results of previous studies where PTSD and posttraumatic growth showed significant direct and/or indirect effect on quality of life perceptions (Schnurr et al 2006, Teodorescu et al 2012) and the effects are both indirect and direct (Kashdan & Kane 2011).…”

Study of the Correlation between Posttraumatic Growth with the Quality of Life of the Spinal Cord Injury Patients

“…In this study it was observed that there is a significant correlation between satisfaction and importance of the quality of life dimensions and posttraumatic growth that this finding is in line with the results of the study of Halam (2012) and Thoedoresco et al (2012), where it was determined there is a direct and significant correlation between posttraumatic growth and quality of life [15][16] . Also, Tomich and Helgeson (2006) in their research stated that individuals whose mental dimension of their quality of life is lower, experience higher growth 17 .…”

Relationship of Pretreatment Rorschach Factors to Symptoms, Quality of Life, and Real-Life Functioning in a 3-Year Follow-Up of Traumatized Refugee Patients

“…An anxiety score of > 1.75 represents a clinical level of anxiety that was found to be consistent with several anxiety diagnoses, whereas a depression score > 1.75 represents a clinical level of depression found to be consistent with major depressive disorder (Mollica et al, 2004). In studies of traumatized refugee populations of various ethnic backgrounds, internal consistency for the HSCLÀ25 has been reported with Cronbach's alpha ranging from .83 to .96 (e.g., Bentley et al, 2012;Renner, Salem, & Ottomeyer, 2006;Teodorescu et al, 2012). We obtained a Cronbach's alpha for the HSCLÀ25 of .91 at T1, .94 at T2, and .94 at T3.…”

“…The WHOQOLÀBREF has frequently been used in research of traumatized populations, often in conjunction with the HTQ and the HSCLÀ25 (e.g., Teodorescu et al, 2012). Scoring is marked on 5-point Likert scales ranging from 1 (very dissatisfied) to 5 (very satisfied), disagree strongly to agree strongly, and related formulations.…”