Mental Health Outcomes in Iraqi Refugees as Compared to Arab Immigrants: The Importance of Violence, Daily Life Stressors, and Social Support

Background: Refugees are at an increased risk to have a history of violence, trauma, and other stressors well-recognized to be detrimental to mental health. Few studies have compared mental health outcomes between refugees and appropriate comparison groups.

Methods: Data were collected from a representative sample of Iraqi refugees (N=75) and Arab immigrants (N=122). Standardized measures were used to assess mental health, violence exposure, stressors, and social support. Chi square tests were used to evaluate group differences. Logistic regression was used to test the association between violence exposure, life stressors, and social support and mental health outcomes.

Results: The prevalence of psychological distress (66.7% vs. 41.2%, p≤.001) and PTSD (16% vs. 5%, p< .05) was significantly greater in refugees as compared to immigrants. Results from logistic regression analyses revealed significant associations between female gender (15.602, C.I. = 2.294- 106.185), pre-migration exposure to violence (1.062, C.I. =1.007-1.078), and lower levels of social support (7.620, C.I. =2.227-26.079) with PTSD after adjusting for demographic variables, post migration exposure to violence, and life stressors. Additionally, Iraqi refugee status (1.927, C.I. =.970-3.831) and lower levels of social support (4.167, C.I. =1.750-9.919) were significantly associated with psychological distress after adjusting for demographic variables, life stressors, and exposure to violence.

Conclusions: Refugees reported greater pre-migration exposure to violence, which was also found to be associated with PTSD. Lower levels of social support were found to be associated with both PTSD and psychological distress, possibly indicating the importance of relational support in mediating prior trauma, adjustment, and overall well-being.