227418 Mental Health Outcomes in Iraqi Refugees as Compared to Arab Immigrants: The Importance of Violence, Daily Life Stressors, and Social Support

Monday, November 8, 2010 : 9:45 AM - 10:00 AM

Bengt Arnetz, MD, PhD, MPH, MscEp , Department of Family Medicine & Public Health Sciences, Division of Occupational & Environmental Health, Wayne State University, Detroit, MI
Matthew Ventimiglia, MA, PhD Student , Department of Family Medicine & Public Health Sciences, Division of Occupational & Environmental Health/Department of Psychology, Wayne State University/University of Detroit Mercy, Detroit, MI
Monty M. Fakhouri, MSCHS, CHES , Department of Family Medicine & Public Health Sciences, Division of Occupational & Environmental Health, Wayne State University, Detroit, MI
Judith Arnetz, PhD, MPH , Department of Family Medicine & Public Health Sciences, Division of Occupational & Environmental Health, Wayne State University, Detroit, MI
Hikmet J. Jamil, MD, PhD, FFOMI , Department of Family Medicine & Public Health Sciences, Division of Occupational & Environmental Health, Wayne State University, Detroit, MI
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.

Learning Areas:
Diversity and culture
Other professions or practice related to public health
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify mental health problems common in refugee populations. Differentiate between refugees and and voluntary immigrants. Compare the pre, peri, and post migration experiences of refugees as compared to culturally similar immigrants. Describe risk factors for poor mental health outcomes in refugees and immigrants.

Keywords: Refugees, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because as the director of the department of occupational and environmental health I am involved in programs and research related to such areas as stress prevention and management, stress and mental health in first responders, refugee mental and behavioral health, as well as work place violence, sleep and cell phone use, and smoking.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.