Posttraumatic stress disorder and psychiatric co-morbidity among Syrian refugees: the role of trauma exposure, trauma centrality, self-efficacy and emotional suppression

Abstract

Background: The devastation of the Syrian war can lead to a drastic re-evaluation of oneself and alteration in self-capacities. Yet, little is known regarding its impact on these domains among Syrian refugees.

Aims: To investigate the inter-relationship between trauma characteristics, trauma centrality, self-efficacy, emotional suppression, PTSD and psychiatric co-morbidity among Syrian refugees.

Methods: 1197 refugees from Turkey and Sweden completed the Harvard Trauma Questionnaire, General Health Questionnaire-28, Centrality of Event Scale, Generalized Self-Efficacy Scale and Courtauld Emotional Control Scale.

Results: Using the DSM-IV criteria for PTSD from the Harvard Trauma Questionnaire, 43% met the criteria. The PTSD group reported significantly higher levels of trauma characteristics, trauma centrality and psychiatric co-morbidity but a lower level of self-efficacy than the non-PTSD group. Trauma characteristics were positively associated with trauma centrality; trauma centrality was negatively correlated with self-efficacy. Contrary to hypothesis, self-efficacy was positively correlated with emotional suppression which was positively correlated with psychiatric co-morbidity but not PTSD.

Conclusions: The experience of war can lead to the emergence of PTSD among Syrian refugees. Exposure to war can alter self-perception, belief of personal mastery over one's future and the way emotion is expressed, all of which can have specific effects on general psychological symptoms.

Keywords: PTSD; Trauma characteristics; centrality; emotional suppression; self-efficacy.