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Based on text by Ward, Bochner and Furnham (second edition)

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  1. 1. Refugees For fear of being prosecuted for race, religion, nationality, membership in agroup or political opinion, is outside thecountry of his nationality and unwilling to return.
  2. 2. Refugees included a range of threatened and displaced persons• Asylum seekers who have been forced to leave their countries of origin• Displaced for political, social, economic, and environmental factors and conditions, including war, ethnic conflict, religious prosecution, genocide, political upheaval, human rights violations, economic crises or collapse, drought, famine
  3. 3. Forced migration to accessible geographical locations that are saferBecause refugees are ‘pushed’ into an alienenvironment and are strongly motivated toescape threats, research is distinctive for:• Attention to premigration factors like loss, destruction, torture, witness to genocide etc• Greater emphasis on mental health outcomes
  4. 4. Most disadvantaged of relocating groups• Exposed to premigration experiences that affect adjustment• Migration is involuntary & motivated by ‘push’ factors that increase risk of psychological and social adjustment problems• Displacement is usually permanent, less likely to be able to return home• Poorly prepared for transition (skills, etc)• Cultural backgrounds different from receiving culture
  5. 5. Comparative studies• Refugees exhibit more symptoms of psychological distress (see: Chu, Mojodina)• Refugee children at higher risk of alcohol & substance abuse, stress, PTSD than those in receiving nation• Limitations to descriptive, comparative studies that don’t consider broader psychosocial factors on adaption
  6. 6. Comparisons to other acculturating groups• Early studies revealed more adjustment problems for refugees, but did not account for confounding factors of cultural distance and historical ties• Dube (1968) study of migrants in Agra, Utter Pradesh eliminated confounding factors and found that premigration factors associated with forced migration affect psychological adjustment during resettlement
  7. 7. Mghir et al.’s study (1955) of Afghan young adults in the U.S.• Focused on prevalence and diagnoses of psychiatric problems in refugees• 29% of sample met criteria for major depression, 11% for PTSD (most common diagnoses) –see pg 225• Many studies are medically based and view psychopathology as an inevitable outcome of refugee experience (have been criticized)
  8. 8. A number of investigations show that refugees fare very well• Gelfand (1989) found little evidence of depression in older, illegal Salvadoran refugees settled in U.S. for at least five years• Stopes-Roe (1977) found Asian refugees in UK were better adjusted than native-borns• Evidence that Southeast Asian refugees in U.S. surpass whites and ethnic minorities in academic achievement• Ugandan refugees in U.K. made rapid economic success in last 25 years
  9. 9. Cultural bereavement framework by Eisenbruch (1991)• Alternative to psychiatric taxonomy• Refers to constellation of experiences such as persistent intrusion of past images into daily life, feelings of guilt over abandonment of culture/homeland, mourning over loss of social structures, identity and values.• Gives meaning to refugee experience by representing normal, constructive responses to trauma and obstacles to maintain identity
  10. 10. Nicassio (1985) proposed three frameworksAn alternative to clinical models tounderstand and interpret refugeeexperience:• Stress & Coping• Acculturation• Learned helplessness
  11. 11. Nicassio argues:• Refugess are thrust into passive, victimized roles during flight, displacement and resettlement• forced to surrender control to organizations and bureaucracies• Unpredictability and lack of control become a way of lifeThus, refugees may believe attempts to regaincontrol are futile (may explain passivity &depression observed in refugee communities)
  12. 12. Pre- and post migration stressors• Premigration stressors such as death of family members, threat, trauma, separation from friends and homeland, exert more influence on depression than postmigration circumstances like economic and cultural pressures, which become more important over time.• Some premigration experiences have more lasting effects than others (camp life vs bereavement)
  13. 13. Premigration circumstances of Afghans described by Mghir et al.• Near death incidents (60%)• Forced separation from family (30%)• Witnesses of murder (23% of strangers, 16% of family or friends)• Lack of food or water (23%)• Lack of shelter (21%)• Imprisonment (16%)55% of women refugees from El Salvador had beenvictims of assault, 32% rape, 19% torture (Bowen)
  14. 14. Effects of violence• Profound effect on both victims and observers• Witnesses to wounding and torture more likely to suffer psychological distress, particularly PTSD• Exposure to premigration trauma is associated with significantly less successful postmigration health and adjustment• Those separated from families during evacuation also at greater risk
  15. 15. Refugee Camps• Interim camps often with overcrowding and health problems and excessive levels of psychological dysfunction (depression, anxiety, attempted suicide, along with social problems of sexual abuse, domestic violence)• Studies show those in camps demonstrate more subsequent psychological distress than those who were not in camps (Chung, 1993)
  16. 16. Pattern of adjustment over time remains controversial• Tyhurst (1977) contrasted first months of resettlement (energetic, euphoric) with later period of distress (6 month onset of ‘displaced person syndrome,’ a constellation of symptoms like paranoia, depression/anxiety, skills deficits, identity conflict)
  17. 17. Nguyen (1982) proposed three stages of refugee adaptation:• First month experienced in positive terms (excitement and euphoria)• Second stage is two-six months after resettlement & dominated by pressures of culture learning and fulfillment of basic needs• Third stage from 6-36 months entails period of reflection and coming to grips with reality of life in a foreign country (greatest risk)
  18. 18. Can U-Curve model be applied to Refugees?• Seems more plausible for refugees in many ways, compared with other sojourners, given relief from threatening conditions, but not enough well-designed research to support U-curve proposition• Studies report increases, decreases and no changes over time related to psychological adjustment• New research needed to address high risk periods in changing patterns of adjustment over time
  19. 19. Stress, Coping and Adjustment• Concerned with process of adaption• Pre- and postmigration experiences form the core of these models• These experiences are examined in conjunction with variables such as personality, social support and educational and occupational resources/deficits for direct and mediating influence on acculturation• See Tran’s Path model (pg 239, Ward, figure 10.1)
  20. 20. Adjustment Problems (from studies of refugees in U.S.)• Separation from family• Painful war memories• English (linked to well-being, < depression)• Homesickness• Finances, job skillsRefugees typically report missing the ‘way of life’ oftheir home country and number of life changesthey are exposed to increasespsychological/psychosomatic l susceptibility (seepage 234, Ward)
  21. 21. Differences in Transition & Adaption• Younger & older migrants (older more nostalgic, younger are future-oriented and more resilient)• Male and female (men more influenced by perceived discrimination and prejudice, women report more symptoms of stress; girls helped by co-ethnic support groups, boys by adherence to traditional family values)
  22. 22. Social Support (spouse, family, sponsors, larger community)• Affects the relationship between stress and refugees’ physical and mental health but may result in both positive or negative outcomes• Marriage is positively associated with coping• Living in family units is r/t better adjustment• Maternal apathy or instability puts children at risk & parenting styles affect adjustment• Ethnic enclaves important upon arrival
  23. 23. Acculturation and IdentityBerry & Kim’s (1988) model:• Precontact stage• Contact stage• Conflict stage• Adaption stageAt precontact stage, macro level ‘push’ factors andattitudes of host country toward cultural pluralism,as well as individual factors like personality &education affect relations
  24. 24. Studies look at cognitive and behavior changes resulting from interaction• Most refugees prefer an integrated, bicultural approach to acculturation, which is associated with better psychological and social adaptation, and most adjust• Integration not always easy to achieve• Tensions rise from changing identities and conflicting lifestyles• Intergenerational conflict