@article{ref1,
title="The relationship of pre- and post-resettlement violence exposure to mental health among refugees: a multi-site panel survey of Somalis in the US and Canada",
journal="Social psychiatry and psychiatric epidemiology",
year="2021",
author="Issa, Osob and Ellis, Heidi and Scoglio, Arielle A. J. and Salhi, Carmel and Lincoln, Alisa",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: A large body of research highlights the lasting impact of pre-resettlement violence on the mental health of refugees after resettlement. However, there is limited research on violence exposure after resettlement and its  association with mental health. We examine the association of pre- and  post-resettlement violence with post-resettlement mental health symptoms in a survey  of Somali refugees in the US and Canada. <br><br>METHODS AND FINDINGS: We collected survey  data from 383 Somalis across five cities in the US and Canada (Boston, MA;  Minneapolis, MN; Lewiston, NC; Portland, ME; Toronto, Canada). Wave 1 data were  collected between May 2013 and January 2014, while Wave 2 was collected between June  2014 and August 2015. Data from both waves were used to examine whether the  association of past violence exposures persists across time and with more recent  violence exposures. The War Trauma Screening Scale assessed exposure to any pre- and  post-resettlement violence at Wave 1, while the My Exposure to Violence scale  assessed any past-year violence exposure at Wave 2. Mental health outcomes included  symptoms of depression and anxiety (Hopkins Symptom Checklist) and post-traumatic  stress symptoms (Harvard Trauma Questionnaire). Separate linear regression models at  Waves 1 and 2 examined the relationship of past violence exposure to standardized  scores of mental health symptoms. Participants were 22 years of age, on average. Fifty-six percent of our sample had been exposed to violence after resettlement by  Wave 2. At Wave 1, the associations of pre- and post-resettlement violence with  mental health were comparable in magnitude across depression [β = 0.39, 95% CI (0.21  0.57) vs. β = 0.36, 95% CI (0.10 0.62)], anxiety [β = 0.33, 95% CI (0.12 0.55) vs. β = 0.38, 95% CI (0.01 0.75)], and PTSD [β = 0.55, 95% CI (0.37 0.72) vs. β = 0.47,  95% CI (0.21 0.74)]. At Wave 2, pre-resettlement violence was associated with  depressive symptoms only [β = 0.23, 95% CI (0.06 0.40)], while past-year exposure to  violence had the largest association with all mental health outcomes [depression:  β = 0.39, 95% CI (0.17 0.62); anxiety: β = 0.46, 95% CI (0.01 0.75); PTSD: β = 0.67,  95% CI 0.46 0.88)]. <br><br>CONCLUSIONS: Our study is the first to examine refugees'  exposure to post-resettlement violence across time, finding that Somali refugees'  exposure is both persistent and prevalent after resettlement. Post-resettlement  violence had a larger association with mental health than pre-resettlement exposure  by Wave 2. Our study highlights the urgent need to understand the role of  post-resettlement violence exposure for refugees in the US and Canada.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-020-02010-8",
url="http://dx.doi.org/10.1007/s00127-020-02010-8"
}