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Trauma, mental health, and everyday functioning among Rohingya refugee people living in short- and long-term resettlements

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Abstract

Purpose

This study investigated if Rohingya refugee people resettled in camps in rural Bangladesh and urban locations in Malaysia had different levels of trauma, mental health and everyday functioning. The study also examined if direct and indirect exposure to traumatic events could predict PTSD, depression, generalized anxiety, and everyday functioning in the two groups separately. An attempt was also made to see if the relations between trauma and mental health were different across the two settings.

Methods

This was a cross-sectional study, for which we conveniently recruited 100 adult Rohingyas, 50 from each country; the majority was males. Rohingyas in Bangladesh fled Myanmar’s Rakhine State following a major military crackdown in 2017, whereas Rohingyas in Malaysia fled Rakhine gradually over the last three decades because of recurrent violence and military operations. We assessed trauma (cumulative trauma, direct trauma, and indirect trauma), PTSD, depression, generalized anxiety, and everyday functioning of the participants using traumatic event questionnaire, PTSD-8, PHQ-9, GAD-7, and WHODAS-2.0.

Results

The Bangladeshi cohort experienced more types of traumatic events (i.e., cumulative trauma) than did the Malaysian cohort (d = 0.58). Although the two cohorts did not differ in terms of indirect exposure to traumatic incidents (i.e., indirect trauma), the Malaysian cohort had direct exposure to traumatic events (i.e., direct trauma) more frequently than did the Bangladeshi cohort (d = 1.22). The Bangladeshi cohort showed higher PTSD (d = 1.67), depression (d = 0.81), generalized anxiety (d = 1.49), and functional impairment (d = 2.51) than those in Malaysia. Hierarchical linear regression analyses showed that after controlling for demographic variables, both direct and indirect trauma significantly predicted PTSD, depression, and functional impairment among Rohingyas in Bangladesh, with direct trauma being the stronger predictor. However, similar analyses showed that only indirect trauma predicted PTSD among Rohingyas in Malaysia, while all other effects were nonsignificant. The results also showed that the predictive relationship between direct trauma and PTSD was different across the two countries. With the same level of direct trauma, a participant from Malaysia would score 0.256 points lower in PTSD than a participant from Bangladesh.

Conclusion

The recently experienced direct and indirect trauma have impaired mental health and everyday functioning among the Bangladeshi cohort. However, only indirect trauma was active to cause PTSD in the Malaysian cohort as direct trauma was weakening due to the time elapsed since migration. We discuss the results in the context of the current theories of trauma and mental health and suggest therapeutic interventions for the refugee population.

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Availability of data and materials

As it is an ongoing PhD research project of the first author, data is not publicly available. However, it could be accessed upon request from the authors.

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Acknowledgements

The authors acknowledge the contributions of the members of the Rohingya refugee communities in Bangladesh and Malaysia, who participated in the study. They also acknowledge Tony Wainwright for giving feedback on the earlier version of the manuscript.

Funding

The authors thank Monash University Malaysia for offering a Merit Scholarship for PhD to Sanjida Khan.

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Contributions

SH and SK conceived the research idea. SK was involved in data collection. SH and SK contributed to data analysis and equally involved in the writing of the manuscript.

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Correspondence to Shamsul Haque.

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The authors declare no conflict of interest.

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Data collection commenced after ethics clearance from Monash University Human Research Ethics Committee (Project No. 12032) and the National Research Ethics Committee (NREC) under Bangladesh Medical Research Council (Registration No. 13831072018).

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Informed consent was taken from participants.

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Khan, S., Haque, S. Trauma, mental health, and everyday functioning among Rohingya refugee people living in short- and long-term resettlements. Soc Psychiatry Psychiatr Epidemiol 56, 497–512 (2021). https://doi.org/10.1007/s00127-020-01962-1

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