Journal of Immigrant and Minority Health

, Volume 22, Issue 1, pp 50–60 | Cite as

Assessing Predictors of Emotional Distress by Immigrant Type: An Exploration of Adult Refugees, Asylees, and SIV Holders in Maryland

  • Aafreen A. MahmoodEmail author
  • Dipti D. Shah
  • Georgia J. Michlig
  • Mary Elizabeth Hughes
  • Judith K. Bass
Original Paper


Stressors and trauma experienced by persons fleeing harm or persecution can cause elevated distress. This study assessed predictors of elevated distress among newly arrived refugees, asylees, and Special Immigrant Visa (SIV) holders in Maryland. A secondary analysis of Refugee Health Screener-15 data from 4385 refugees, asylees, and SIV holders arriving in Maryland from 2014 to 2017 was conducted. Mean scores were compared across immigrant groups, and positive screening predictors were identified using logistic regression. Mean scores were highest among SIV holders and lowest among asylees. Compared to refugees, SIV holders had greater odds of screening positive; significance was reduced after adjusting for covariates. A significant interaction term was found for SIV women, who had 1.74 greater odds than SIV males. Distress varied between immigrant groups, with asylees having lowest odds of screening positive. SIV women’s significant results may owe to acculturation distress, disrupted gender expectations, and resettlement difficulties.


Emotional distress Women Refugees Asylees SIV holders 



This research was supported by MDH and JHSPH. Funding to conduct and disseminate this research was provided by the Society of Refugee Health Providers, as well as the Department of Mental Health and Center for Humanitarian Health at JHSPH. The authors would also like to acknowledge Dr. Michael Hollifield and Pathways to Wellness for developing the RHS-15 screening tool.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Population, Family and Reproductive HealthJohns Hopkins School of Public HealthBaltimoreUSA
  2. 2.Maryland Department of HealthBaltimoreUSA
  3. 3.Department of International HealthJohns Hopkins School of Public HealthBaltimoreUSA
  4. 4.Department of Mental HealthJohns Hopkins School of Public HealthBaltimoreUSA

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