Emerging evidence suggests that the loss of loved ones under traumatic circumstances is highly prevalent among refugees and asylum seekers. We evaluated the effects of traumatic and multiple losses of family members and friends on psychopathology, disability, and quality of life in Iraqi asylum seekers in the Netherlands, and investigated mediation of these effects through psychopathology. Respondents (N = 294) completed structured Arabic interviews. Data were analyzed using structural equation modeling. The loss of a loved one was reported by 87.6% of the sample. Traumatic and multiple losses of family members independently predicted psychopathology, taking the effects of other traumatic events, postmigration stressors, and sociodemographic characteristics into account. Effects of traumatic and multiple losses on quality of life and disability were either partially or fully mediated by psychopathology. These findings highlight the need to evaluate and treat the effects of the loss of loved ones when working with asylum seekers and refugees as well as to incorporate grief-related psychopathology in diagnostic classifications.
*Foundation Centrum '45/Arq Psychotrauma Expert Group, Diemen; and †“De Evenaar,” Centre for Transcultural Psychiatry, Institute of Community Mental Health Care Drenthe, Beilen, the Netherlands.
Send reprint requests to Sophie M.C. Hengst, MD, Foundation Centrum '45/Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE Diemen, the Netherlands. E-mail: firstname.lastname@example.org.
Sophie M.C. Hengst, MD, is a psychiatrist at Foundation Centrum '45/Arq Psychotrauma Expert Group, the Dutch national expert center for diagnosis and treatment of (complex) psychological trauma. Dr Hengst is involved in research on traumatic grief and the diagnostics and treatment of (complex) posttraumatic stress disorder (PTSD), persistent complex bereavement disorder (PCBD), and depression in refugees and nonrefugees.
Geert E. Smid, MD, PhD, is a consultant psychiatrist and associate director of residency training at Foundation Centrum '45/Arq Psychotrauma Expert Group. Dr Smid researches PTSD, stress sensitization, traumatic grief, and mental health services, especially in refugees and other ethnic populations. His published works focus on the prevalence, diagnosis, and treatment of PTSD and traumatic grief as well as stress sensitization.
Cornelis J. Laban, MD, PhD, is the medical director at De Evenaar, North Netherlands Centre for Transcultural Psychiatry. His main research programme (the “Dutch Study Iraqi Asylum Seekers”) focuses on the impact of a long asylum procedure on health and health-related dimensions among Iraqi asylum seekers in the Netherlands and on health services use. His special interest on resilience in refugees and asylum seekers resulted in several publications. He is involved in the national training and regional programme for residents as an expert in transcultural psychiatry and trauma and as guest lecturer at the University of Groningen. Since 2015, he is the chair of the World Psychiatric Association, Transcultural Psychiatry.