Epidemiol Psychiatr Sci. 2026 Apr 7;35:e22. doi: 10.1017/S2045796026100614.
ABSTRACT
AIM: Social functioning is a crucial aspect of psychosocial adaptation following forced displacement. Yet, it has received far less attention than understanding and addressing mental health problems among refugees and asylum-seekers. This study aimed to extend the ecological model of refugee distress – one of the most widely used frameworks in refugee mental health – to social functioning, and to identify direct and indirect pathways from established conflict- and displacement-related factors to social functioning alongside mental health problems.
METHOD: An online study with 1,235 refugees in Indonesia was conducted over a 2-year period. Conflict-related traumatic experiences before arrival in Indonesia, post-displacement stressors in the past 12 months, were measured at the onset of the study, while social functioning and mental health outcomes (symptoms of posttraumatic stress disorder, depression, and anger) were assessed 1 year later.
RESULTS: Longitudinal Structural Equation Modelling analysis revealed that diversity of conflict-related trauma predicted more post-displacement stress (β = 0.45, SE = 0.03, p < 0.001), higher mental health problems (β = 0.13, SE = 0.05, p = 0.004), but increased social functioning 1 year later (β = 0.10, SE = 0.04, p = 0.011), while post-displacement stressors predicted poorer mental health (β = 0.46, SE = 0.05, p < 0.011) and reduced social functioning (β = –0.09, SE = 0.04, p = 0.041). The indirect pathway from traumatic experiences via post-displacement stressors was positive for mental health (β = 0.21, 95% CI = 0.162-0.257) and negative for social functioning (β = –0.04, 95% CI = -0.082 to -0.003).
CONCLUSIONS: This study conceptually and empirically extended the ecological model of refugee distress to social functioning by highlighting the dual influences of conflict-related traumatic experiences. The findings provide a springboard for advancing research and practice in the mental health and psychosocial field.
PMID:41943947 | DOI:10.1017/S2045796026100614
