Discrimination-Based Continuous Traumatic Stress, PTSD and Chronic Pain in Syrian Refugees: A Moderated Mediation Analysis

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-07-23 DOI:10.1002/cpp.70133

Emre Han Alpay, Ibrahim Aref Kira

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Abstract

Purpose

This study aimed to examine the relationships among continuous traumatic stressors (CTS), posttraumatic stress disorder (PTSD), somatic symptoms, and chronic pain in a sample of Syrian refugees. Specifically, we hypothesized that PTSD would mediate the association between discrimination-based CTS and chronic pain and that somatic symptoms would moderate the link between PTSD and chronic pain—such that higher somatic symptom levels would amplify this association.

Materials and Methods

A total of 669 Syrian refugees residing in Türkiye participated in the study. Data were collected through face-to-face interviews using validated self-report instruments, including the Patient Health Questionnaire-15 (PHQ-15), the PTSD Checklist for DSM-5 (PCL-5), the Short-Form McGill Pain Questionnaire (SF-MPQ) and the Cumulative Trauma Scale.

Results

PTSD symptoms mediated the relationship between discrimination-based CTS and chronic pain. Additionally, somatic symptoms significantly moderated the association between PTSD and chronic pain, such that individuals with higher levels of somatic symptoms exhibited a stronger link between PTSD symptoms and chronic pain severity.

Conclusion

These findings emphasize the relationship between discrimination-based CTS, psychological distress, and physical complaints among Syrian refugees in Türkiye. While the results provide important insights into trauma-related health outcomes in this group, caution should be exercised in generalizing the findings to all displaced populations. The results highlight the profound impact of prolonged traumatic stress on both psychological and physical health and emphasize the need for trauma-informed, culturally sensitive clinical interventions for displaced individuals.

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基于歧视的持续创伤应激、PTSD与叙利亚难民慢性疼痛：一个有调节的中介分析

目的本研究旨在探讨持续创伤应激源（CTS）、创伤后应激障碍（PTSD）、躯体症状和慢性疼痛在叙利亚难民样本中的关系。具体来说，我们假设创伤后应激障碍会介导基于歧视的CTS和慢性疼痛之间的联系，而躯体症状会缓和创伤后应激障碍和慢性疼痛之间的联系，因此较高的躯体症状水平会放大这种联系。材料与方法共有669名居住在 rkiye的叙利亚难民参与了这项研究。通过面对面访谈收集数据，采用有效的自我报告工具，包括患者健康问卷-15 （PHQ-15）、DSM-5创伤后应激障碍检查表（PCL-5）、短格式麦吉尔疼痛问卷（SF-MPQ）和累积创伤量表。结果创伤后应激障碍症状介导了基于歧视的CTS与慢性疼痛的关系。此外，躯体症状显著减缓了创伤后应激障碍和慢性疼痛之间的联系，因此，躯体症状水平较高的个体在创伤后应激障碍症状和慢性疼痛严重程度之间表现出更强的联系。结论：这些研究结果强调了基于歧视的CTS、心理困扰和叙利亚难民身体不适之间的关系。虽然研究结果为这一群体的创伤相关健康结果提供了重要见解，但在将研究结果推广到所有流离失所人群时应谨慎。研究结果强调了长期创伤压力对心理和身体健康的深远影响，并强调需要对流离失所者进行了解创伤情况、对文化敏感的临床干预。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.