战争暴露、移民后生活困难和社会支持与（复杂）创伤后应激障碍的关系：对在丹麦重新安置的乌克兰难民的队列研究

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-04-20 DOI:10.1016/j.socscimed.2025.118080

Karen-Inge Karstoft , Ludvig Daae Bjørndal , Anne Agathe Pedersen , Nataliia Korchakova , Séamus A. Power , Thomas A. Morton , Vibeke J. Koushede , Marie H. Thøgersen , Brian J. Hall

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引用次数: 0

摘要

乌克兰的战争迫使数百万乌克兰人逃离他们的国家，许多人在经历了战争之后。先前的研究发现，战争暴露（WE）和移民后生活困难（PMLD）都与创伤后应激障碍的风险有关。在本研究中，我们测试了we、PMLD和PTSD/Complex PTSD （CPTSD）之间的关系。此外，我们测试了社会支持是否会调节这种关联。方法在一项具有代表性的前瞻性队列研究中，对俄罗斯全面入侵后第一年抵达丹麦的成年乌克兰人（N = 4,229），我们使用多项logistic回归分析来检验we、PMLD和(C)PTSD之间的相关性。结果PTSD和CPTSD的患病率分别为12.1%和12.2%。我们发现家族相关的PMLD、健康相关的PMLD、一般PMLD和CPTSD之间存在统计学意义上的关联（aor从1.25到1.56），健康相关的PMLD和家庭相关的PMLD和PTSD之间存在统计学意义上的关联（aor从1.18到1.35）。WE与PTSD相关(AOR (CI): 1.15(1.07-1.25))，但与CPTSD无关(AOR （CI): 1.05(0.97-1.13)）。社会支持与CPTSD相关(AOR (CI): 0.69(0.60-0.78))，而与PTSD无关(AOR （CI):0.94(0.83-1.07)）。交互作用项仅对PTSD有显著意义，其中社会支持减弱了PMLD与PTSD之间的负相关。结论pmlds是战争难民创伤后精神病理的重要危险因素。社会支持减轻了PTSD与PTSD之间的负相关关系，而低社会支持是CPTSD的独立危险因素。应注意难民的日常生活挑战和社会支助网络。

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Associations of war exposures, post-migration living difficulties and social support with (complex) PTSD: a cohort study of Ukrainian refugees resettled in Denmark

Background

The war in Ukraine has forced millions of Ukrainians to flee their country, many after exposure to actions of war. Previous research found that both war exposures (WE) and post-migration living difficulties (PMLD) are associated with risk of PTSD. In the current study, we test associations between WE, PMLD and PTSD/Complex PTSD (CPTSD). Further, we test if the associations are moderated by social support.

Methods

In a representative prospective cohort study of adult Ukrainians arriving in Denmark in the first year after Russia's full-scale invasion (N = 4,229), we test associations between WE, PMLD, and (C)PTSD using multinomial logistic regression analysis. Interaction terms were added to assess if associations were moderated by SS.

Results

Prevalence of PTSD and CPTSD was 12.1 % and 12.2 %, respectively. We found statistically significant associations between family-related PMLD, health-related PMLD, and general PMLD and CPTSD (AORs from 1.25 to 1.56), and between health-related PMLD and family-related PMLD and PTSD (AORs from 1.18 to 1.35). WE were associated with PTSD (AOR (CI): 1.15 (1.07–1.25)), but not CPTSD (AOR (CI): 1.05 (0.97–1.13)). Social support was associated with CPTSD (AOR (CI): 0.69 (0.60–0.78)) but not PTSD (AOR (CI):0.94(0.83–1.07)). Interaction terms were significant only for PTSD, where social support attenuated the negative association between PMLD and PTSD.

Conclusion

PMLDs are important risk factors for post-trauma psychopathology in war refugees. Social support mitigates the negative association between PMLDs for PTSD, while low social support is an independent risk factor for CPTSD. Attention should be paid to refugees’ daily life challenges and social support networks.

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.