The longitudinal relationship between economic and social stressors, emotion dysregulation and mental health among refugees in protracted displacement.

Economic stressors were associated with subsequent increases in posttraumatic stress symptoms among refugees in protracted displacement.

• Random-intercept cross-lagged panel analysis was used on data from 1,235 refugees displaced in Indonesia
• Economic stressors predicted subsequent PTS symptoms (B = 0.07, p = 0.047)
• Surveys were completed at four timepoints, 6 months apart
• PTS symptoms were assessed using the Posttraumatic Diagnostic Scale

Economic stressors were associated with subsequent increases in depressive symptoms.

• Economic stressors predicted subsequent depressive symptoms (B = 0.17, p < .001)
• Depressive symptoms were assessed using the Patient Health Questionnaire
• This was one of the strongest cross-lagged associations found in the study

Economic stressors were associated with subsequent increases in social stressors.

• Economic stressors predicted subsequent social stressors (B = 0.28, p < .001)
• Social stressors were indexed using the Post-Migration Living Difficulties Checklist
• This was among the largest cross-lagged coefficients observed in the model

Emotion dysregulation was antecedent to increases in posttraumatic stress symptoms.

• Emotion dysregulation predicted subsequent PTS symptoms (B = 0.16, p < .001)
• Emotion dysregulation was assessed using the Difficulties in Emotion Regulation Scale
• This finding held in a random-intercept cross-lagged panel model controlling for stable between-person differences

Emotion dysregulation was antecedent to increases in depressive symptoms.

• Emotion dysregulation predicted subsequent depression symptoms (B = 0.13, p < .001)
• The random-intercept cross-lagged panel approach was used to isolate within-person temporal effects

Emotion dysregulation was antecedent to increases in social stressors.

• Emotion dysregulation predicted subsequent social stressors (B = 0.10, p = .017)
• This suggests emotion dysregulation may contribute not only to psychopathology but also to worsening social circumstances

Depression was associated with subsequent increases in economic stressors, indicating a reciprocal relationship.

• Depression predicted subsequent economic stressors (B = 0.18, p = .001)
• This bidirectional relationship suggests depression and economic hardship mutually reinforce each other over time

Social stressors were associated with subsequent increases in economic stressors.

• Social stressors predicted subsequent economic stressors (B = 0.12, p = .037)
• This indicates that social difficulties encountered in displacement may compound economic hardship

The study sample consisted of 1,235 refugees displaced in Indonesia from multiple linguistic and cultural backgrounds.

• Participants came from Farsi, Dari, Arabic, Somali, and English-speaking backgrounds
• Participants completed an online survey at four timepoints, each 6 months apart
• Indonesia represents a protracted displacement context where refugees have limited rights to work or formal integration

Social stressors did not emerge as a primary driver of psychopathology in the longitudinal model, in contrast to economic stressors.

• While social stressors were predicted by economic stressors and emotion dysregulation, they were not independently associated with subsequent increases in PTS or depressive symptoms in the cross-lagged model
• Economic stressors and emotion dysregulation were identified as 'the main drivers of psychopathology for refugees'
• The authors note this highlights the importance of distinguishing between types of post-migration stressors