"I'm Going to Tell You Something I Never Told Anyone": Ethics- and Trauma-Informed Challenges of Implementing a Research Protocol with Syrian Refugees.

As research subjects, refugees have numerous potential vulnerabilities. This study aimed to examine the ethics- and trauma-informed challenges of implementing a mental health research protocol with Syrian refugees living in Portugal. Guided by the integrated meaning-making model, the research project "Journeys in Meaning" employed a mixed-methods cross-sectional design to explore posttraumatic cognitive processing in refugees using two phases of data collection: two focus groups (Phase 1) to test the protocol and 39 in-depth individual interviews (Phase 2) to implement the protocol. Results examine the strategies used to address the following: methodological challenges related to protocol design, participant recruitment, and language; ethics- and trauma-informed challenges aimed at minimizing harm and maximizing benefit to participants that followed social justice principles; and perceived compassion fatigue on the part of the researcher following repeated empathetic exposure to traumatic content. Findings suggest the need for adaptive approaches to research with refugee populations that challenge strict compliance with the traditional principles of "do no harm" and researcher neutrality, and that accommodate individual and community complexities.

Assessing meaning violations in Syrian refugees: A mixed-methods cross-cultural adaptation of the Global Meaning Violations Scale-ArabV.

Refugees are disproportionately affected by extreme traumatic events that can violate core beliefs and life goals (i.e., global meaning) and cause significant distress. This mixed-methods study used an exploratory sequential design to assess meaning violations in a sample of Syrian refugees living in Portugal. For this purpose, we cross-culturally adapted the Global Meaning Violations Scale (GMVS) for use with Arabic-speaking refugees. In total, 43 war-affected Syrian adults participated in the two-phase study. Participants completed measures of trauma and narrated violations as they filled out the newly adapted GMVS-ArabV. GMVS-ArabV validity evidence based on response processes was investigated through Phase 1 focus groups (FGs; n = 2), whereas data from Phase 2 cognitive interviews (n = 38) were used to preliminarily explore the measure's internal structure through descriptive statistics as well as culture- and trauma-informed content evidence through thematic analysis. The results suggested highest goal (M = 3.51, SD = 1.46) and lowest belief (M = 2.38, SD = 1.59) violations of educational goals and religious beliefs, respectively. Themes related to stressors, item formulation, response scale, and the global meaning construct suggested that (a) beliefs and goals can be differentially violated by different stressors; (b) much like war trauma, including torture, daily stressors can additionally shatter pretrauma global meaning; and (c) refugees reappraise meaning and suffer violations anew throughout their migration journeys. The GMVS-ArabV offers a promising tool for exploring shattered cognitions in refugees and informs evidence-based approaches to trauma recovery and psychological adjustment in postmigration settings (the Arabic abstract and keywords are available in the Supplementary Materials).

"That is not my country anymore": Pre- and postdisplacement trauma, stressors, and distress in war-affected Syrian civilians.

Objective: This mixed-methods study assessed the prevalence of pre-and postmigration trauma and stressors as determinants of refugee mental health in resettlement. Method: Forty-four war-affected Syrian civilians arriving in Portugal through four streams-UNHCR resettlement, EU relocation, spontaneous asylum, and higher education programs for refugees-participated in focus groups and individual interviews. Participants completed self-report measures of trauma and torture and PTSD symptoms, and narrated pre- and postmigration experiences and distress through semistructured interviews. We used descriptive statistics to characterize incidence of trauma and distress, and thematic analysis to identify themes of pre- and postflight stressors. Results: Participants reported a mean 12.9 (SD = 7.2) war trauma events, with six men also disclosing having been tortured. Twenty-five percent met diagnostic criteria for PTSD. Key results identified preflight contextual, personal, family, and community daily stressors capable of shattering prewar meaning systems, and postflight common stressors aggravated by state-sponsored host conditions, the ongoing conflict, and, for the student group, subsequent to temporary returns to Syria. Conclusion: Regardless of legal status on arrival, civilians from war-torn countries may be exposed to pre- and postmigration trauma and stressors that severely impact their mental health, reinforce feelings of uprootedness, and dim integration prospects. Findings highlight the need for host countries to create opportunities for agency and autonomy to improve refugees' own integration prospects and ability to initiate their path to recovery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

'The War Made Me a Better Person': Syrian Refugees' Meaning-Making Trajectories in the Aftermath of Collective Trauma.

The centrality of the collective to Syrian identity and the ability of war to disrupt community ties have led to significant violations of Syrians' pre-war assumptions about themselves, the world, and their place in the world. Guided by the integrated meaning-making model, this qualitative cross-sectional study assessed Syrian refugees' meaning trajectories through their reappraisals of the war, attempts to repair community-informed shattered meanings, and those processes' outputs (i.e., meanings-made) and outcomes (i.e., perceived psychological adjustment). We conducted semi-structured cognitive interviews with 39 Syrian war-exposed adults living in urban communities across Portugal, most of whom were beneficiaries of higher education programs for refugees. Interviews were analyzed through thematic analysis. Results suggest that the war severely disrupted Syrians' sense of collective self, and that they repeatedly engaged in search for meaning, appraisals of the war, and reappraisals of shattered beliefs, life goals, and sense of purpose, both during wartime and in resettlement. In Portugal, despite persistent negative beliefs about the collective and ongoing and distressing searches for meaning, participants' lived experiences concomitantly informed positive meaning reappraisals, including progressive restoration of worldviews, new opportunities for self-realization, and newly-found purpose, leading to perceived psychological benefits and growth. These findings suggest that meaning-making is both a trajectory and a dynamic process, informed by place and sociopolitical context. Clinical work to facilitate adaptive meaning-making and meaning-informed psychosocial interventions that help restore refugees' shattered beliefs about safety, predictability, trust, and belonging, may be helpful directions to promote positive psychological adjustment and improve long-term integration prospects in refugees.