Journal Article

Psychosocial mechanisms of change in symptoms of Persistent Complex Bereavement Disorder amongst refugees from Myanmar over the course of Integrative Adapt Therapy

Morgan, Karen, Fadil Azim, Darlina, Silove, Derrick, Tay, Alvin Kuowei, Mohsin, Mohammed, Khat Mung, Hau, Badrudduza, Mohammad, Balasundaram, Susheela, Arfah Zaini, Nur

2020

Overview

Background: The ability to adapt to the psychosocial disruptions associated with the refugee experience may influence the course of complicated grief reactions. Objective: We examine these relationships amongst Myanmar refugees relocated to Malaysia who participated in a six-week course of Integrative Adapt Therapy (IAT). Method: Participants (n = 170) included Rohingya, Chin, and Kachin refugees relocated to Malaysia. At baseline and six-week post-treatment, we applied culturally adapted measures to assess symptoms of Prolonged Complex Bereavement Disorder (PCBD) and adaptive capacity to psychosocial disruptions, based on the Adaptive Stress Index (ASI). The ASI comprises five sub-scales of safety/security (ASI-1); bonds and networks (ASI-2); injustice (ASI-3); roles and identity (ASI-4); and existential meaning (ASI-5). Results: Multilevel linear models indicated that the relationship between baseline and posttreatment PCBD symptoms was mediated by the ASI scale scores. Further, ASI scale scores assessed posttreatment mediated the relationship between baseline and posttreatment PCBD symptoms. Mediation of PCBD change was greatest for the ASI II scale representing disrupted bonds and networks. Conclusion: Our findings are consistent with the informing model of IAT in demonstrating that changes in adaptive capacity, and especially in dealing with disrupted bonds and networks, may mediate the process of symptom improvement over the course of therapy. * Our finding supports the core premise of IAT in improving adaptive stress (reflected in the ASI scales) as a potential mechanism through which mental health symptoms can be mitigated with ASI-2 (bonds and networks) exerting the largest effect on PCBD symptoms at follow-up.

• Publisher: Taylor & Francis,Taylor & Francis Ltd,Taylor & Francis Group
• Subject: adaptive stress index / Clinical / Grief / integrative Adapt Therapy / Persistent complex bereavement disorder / prolonged grief / refugee mental health / Refugees / salud mental de los refugiados / Terapia de Adaptación Integrativa / Trastorno de duelo complejo persistente / trastorno de duelo prolongado / Índice de Estrés Adaptativo / 延长哀伤 / 持续性复杂丧痛障碍 / 综合适应疗法 / 适应应激指数 / 难民心理健康