Geocultural variation in correlates of psychological distress among refugees resettled in the United States

Attention to cultural variability in mental health symptoms could inform intervention targets; however, this is currently a neglected area of study. This study examined whether the associations between common mental health disorder (CMD) symptoms and predictors of CMDs varied cross-culturally. Participants were 290 refugees from three geocultural regions (Afghanistan, Great Lakes region of Africa, and Iraq and Syria) who recently resettled in the United States and completed assessments of CMD symptoms and predictors. Multilevel generalized linear modeling was used to examine the interactions between correlates of depressive, anxiety, and posttraumatic stress disorder (PTSD) symptoms and each of the three cultural reference groups. Relative to refugees from other regions, Iraqi and Syrian participants demonstrated stronger associations between the number of reported traumatic experiences and both depressive, B = 0.01, SE = .003, p = .003, and anxiety symptoms, B = 0.01, SE = .003, p < .001; Afghan participants showed a stronger association between physical quality of life and PTSD symptoms, B = 0.02, SE = .011, p = .037; and African participants demonstrated stronger associations between gender and symptoms of all three CMDs, Bs = 0.11-.020, SEs = .04-.06, ps = .005-.008, and weaker associations between traumatic event exposure and CMD symptoms, Bs = -0.01--0.02, SEs = .003-.006, ps = .000-.002. CMD symptoms likely present differently across cultures, with various predictors more salient depending on cultural backgrounds and differential experiences that vary based on context. These findings have implications for cross-cultural assessment research and mental health.