Differential contributions of PTSD symptom clusters and their associations with resilience in traumatized individuals with a refugee background
ABSTRACT Background: Post-traumatic stress disorder (PTSD) is highly prevalent among refugees due to their exposure to traumatic events; however, many demonstrate resilience that mitigates its impact. Given the ethnocultural diversity of refugee populations, questions remain regarding whether their symptom presentation aligns with diagnostic and therapeutic frameworks developed in Western contexts. Furthermore, evidence is limited on how resilience relates to PTSD symptom clusters. Objective: We examined (a) the contribution of PTSD symptom clusters to the overall PTSD construct in traumatized individuals with a refugee background, and (b) the structural relationships between PTSD symptom clusters and psychological resilience. Method: The study included 267 (61% male) young adults (Mage = 25.21) with a refugee background who had experienced trauma. Questionnaires measured PTSD symptoms, psychological resilience and socio-demographic characteristics. Confirmatory factor analyses (CFA) and structural equation modeling (SEM) were utilized. Results: Hyperarousal, negative alterations in cognition and mood (NACM), and re-experiencing symptom clusters were stronger indicators of PTSD, compared to avoidance symptoms. Additionally, resilience exhibited a stronger association with hyperarousal and NACM than re-experiencing, while its association with avoidance was not significant. Conclusions: Hyperarousal represents an important symptom cluster within this population, possibly reflecting the impact of migration-related ongoing stressors. The findings also suggest patterns that may be related to ethnocultural differences in symptom expression and coping strategies. Higher resilience is associated with lower PTSD symptoms, but this association is contingent upon the strength of individual PTSD symptom clusters. Further research is warranted to replicate and extend these results.