Longitudinal investigation of the relationships between trauma exposure, post-migration stress, sleep disturbance, and mental health in Syrian refugees

Figures & data

Table 1. Demographic profiles between two time points

	Time 1	Time 2				Cramer’s V
Demographic	n (%)	n (%)	Chi-square	df	Sig.	Effect size
Employment			21.2	1	<.001	.28
Employed	4 (5.8)	18 (26.1)
Unemployed	65 (94.2)	51 (73.9)
Counselling			1.02	1	.31
Yes	10 (14.5)	8 (11.6)
No	59 (85.5)	61 (88.4)
Health concerns			1.6	3	.66
0	46 (66.7)	48 (69.6)
1	8 (11.6)	7 (10.1)
2	9 (13.0)	9 (13.0)
3	6 (8.7)	5 (7.2)
Medication			.98	1	.32
Yes	9 (13.0)	10 (14.5)
No	60 (87.0)	59 (85.5)

Cohen’s (1988) effect size r. 10 = small; 30 = medium; 50 = large; and 70 = very large.

Table 2. Descriptive t-test to compare T1 – T2 study variables

	T1		Above	T2		Above		Effect size
	Mean	SD	Clinical cut-off	Mean	SD	Clinical cut-off	Sign.	Cohen’s d
Migration stress	7.97	1.70		10.51	4.25		.00	.78
PTSD	21.96	9.30	43 (62.3%)	16.78	6.02	29 (42.0%)	.00	−.66
Anxiety & depression	1.82	0.55	38 (55.1%)	1.68	0.57	24 (34.8%)	.04	−.25
Insomnia severity	10.86	5.70	37 (53.6%)	8.84	6.03	28 (40.6%)	.01	−.34
Pre-sleep arousal	29.20	10.29		30.57	12.35		.28	.12
Cognitive	16.78	7.01	22 (32.9%)	17.80	8.35	26 (37.7%)	.28	.13
Somatic	12.42	4.34	24 (34.8%)	12.77	5.30	25 (36.2%)	.52	.07

Table 3. Trend of sleep categories between two time points

		Time 2			Total
		Normal Sleepers	Moderate Sleep Disturbance	Severe Sleep Disturbance	Total
Time 1	Normal Sleepers	20	6	0	26 (37.7%)
	Moderate Sleep Disturbance	8	12	1	21 (30.4%)
	Severe Sleep Disturbance	6	7	9	22 (31.9%)
Total		34 (49.3%)	25 (36.2%)	10 (14.5%)	69 (100%)

Table 4. Multiple regression analyses predicting time 2 mental health symptoms

Outcome variable	Independent variable	B	SE	β	t-value	p	F	p	R2
T2 PTSD							3.47	.01	.22
	Trauma exposure	.16	.19	.14	.82	.42
	T1 PTSD	−.10	.16	−.16	−.61	.54
	T1 Migration Stress	1.28	.76	.36	1.68	.10
	T1 Insomnia severity	−.31	.22	−.29	−1.41	.16
	T1 Pre-sleep arousal	.29	.13	.49*	2.27	.03
T2 Anxiety/depression							7.52	.01	.37
	Trauma exposure	.05	.35	.02	.14	.89
	T1 Anxiety/ depression	.04	.21	.04	.21	.83
	T1 Migration Stress	1.97	1.67	.23	1.18	.24
	T1 Insomnia severity	−.43	.48	−.17	−.88	.38
	T1 Pre-sleep arousal	.80	.32	.57**	2.51	.01

* p value <.05, ** p value <.001

Figure 1. The effect of change in post-migration stress on change in PTSD through change in pre-sleep arousal

Figure 2. The effect of change in post-migration stress on change in anxiety/depression through change in pre-sleep arousal

Figure 3. Post-migration stress and pre-sleep arousal mediating the relationship between trauma exposure and PTSD

Figure 4. Post-migration stress and pre-sleep arousal mediating the relationship between trauma exposure and anxiety/depression

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed. ed.). Hillsdale, NJ: Lawrence Erlbaum.

 Google Scholar

Data available statement

The data file can be accessed at Open Science Framework (DOI 10.17605/OSF.IO/D3J7F).