During the last years, the number of refugees around the world increased to about 22.5 million. The mental health of refugees, especially of unaccompanied minors (70% between the ages of 16 and 18 years) who have been exposed to traumatic events (e.g., war), is generally impaired with symptoms of post-traumatic stress disorder, depression, and anxiety. Several studies revealed (1) a huge variation among the prevalence rates of these mental problems, and (2) that post-migration stressors (e.g., language barriers, cultural differences) might be at least as detrimental to mental health as the traumatic events in pre- and peri-flight. As psychotherapy is a limited resource that should be reserved for severe cases and as language trainings are often publicly offered for refugees, we recommend focusing on intercultural competence, emotion regulation, and goal setting and goal striving in primary support programs: Intercultural competence fosters adaptation by giving knowledge about cultural differences in values and norms. Emotion regulation regarding empathy, positive reappraisal, and cultural differences in emotion expression fosters both adaptation and mental health. Finally, supporting unaccompanied refugee minors in their goal setting and goal striving is necessary, as they carry many unrealistic wishes and unattainable goals, which can be threatening to their mental health. Building on these three psychological processes, we provide recommendations for primary support programs for unaccompanied refugee minors that are aged 16 to 18 years.

Background: Religiosity can foster mental health after traumatic experiences. Yet, religiosity among Muslim immigrants has also been linked to separation-oriented acculturation, which is linked to reduced mental health. Therefore, the function of religiosity for resilience in Middle Eastern refugee and immigrant adolescents might differ as their migration contexts differ in terms of traumatic experiences and the nature of cultural interactions . Aims: This study examined whether religiosity is associated with better mental health after traumatic experiences, particularly among young refugees. In addition, it was explored whether religiosity is associated with better mental health among refugees through less marginalization and whether religious immigrant peers show worse mental health through stronger separation. Method: 135 adolescents ( M_Age= 18.25 years, SD = 1.73; n_refugees= 75, n_immigrants= 60) completed self-reports on religiosity, mental health, trauma, and acculturation orientations. Regression analyses were calculated examining group-specific differences in potential moderating effects of religiosity on the relationship between trauma exposures and internalizing symptoms. Furthermore, potential indirect effects of religiosity on internalizing symptoms via acculturation orientations were investigated. Results: Stronger religiosity was associated with better mental health following trauma exposure. No group-specific differences were observed. While religious refugee adolescents reported less marginalization associated with fewer internalizing symptoms, religious immigrant peers reported more separation and internalizing symptoms. Limitations: Results are limited to male Muslim adolescents in Germany. The cross-sectional nature prohibits any implications for causal dynamics in the associations. Conclusion: Religiosity is generally protective against post-traumatic consequences, but associations with acculturation differ across migration contexts.

The large number of adolescent refugees around the world constitutes a great challenge for societies. However, current models of acculturation have been developed for migrants, but not specifically for adolescent refugees. Crucial factors to describe adolescent refugee acculturation, such as intentions to return to their homeland, especially with respect to adolescent refugees with temporary residency and experiences of potentially traumatic events, are missing. Hence, the Multidimensional Intercultural Training Acculturation (MITA) model is introduced. The model proposes that two major concerns for adolescent refugees, which are socio-cultural adjustment and mental health, are predicted by intercultural and social–emotional competence, intentions to return to their homeland, and experiences of traumatic events. Moreover, the effects of three modes of acculturation are also proposed in the model. It is expected that these variables mediate the effects of intercultural competence, social–emotional competence, intentions to return to the homeland, and experiences of traumatic events on socio-cultural adjustment as well as mental health. Finally, it is also expected that in-group social support and out-group social support moderate the direct connection between the experiences of traumatic events and mental health.

Background: On their way to host countries, refugees are often exposed to severe adversity, including cumulative experiences of fraud, extortion, robbery, detention, and shipwrecks, as well as prolonged, life-threatening small boat crossings. However, little research has examined the long-term impact of such peri-migration stressors on subsequent stress and mental health after arrival. This study explored how cumulative exposure to potentially traumatic events (PTEs) and small boat crossings before arrival affected psychological distress in Middle Eastern refugees, considering the mediating role of post-migration stress in the years following resettlement in Germany. Methods: Longitudinal data from the IAB-BAMF-SOEP Survey of Refugees collected at three survey waves (2016, 2018, and 2020; N = 541, M _age = 38.77, 14% female) were analyzed using a causal mediation approach with linear mixed models. Self-reports of cumulative exposure to PTEs and small boat crossings in the Mediterranean indicated peri-migration stressors, while perceived discrimination and migration-related worries reflected post-migration stress. Psychological distress was assessed using a general health questionnaire. Results: PTEs were significantly associated with higher migration-related worries (β = 0.10, p < .001). Migration-related worries significantly mediated the association between PTEs and psychological distress (ACME = 0.02, 95% CI [0.01, 0.04], p < .001; ADE = 0.07, 95% CI [0.03, 0.11], p < .001). In contrast, perceived discrimination did not mediate this link. However, small boat crossings were significantly associated with higher perceived discrimination (β = 0.11, p < .001), which in turn mediated their association with psychological distress (ACME = 0.05, 95% CI [0.02, 0.08], p < .001), while the direct effect was non-significant. These indirect effects intensified over time. Conclusions: Peri-migration stressors may contribute to long-term mental health issues in refugees via their post-migration stress experiences. However, these mediation pathways may differ, underscoring the need for nuance and further investigation. Addressing both early traumatic experiences and post-migration adversities, such as discrimination and migration-related worries, is crucial to mitigating refugees’ long-term psychological distress. These findings highlight the importance of early prevention and intervention efforts that address post-migration stress as a key factor in reducing the long-term mental health burden among refugees.

Background: Young Middle Eastern male refugees are currently among the most vulnerable groups in Europe. Most of them have experienced potentially traumatic events (PTEs) such as rape, torture, or violent assaults. Compared to their peers, young refugees suffer more from internalizing and externalizing symptoms, especially when unaccompanied. Little is known about the cumulative impact of experiencing different types of PTEs on mental health outcomes (polytraumatization) of young male refugees from the Middle East. We investigated (1) whether there is a dose–response relationship between multiple PTE types experienced and mental health outcomes, (2) whether individual types of PTEs are particularly important, and (3) to what extent these are differentially associated with mental health outcomes among unaccompanied or accompanied peers. Methods: In total, 151 young Middle Eastern male refugees in Germany (M_age = 16.81 years, SD_age = 2.01) answered questionnaires on PTEs, mental health, and post-migration stress. Results: Hierarchical regression analyses revealed, while controlling for age, duration of stay, unaccompanied status, and post-migration stress, (1) a dose–effect between PTE types on both internalizing and externalizing symptoms. Moreover, (2) regarding internalizing symptoms, violent family separation and experiencing life-threatening medical problems were particularly crucial. The latter was driven by unaccompanied refugees, who also reported higher levels of substance use. Conclusions: The results extend findings from the literature and suggest that not only may greater polytraumatization be related to greater depression among refugees, but also to a range of other mental health outcomes from the internalizing and externalizing symptom domains. Furthermore, the results highlight the mental health risks that unaccompanied and accompanied refugee adolescents face after exposure to PTEs, and provide information for practitioners as well as researchers about event types that may be particularly relevant.