Comorbid common mental disorders (CMDs) are pervasive in refugee populations. However, limited research has explored psychosocial factors for mental disorder comorbidity in Somali refugee samples. This study aims to explore potential risk and protective factors for comorbid depression-anxiety and comorbid depression-PTSD by examining associations between trauma exposure, psychosocial factors, and mental health symptoms among a sample of Somali refugees displaced in urban Kenya. We used snowball sampling to recruit Somali youth aged 15 to 35years(N = 250,n = 143 female, n = 88 male, n = 19 unknown gender). We measured 16 common types of trauma exposure and three psychosocial factors (endorsing violence, willingness to share problems, and symptom awareness) and used the HSCL-25 and PCL-C to capture individual and comorbid CMD symptoms, using guided cutoff points and/or algorithms. We then ran a series of logistic regression analyses to examine relationships between trauma exposure, psychosocial factors, and individual and comorbid CMD symptoms. Findings showed that increased trauma exposure predicted symptoms of individual and comorbid CMDs. Increased symptom awareness and endorsement of violence predicted comorbid depression-PTSD and comorbid anxiety-depression symptoms, respectively. Willingness to share problems buffered depressive symptoms but did not predict comorbidity. These findings revealed the high CMD comorbidity prevalence with differential effects of trauma and psychosocial factors on individual or comorbid mental disorders. This study suggests a need for transdiagnostic approaches that cut across Western diagnostic boundaries and consider culturally responsive and relevant items for mental health measures.

Trauma-informed care (TIC) approaches have gained popularity in various contexts of human services over the past decades. However, relatively little has been explored about how it is applicable and built into services for refugee populations in resettlement programs. This study explores the current status of the application of TIC in refugee-serving agencies and identifies perceived and experienced challenges and opportunities for culturally responsive TIC in the United States. As designed as part of the evaluation of state-wide refugee health promotion programs, this study conducted individual interviews with 78 refugee service providers from five resettlement sites. Despite the burgeoning interest and attempt to embrace TIC, our findings show that there is clear inconsistency and inexperience in TIC adaptation in resettlement programs. This study highlights that TIC that is culturally responsive and relevant to refugee trauma and acculturation experiences is a vital way to address the chasms between refugee-specific programs and mainstream services including mental health care systems. This study also discusses community resources and opportunities to bridge the deep divide and substantial gaps between mental health services and refugee resettlement services and to address comprehensive needs around mental health and wellness in the refugee community.

Female genital mutilation or circumcision (FGM/C) is a perilous social and cultural practice that affects the physical, mental, and psychological health of affected women. It is widespread around the world, affecting 200 million women and girls. This study aimed to explore the relation of FGM/C to mental and physical conditions in Somali refugees displaced in a low-resource setting, applying the concept of poly-victimization to reveal multifaceted trauma sequelae. Data for this cross-sectional study with 143 female Somali youth living in Eastleigh, Kenya were collected between April and May in 2013. FGM/C was strongly associated with negative physical and mental health outcomes, including post-traumatic stress disorder and depressive, anxiety, and somatic symptoms. Logistic regression analysis revealed that separation from a parent and poly-victimization experiences were significantly associated with FGM/C experience. The results also showed that FGM/C and other traumas did not occur singly but were indicative of cumulative adversities, especially for women who were socially vulnerable and marginalized. The results of this study highlight the practice of FGM/C in the context of other adverse living conditions of refugees and the importance of attending to other co-occurring risk factors that prevail with FGM/C practice in the ecological system of refugee forced migration.

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience intimate partner violence (IPV) at high rates, even bidirectionally, yet no studies to date have investigated IPV among LGBT individuals in Latin America. Thus, this study explored discrimination and IPV victimization and perpetration among LGBT individuals in Latin America. Participants (N = 99) were recruited for this online, cross-sectional survey via convenience sampling and completed measures of LGBT discrimination and lifetime IPV victimization and perpetration. Results indicated that 60.61% of the sample reported at least one form of IPV victimization at some point in their life, and 56.57% reported at least one form of perpetration. Psychological aggression was the most common type of IPV victimization and perpetration. Physical assault victimization was positively correlated with work/school heterosexism. Perpetration and victimization of physical assault, psychological aggression, and sexual coercion were correlated with the “other” heterosexism subscale. Cluster analysis revealed a three-cluster solution: participants in Cluster 1 were high in IPV victimization and perpetration; Cluster 2 participants were low in IPV victimization and perpetration; and Cluster 3 participants were moderate on psychological aggression perpetration and victimization, but low on the other three forms of IPV. Cluster 1 participants had a higher score for the “other” heterosexism subscale than Cluster 2. This study highlights the need to address certain aspects of IPV, such as bidirectionality, in clinical encounters such as safety planning. Future research should examine the role of Latinx identity in LGBT individuals’ experiences of discrimination and IPV.

Refugee mental health needs are heightened during resettlement but are often neglected due to challenges in service provision, including lack of opportunities for building capacity and partnership among providers. We developed and implemented culturally-responsive refugee mental health training, called Cross-Cultural Trauma-Informed Care (CC-TIC) training. We evaluated CC-TIC, using a free listing and semi-structured retrospective pre- and post-training evaluation with five localities in two states in the U.S. The results showed significant improvement in providers’ knowledge of trauma impacts, cultural expressions of trauma/stress-related symptoms, and culturally-responsive trauma-informed care. Trauma-informed care specific to refugee resettlement was regarded as the most helpful topic and community partnership building as the most requested area for future training. This study emphasizes that culturally-responsive trauma-informed approaches can help bridge gaps between mental health care and resettlement services and promote exchanges of knowledge and expertise to build collaborative care and community partnership.

Reproductive coercion is behavior, typically perpetrated by a partner, that interferes with autonomous reproductive decision making, often through pregnancy coercion and/or contraceptive interference. Existing literature suggests that reproductive coercion is associated with intimate partner violence in the general population and among college women. However, there is limited research regarding the prevalence and correlates of reproductive coercion in college populations, especially regarding interpersonal violence victimization other than intimate partner violence. To fill this gap in knowledge, this study investigated the relationship between reproductive coercion and multiple forms of interpersonal violence victimization (sexual harassment, sexual abuse, physical partner abuse, psychological partner abuse, stalking, bullying, and polyvictimization). We conducted a secondary analysis of anonymous survey data, which were collected in fall 2015 with college students at a large public university in the southeast United States. The analysis sample was limited to cisgender college students endorsing at least one sexual partner in the past year (N = 431). Most (67.05%) participants indicated that they had experienced at least one form of interpersonal violence victimization, and 39.91% indicated that they had experienced polyvictimization. About 11% of the sample indicated that they had experienced reproductive coercion. Logistic regression analyses showed that reproductive coercion was associated with an increased likelihood of experiencing polyvictimization and all interpersonal violence victimization experiences except for physical partner abuse while controlling for demographic factors. Health providers, especially those working with college populations, could consider screening for reproductive coercion, to meet students’ reproductive health needs and uncover associated interpersonal violence victimization experiences.