Abstract
The civil war in Syria began in 2011 and escalated over years resulting in one of the largest humanitarian crises since the Second World War. Injury, loss, poverty, and immigration trapped the Syrian population in a diversity of psychological disorders, including post-traumatic stress disorder (PTSD). Spirituality has, on the other hand, been consistently reported as a resilient factor against developing mental disorders. Hence, spirituality or religiosity have been incorporated in clinical and psychotherapeutic practice for several mental disorders. We explored the association between spirituality and the development of PTSD symptoms among Syrian refugee adolescents in Jordanian schools. A sample of 418 Syrian adolescent students (age range between 12–16 years) from Jordanian schools in the northern part of the country were enrolled in the study after informing on study context and objectives. The study questionnaire included sample demographics, smoking status, PTSD checklist – Civilian Version (PCL-C), two spirituality-targeting questions, and trauma and loss history. `Almost half of participants (N = 196) showed moderate PTSD symptoms while around 30% (N = 124) had a severe level of PTSD symptoms. On the other hand, 3 out of four students perceived themselves as highly spiritual. The study resulted in a positive correlation between belief in God and God’s thankfulness. Furthermore, increased spirituality level did not appear to lower the risk of developing PTSD symptoms. Spiritual self-perception of Syrian refugee adolescents showed neither protective nor aggravating effect of on the occurrence of post-traumatic stress symptoms. Additional research and more accurate tools are needed to assess the potential impact of spiritual/religious values towards PTSD symptoms among adolescents.
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References
Abraham, R., Lien, L., & Hanssen, I. (2018). Coping, resilience and post-traumatic growth among Eritrean female refugees living in Norwegian asylum reception centres: A qualitative study. International Journal of Social Psychiatry, 64(4), 1. https://doi.org/10.1177/0020764018765237
Berg, G. (2011). The relationship between spiritual distress, PTSD and depression in Vietnam combat veterans. Journal of Pastoral Care & Counseling, 65(1–2)(6), 1–11.
Chandler, C. K., Holden, J. M., & Kolander, C. A. (1992). Counseling for spiritual wellness: Theory and practice. Journal of Counseling & Development, 71, 168–175. (n.d.).
Ellison, C. (1983). Spiritual Well-Being: Conceptualization and Measurement. Journal of Psychology and Theology, 11(4), 330–340.
Fares, J., Gebeily, S., Saad, M., Harati, H., Nabha, S., Said, N., Kanso, M., & Rassoul, R. A. (2017). Post-traumatic stress disorder in adult victims of cluster munitions in Lebanon : a 10-year longitudinal study. 1–8. https://doi.org/10.1136/bmjopen-2017-017214
Fazel, M., Wheeler, J., & Danesh, J. (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet, 365, 1309–1314. (n.d.).
Hourani, L. L., Williams, J., Forman-Hoffman, V., Lane, M. E., Weimer, B., & Bray, R. M. (2012). Influence of spirituality on depression, post-traumatic stress disorder, and suicidality in active duty military personnel. Depression Research and Treatment, 2012, 1. https://doi.org/10.1155/2012/425463
Kazour, F., Zahreddine, N. R., Maragel, M. G., Almustafa, M. A., Soufia, M., Haddad, R., & Richa, S. (2017). Post-traumatic stress disorder in a sample of Syrian refugees in Lebanon. Comprehensive Psychiatry, 72, 41–47. (n.d.).
Khamis, V. (2012). Impact of war, religiosity and ideology on PTSD and psychiatric disorders in adolescents from Gaza Strip and South Lebanon. Social Science & Medicine, 74(12), 1. https://doi.org/10.1016/j.socscimed.2012.02.025
Koenig, H. G., Larson, D. B., & Larson, S. S. (2001). Religion and coping with serious medical illness. Annals of Pharmacotherapy, 35(3), 352–359.
Ladd, K. L., & McIntosh, D. N. (2008). Meaning, God, and prayer: Physical and metaphysical aspects of social support. Mental Health, Religion and Culture, 11(1), 23–38. https://doi.org/10.1080/13674670701475053
McIntosh, D. N. (2009). Religion-as-Schema, With Implications for the Relation Between Religion and Coping. The International Journal for the Psychology of Religion, 5(1), 1–16.
McIntosh, D. N., Poulin, M. J., Silver, R. C., & Holman, E. A. (2011). The distinct roles of spirituality and religiosity in physical and mental health after collective trauma_ a national longitudinal study of response. Journal of Behavioral Medicine, 34(6), 1.
Miller, W. R., & Thoresen, C. E. (2003). Spirituality, religion, and health. An emerging research field. The American Psychologist, 58(1), 24–35. (n.d.).
Omar, A. (2020). Understanding and preventing attacks on health facilities during armed conflict in Syria. Risk Management and Healthcare Policy, 13, 191–203. https://doi.org/10.2147/RMHP.S237256
Oren, L., & Possick, C. (2009). Religiosity and post-traumatic stress following forced relocation. Journal of Loss and Trauma, 14(2), 1.
Oren, Y. I., & Smadar, K. (2016). Religiosity as a Moderator of Self-Efficacy and Social Support in Predicting Traumatic Stress Among Combat soldiers. Journal of Religion and Health, 55(4), 1160–1171. https://doi.org/10.1007/s10943-016-0187-x
Parekh, R. (2017). Posttraumatic Stress Disorder. American Psychiatric Association.
Perkins, J. D., Ajeeb, M., Fadel, L., & Saleh, G. (2018). Mental health in Syrian children with a focus on post-traumatic stress: A cross-sectional study from Syrian schools. Social Psychiatry and Psychiatric Epidemiology, 53(11), 1231–1239. https://doi.org/10.1007/s00127-018-1573-3
Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., & Cella, D. (2002). Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy--Spiritual Well-being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24(1), 49–58. (n.d.).
Rajaei, A. R. (2010). Religious cognitive-emotional therapy: a new form of psychotherapy. Iranian Journal of Psychiatry, 5(3), 81–87. http://www.ncbi.nlm.nih.gov/pubmed/22952497%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3430504
Roberts, A., Galea, S., Austin, S., Cerda, M., Wright, R., Rich-Edwards, J., & Koenen, K. (2012). Post-traumatic stress disorder across two generations: concordance and mechanisms in a population-based sample. Biological Psychiatry, 15, 72(6).
Scheeringa, M. S., & Zeanah, C. H. (2008). Reconsideration of harm’s way: Onsets and comorbidity patterns of disorders in preschool children and their caregivers following Hurricane Katrina. Journal of Clinical Child and Adolescent Psychology, 37(3), 508–518. https://doi.org/10.1080/15374410802148178
Smith-macdonald, L. A., Morin, J., & Brémault-phillips, S. (2018). Spiritual Dimensions of Moral Injury : Contributions of Mental Health Chaplains in the Canadian Armed Forces, 9, 1–7. https://doi.org/10.3389/fpsyt.2018.00592.
Soykoek, S., Mall, V., Nehring, I., Henningsen, P., & Aberl, S. (2017). Post-traumatic stress disorder in Syrian children of a German refugee camp. The Lancet, 389(10072), 904.
Thabet, A. A., Abed, Y., Vostanis, P. (2002) Emotional problems in Palestinian children living in a war zone: a cross-sectional study. Lancet, 359(9320):1801–4. (n.d.).
Verghese, A. (2008). Spirituality and mental health. Indian Journal of Psychiatry, 50(4), 233–237.
Weathers, F. W., Huska, J. A., & Keane, T. M. (1991). PCL-C for DSM-IV. Boston: National Center for PTSD – Behavioral Science Division, 15–16.
Wortmann, J. H., & Park, C. L. (2012). Trauma and PTSD Symptoms: Does Spiritual Struggle Mediate the Link? 3(4), 442–452. https://doi.org/10.1037/a0021413.Trauma
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Ramadan, M., Kheirallah, K., Saleh, T. et al. The Relationship Between Spirituality and Post-Traumatic Stress Symptoms in Syrian Adolescents in Jordan. Journ Child Adol Trauma 15, 585–593 (2022). https://doi.org/10.1007/s40653-021-00401-w
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DOI: https://doi.org/10.1007/s40653-021-00401-w