Cross-cultural assessment of psychological symptoms among Somali refugees

The primary aim of this study was to examine the influence of somatization and post-migration living difficulties (PMLD) on the report of psychological symptoms among Somali refugees living in the United States. This study was also designed to provide psychometric data for a Somali version of the Harvard Trauma Questionnaire (HTQ). Four hypotheses were proposed in this study: (a) pre-migration traumatic exposure will predict self-reported psychological symptoms (e.g., depression, anxiety, and posttraumatic stress disorder [PTSD]), (b) somatic complaints will have an indirect effect on the relationship between trauma and outcome symptoms, (c) PMLD will moderate the trauma -- symptoms relationships, and (d) the indirect effect of somatic complaints on the relationship between traumatic exposure and psychological symptoms will be conditional on values of PMLD. To test these hypotheses, data was collected from a predominantly male sample (64.9%) of 74 adult Somali participants. Preliminary analysis of the Somali HTQ demonstrated a high level of internal consistency for the measure (alpha = .95). The results of this study also indicated traumatic exposure as a significant predictor of depression, anxiety, and PTSD among Somalis. Somatization served as a mediating influence between pre-migration trauma and mood disturbance, accounting for 9% of the variance in the relationship with depression and 14% of the variance in the relationship with anxiety. PMLD moderated the relationship between trauma and depression only (DeltaR 2 = .068, p = .017). Furthermore, PMLD was found to moderate the indirect effect of somatization on the relationship between trauma and depression. These findings are consistent with previous research suggesting that Somali refugees are at significant risk for posttraumatic stress and overall mood disturbance following traumatic exposure. This study furthers the available literature on Somali mental health by highlighting the differential course of PTSD from either depression or anxiety. Endorsement of PTSD symptoms does not appear to be influenced by report of somatic complaints or moderated by PMLD in this refugee sample. By contrast, somatic complaints may play an influential role in the presentation of depression and anxiety among Somalis. Moreover, psychosocial stress encountered post-migration appears to exacerbate depressive symptoms relative to other psychological difficulties reported by this group.