Untangling the Mental Health of Forced Migrants and Sexual Violence Survivors

Abstract

SECTION 1. SURVIVORS OF SEXUAL VIOLENCE AND TRAFFICKING The first section was focused on migrant survivors of sexual violence and trafficking and contained three chapters. In chapter 2 we explored the nexus between labels of “trafficking in human beings” and “conflict-related sexual violence” from a psychological and legal point of view. We found a tension between psychological perspectives and legal standpoints on these labels. In chapter 3 we applied a person-centered approach to identify subgroups within sex trafficking experiences amongst a clinical sample of 337 women adult survivors. We found two subgroups of survivors: 1) those who were restricted in their movement (“locked up”) by a non-intimate perpetrator, and 2) those who were mainly emotionally coerced into sex trafficking within an intimate relationship. Finally, in chapter 4 we used a multimethod approach to examine the feasibility of a novel body-oriented module aimed at mitigating sexual revictimisation amongst 13 (forced) migrant survivors of sexual violence and trafficking.Patients and facilitators attributed changes to the module that were in line with the intended outcomes. We concluded that a body-oriented approach to sexual revictimisation risk mitigation was feasible, and that the module’s effectivity and further implementation are worthwhile to consider. SECTION 2. FORCED MIGRANTS In the second section, containing four chapters, we focused on the mental health of forced migrants, including those who survived sexual violence and trafficking. In chapter 5 we explored conceptualisations of “neglect” at the intersect of mental health, gender and protracted displacements. We concluded that “neglect” must be considered in the context of: i) differential (health) priorities; ii) discrepancies between overt socially disruptive distress and covert socially containable distress; and iii) containment strategies around sexual violence. In chapter 6 we introduced the protocol for an observational treatment study on adherence and predictors of change during Narrative Exposure Therapy (NET) for forced migrants suffering from posttraumatic stress disorder (PTSD). We considered perceived daily stress, emotion dysregulation, and mood as predictors of change in posttraumatic stress (PTS) during NET. In total, 86 patients were included in the study and 40 patients completed therapy in line with the study protocol. We shared the main findings of this study in the two following chapters. In chapter 7 we presented the findings on measures administered prior to each NET session. We found that NET coincides with improvements in PTS, perceived daily stress and emotion dysregulation. Furthermore, although changes in perceived daily stress and PTS were interrelated, they did not consistently predict each other over time. Lastly in chapter 8, we presented findings on the predictive value of perceived daily stress and emotion regulation pretreatment levels on subsequent NET treatment adherence and completion. We concluded that, in the current sample, perceived daily stress and emotion dysregulation were not specifically related to NET treatment completion and adherence.