Trauma and Posttraumatic Growth in Women Refugees

Traumatology | 2024, Vol. 30, No. 2, p. 143 - 152

Trauma and Posttraumatic Growth in Women Refugees: A Bibliometric Analysis of Research Output Over Time

Melika Taheri; School of Psychology/College of Engineering, Science and Environment, University of Newcastle

Natasha Harding; School of Public Health and Medicine/College of Health, Medicine and Wellbeing, University of Newcastle

Sally Fitzpatrick; School of Public Health and Medicine/College of Health, Medicine and Wellbeing, University of Newcastle

Lynne McCormack; School of Psychology/College of Engineering, Science and Environment, University of Newcastle

Refugee women represent one of the biggest minority groups around the globe, yet little is known of the short- or long-term psychosocial consequences they incur from the refugee journey involving possible growth in the face of trauma. Thus, this bibliometric study aimed to assess the volume and characteristics of research output over time concerning the pre-, during, and post-refugee journey of refugee women, inclusive of the theoretical constructs of complex trauma and posttraumatic growth. A descriptive repeat cross-sectional study of publications was conducted from the databases EMBASE, Medline, PsycINFO, and Psychology and Behavioural Sciences Collection (EBSCO) across the time periods 1995 to 2000; 2005 to 2010; and 2015 to 2020. Authors jointly assessed the article's relevance for inclusion. Classifications included the following: database; country of research institution; country of participants; type of trauma experienced; and trauma and growth terminology. In summary, 10 articles, all conducted in the third time period (2015–2020), met criteria for review, providing an increase in the volume of publications reporting on trauma and posttraumatic growth in refugee women despite an overall paucity of research. Most studies were conducted in the United States and Asian refugee women were the greatest recruited participants in studies. A wide range of trauma types were classified as (a) individual trauma, including gender-based trauma, witnessing trauma, forced migration, multiple losses, dehumanization and denial of human rights; (b) collective trauma included internal conflicts, interterritorial war, war civilians, genocide, and systematic government threats. Lastly, the posttraumatic growth domains of positive relations with others, meaning-making, and spirituality were most represented.

Bibliometric study; mental health; posttraumatic growth; women refugees; trauma

“Twenty individuals are newly exiled every minute around the globe. Greater than 80% are reported by the UNHCR to be women and children. In some societies, women and girls face discrimination and violence every day simply because of their gender and it is from within many of these societies that women become refugees. The plight of women refugees is poorly explored in the literature including the longitudinal narrative from premigration to during and after, and the types and frequency of gender-specific trauma and violence despite their unique circumstances. Similarly, how women and girls make sense of the refugee journey, resettle, recover, and grow is equally poorly researched despite literature on post trauma growth appearing in the literature in the early 1990s” (p. 143). 

Prior research has shown that “among refugees, women and girls experience specific hardships associated with forced displacement, for example, being harassed by male refugees, muggers, or soldiers and reportedly experience an inferior standard of living in the same context compared with male refugees. Physical incapability, downgrading, diverse gender identities further enhance the risks of violence and discrimination for refugee women and girls. Moreover, refugee women tend to express a low perceived need for professional help in the country of resettlement because they normalize psychological complications as a logical outcome of their unpredictable humanitarian migration journey” (p. 144). 

“This research conducted a descriptive repeat cross-sectional study of peer-reviewed publications. As an observational study, it analyzed extracted data from particular periods of time (1995-2000; 2005–2010; and 2015–2020), evaluating the prevalence of research interested in the plight of refugee women, their trauma and posttraumatic growth. In addition, cross-sectional studies aim to produce other study design hypotheses apprizing on the prevalence of extracted outcomes” (p. 145).

“There had been almost no interest in the field of the current study in relation to the first and second time periods, but there was no table growth in publications in the last time period of 2015 to 2020. The initial time period of 1995 to 2000 had been chosen to capture any early studies that brought into focus the constructs of trauma and posttraumatic growth in relation to refugee women. Although these findings were unexpected, results emphasize the lack of interest in this field in the first two periods and a growing interest in the last period, 2015 to 2020. Overall, there were changes from none to10 studies within the pattern of study types published, including measures, descriptive, intervention, and updating framework” (p. 150).

“Given that most refugee women around the globe come from the Middle East, South America, and Africa, these results emphasize a paucity of research addressing the experiences of women refugees from these parts of the world. Similarly, and relevant to this study, the ongoing conceptual and theoretical underpinnings of post traumatic growth would benefit from a greater volume of research exploring psychological well-being cross-culturally and throughout the years of post resettlement in the aftermath of traumatic events to inform programs of support, well-being, and resettlement” (p. 151). 

“Trauma studies have underscored a noticeable lack of uniformity concerning definitions of psychological trauma. There was a wide range of trauma types studied in the identified articles: (a) collective trauma (comprising internal conflicts in the home country, interterritorial war, war civilians, genocide and the systematic government threats and carrying out the imprisonment, torture, rape, and murder of civilians with a specific ethnic background to make them leave the country); (b) individual trauma (comprising gender-based trauma, witnessing traumatic incidents, forced migration, multiple losses, dehumanization and denial of human right). Therefore, the findings were across the studies rather than the time periods and the variation of trauma-type subgroups in just 10 studies, based on the combination of the phase of the refugee journey, revealed the inconsistency of the trauma subgroups on these women refugees’ perilous journeys in the current review” (p. 151).

“This study highlights the lack of studies concerning the plight of refugee women, the lack of research with refugee women from the largest subgroups (Syrian Arab Republic, Venezuela, Afghanistan, South Sudan, and Myanmar), the types of trauma they encountered, their counter affective factors (e.g., cross-cultural attitudes, values, and roles), and their potential for posttraumatic growth. It also highlights the lack of awareness regarding intensity, complexity and occurrence of gender-specific trauma in refugee women. The majority of studies interpret trauma and posttraumatic growth through a western cultural lens, which then shapes trauma-informed interventions. Thus, potential bias informs research outcomes around types of trauma and other characteristics advising therapeutic directions. Clinically, it is vital to recognize and harness the cultural nuances of traumatic responses to provide culturally sensitive interventions and services to the specific community or individual in need” (p. 151).

“Findings can inform future clinical practice, policy, and research including the need for the following: 

• Longitudinal studies given that posttraumatic growth requires the distress of trauma to be at a tolerable level for sense-making to begin, and given that the refugee journey is likely to present cumulative and complex traumatic events sequentially, delaying the reporting of posttraumatic growth until sometime after resettlement. 
• Further cross-cultural research explicitly defines trauma types experienced by refugee women and domains of posttraumatic growth specific to refugee women.
• The development of relevant interventions and community programs specific to the cultural needs and trauma interpretation with different groups of refugee women.
• The need for further focus on the diversity of backgrounds when considering gender experiences and whether the current interpretation of trauma and posttraumatic growth is sufficient and relevant across all stages of the refugee journey for women from different cultures” (p. 150-151).