Intolerance of uncertainty, posttraumatic stress, depression, and fears for the future among displaced refugees

Angela Nickerson, Joel Hoffman, David Keegan, Shradda Kashyap, Rizka Argadianti, Diah Tricesaria, Zico Pestalozzi, Randy W. Nandyatama, Mitra Khakbaz, Nindita Nilasari, Belinda Liddel
The vast majority of the 100 million forcibly displaced persons worldwide live in a state of prolonged uncertainty with limited resettlement prospects and access to resources. Little is known, however, regarding how refugees and asylum-seekers cope with this uncertainty.In this study, we investigated the longitudinal association between a measure of how people cope with uncertainty (intolerance of uncertainty (IU)), fears for the future, posttraumatic stress disorder (PTSD) symptoms and depression symptoms. A sample of 1,237 refugees displaced in Indonesia completed an online survey in Arabic, Farsi, Dari, Somali or English at two time-points six-months apart.

Results indicated that greater IU-inhibitory anxiety (IU-IA or impairment related to uncertainty) was associated with subsequent increases in PTSD and depression symptoms and fears for the future. Greater PTSD symptoms and fears for the future were associated with increases in IU-prospective anxiety (IU-PA or distress related to uncertainty), and greater depression symptoms were associated with increases in IU-IA.

These findings provide evidence for the mechanistic role of IU in psychological symptoms amongst displaced refugees. Results underscore the importance of policies to reduce uncertainty in displacement environments, and highlight IU as a potential intervention target to help refugees cope with protracted displacement.

DOI: https://doi.org/10.1016/j.janxdis.2023.102672

Tags: intolerance of uncertainty Posttraumatic Stress Disorder Refugees; depression