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The Perceptions of Trauma, Complaints, Somatization, and Coping Strategies among Syrian Refugees in Germany—A Qualitative Study of an At-Risk Population

Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
Department of Psychiatry and Psychotherapy, Paracelsus Medical University, 90419 Nürnberg, Germany
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(3), 693;
Received: 26 October 2019 / Revised: 9 January 2020 / Accepted: 12 January 2020 / Published: 21 January 2020
(This article belongs to the Special Issue Community-Based Global Mental Health for Refugees and other Migrants)
Background: A high prevalence of mental distress, especially posttraumatic stress disorder, has been widely confirmed among refugees. In order to establish adequate interventions in psychotherapy, however, it must first be examined whether refugees have similar ideas and concepts of stress, trauma, and healing. This study, therefore, aimed to analyze the representations of trauma, self-reported complaints, indications of somatization, and coping strategies among a refugee population. Methods: Semi-structured interviews based on the Cultural Formulation Interview (CFI) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were conducted with Syrian refugees who have residence permission in Germany. The interviews were audio-recorded, transcribed, and analyzed according to the qualitative content analysis of Mayring. The foci of interest were determined on the basis of the predefined interview guideline, and inductive subcategories were extracted from the transcripts. Results: Sixteen refugees participated (50% women; mean age: 35.5 years, SD = 11.2; the mean duration of stay in Germany: 23.3 months, SD = 6.6). War experiences were the most frequently reported subjective perceptions of trauma. Frequently reported complaints included sleeping disturbance, cardiovascular symptoms, rumination, and pain. Among half of the participants, we found indications of somatization. We identified the following coping strategies: Activity, cognitive coping, social coping, religious coping, avoidance, and emotional coping. Conclusions: War-related traumatic events are the most common trauma perceptions among Syrian refugees. The self-reported complaints demonstrate somatoform, depressive, and posttraumatic symptoms. Syrian refugees should be screened for somatization, depression, and posttraumatic stress disorder and should receive targeted interventions that consider and support individual coping resources. View Full-Text
Keywords: refugees; Syria; trauma; coping; symptoms; somatization refugees; Syria; trauma; coping; symptoms; somatization
MDPI and ACS Style

Zbidat, A.; Georgiadou, E.; Borho, A.; Erim, Y.; Morawa, E. The Perceptions of Trauma, Complaints, Somatization, and Coping Strategies among Syrian Refugees in Germany—A Qualitative Study of an At-Risk Population. Int. J. Environ. Res. Public Health 2020, 17, 693.

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