Lyn Vromans

The Multidimensional Loss Scale: validating a cross-cultural instrument for measuring loss.

Abstract The Multidimensional Loss Scale (MLS) represents the first instrument designed specifically to index Experience of Loss Events and Loss Distress across multiple domains (cultural, social, material, and intrapersonal) relevant to refugee settlement. Recently settled Burmese adult refugees (N = 70) completed a questionnaire battery, including MLS items. Analyses explored MLS internal consistency, convergent and divergent validity, and factor structure. Cronbach alphas indicated satisfactory internal consistency for Experience of Loss Events (0.85) and Loss Distress (0.92), reflecting a unitary construct of multidimensional loss. Loss Distress did not correlate with depression or anxiety symptoms and correlated moderately with interpersonal grief and trauma symptoms, supporting divergent and convergent validity. Factor analysis provided preliminary support for a five-factor model: Loss of Symbolic Self, Loss of Interdependence, Loss of Home, Interpersonal Loss, and Loss of Intrapersonal Integrity. Received well by participants, the new scale shows promise for application in future research and practice.

Contributions of Loss Events to Loss Distress and Trauma Symptoms in Recently Resettled Refugee Women at Risk

ABSTRACT This research examined contributions of loss events to loss distress and trauma symptoms (accounting for trauma events) for refugee women at risk. Participants (N = 104) responded to the Multidimensional Loss Scale (loss events and distress) and Harvard Trauma Questionnaire (trauma events and symptoms). Loss events contributed uniquely to loss distress (explaining additional 50.8% variance), and made a unique contribution to trauma symptoms (explaining additional 5.2% variance) approximately equal to trauma events. Appropriate response to psychic distress in refugee women at risk requires assessment of both loss and trauma and consideration of cultural differences in ways loss is expressed and meaning ascribed to symptoms.

‘Better than a pill’: digital storytelling as a narrative process for refugee women

ABSTRACT Digital storytelling is a valuable and ethical research tool to engage in collaborative research with refugee women. This paper recounts how digital storytelling was used in a mixed-methods study on settlement, to document the journeys of women who entered Australia through the Woman at Risk program in 2014–2015. Instead of merely asking a series of questions, the digital storytelling process extended our qualitative inquiry as an approach that valued the women’s own memories, interests, and hopes. The methodology represents a meaningful way of engaging in collaborative research, where participating women were not just storytellers but valued as active co-constructors of new knowledge. We outline each of three digital narratives as a ‘whole’ to consider what we can learn from a storytelling process where women with complex circumstances are privileged as protagonists-and-producers of their own stories. We argue that it is worth critically reflecting on the concepts the women propose for themselves as meaningful ways to articulate their lives, when we relinquish the researcher role as question asker to enter a space alongside participants and listen intently. Our paper highlights the broader potential of digital storytelling particularly in mental health research in collaboration with refugee participants.

Psychometric Properties of the Multidimensional Loss Scale with Refugee Women-at-Risk Recently Arrived in Australia

Refugee women-at-risk represent a distinct and vulnerable refugee population. We investigated the psychometric properties of the Multidimensional Loss Scale (MLS) with 104 women-at-risk, recently-arrived in Australia. Cross-sectional survey included: the MLS (indexing loss events and loss distress); Harvard Trauma Questionnaire (Indexing Trauma Events and Trauma Symptoms), and; Hopkins Symptom Checklist-37 (indexing anxiety, depression, and somatization symptoms). Exploratory factor analyses of MLS loss distress revealed a six-factor model (loss of symbolic self; loss of home; loss of interdependence; loss of past aspirations; interpersonal loss, and; loss of intrapersonal integrity). Cronbach alphas indicated satisfactory internal consistency for loss events (0.83) and distress (0.88). Correlations supported convergent validity of loss distress with trauma symptoms (r = 0.41) and divergent validity with anxiety (r = 0.09), Depression (r = 0.29), and somatic (r = 0.24) symptoms. Findings support MLS use in assessment of loss and associated distress with refugee women-at-risk.

Recently resettled refugee women-at-risk in Australia evidence high levels of psychiatric symptoms: individual, trauma and post-migration factors predict outcomes

BackgroundDespite increasing numbers of refugee women-at-risk being resettled and their potential vulnerability, there exists no empirical research into the psychiatric health of this unique subgroup with which to guide policy and practice. This research aimed to investigate psychiatric symptom status of a sample of refugee women-at-risk recently resettled in Australia, as well as factors contributing to symptoms of trauma, anxiety, depression, and somatization. The level of psychiatric symptomatology is compared to reference groups of women from Sudan and Burma, who entered Australia under the Humanitarian Entry Programme, and who did not meet criteria as women-at-risk.MethodsThis is a cross-sectional survey of 104 refugee women-at-risk across several ethnic groups including a demographic questionnaire, the Harvard Trauma Questionnaire, Post-migration Living Difficulties Checklist, and Hopkins Symptom Checklist to assess individual factors, traumatic experiences, post-migration problems, and symptoms of trauma, anxiety, depression, and somatization. A series of multiple hierarchical regression analyses examined factors predicting psychiatric symptoms.ResultsSubstantial proportions of participants reported psychiatric distress in symptomatic ranges, including for traumatization (41%), post-traumatic stress disorder (20%), anxiety (29%), and depression (41%), as well as significant symptoms of somatization (41%). These findings are significantly higher than those derived from reference groups of women from Sudan or Burma, resettled in the same area and utilizing a similar methodology. Higher numbers of trauma events and post-migration living difficulties predicted higher trauma, depression, and somatic (but not anxiety) symptoms. Having children predicted higher trauma, anxiety, and somatic symptoms. Greater English fluency predicted higher anxiety symptoms. Region of birth predicted anxiety and depression symptoms. Age predicted trauma and anxiety symptoms.ConclusionsFindings suggest that recently arrived refugee women-at-risk are at high risk of psychiatric disorders. The results indicate a need for comprehensive psychiatric assessment to identify women in need of treatment very early after resettlement, with implications for medical practice, service delivery, and policy programs.