Posttraumatic stress among refugees: The moderating effect of perceived social support.

Objective: Social support has been associated with the mental health of refugees. However, little is known about the characteristics and effects of social support in this group. The aim of this study was to investigate the protective role of social support, specifically through the perceived opportunity to confide in someone. We hypothesized that the opportunity to confide would have a moderating influence on the dose-effect relationship between trauma exposure and PTSD symptoms. Methods: Clinical face-to-face interviews were conducted with 65 adult refugees who were living in the north-east of North Rhine-Westphalia. Interpreters (Arabic, Farsi, Kurmancî) were present if necessary. Interviews included a detailed assessment of traumatic event types, PTSD symptoms (assessed via the PTSD Checklist for DSM-5 (PCL-5)), and social support experienced by the participants. Results: The multiple hierarchical regression analysis revealed a significant moderation of the perceived opportunity to confide on the association of number of traumatic event types reported and PTSD symptomatology. For refugees with limited trauma exposure, opportunity to confide was associated with lower PTSD symptoms. Most confidants were located within the countries of reception, while contacts in the home countries were less often identified as protective. Conclusions: Social support, in particular the opportunity to confide, seems to act as a buffering factor up to a certain number of experienced traumatic event types. Specialized interventions may be necessary for people with a high trauma load and / or high symptom level.