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Understanding the mechanisms linking these experiences to psychological outcomes is essential for informing targeted interventions in host countries. In the context of resettlement, this study examined whether perceptions of injustice and physiological stress regulation, measured through resting heart rate variability (HRV), mediated the relationship between trauma, perceived discrimination, and mental health problems. Data were collected from 98 refugees and migrants (21.4% female; <jats:italic>M<\/jats:italic>\n            <jats:sub>age<\/jats:sub> = 28.0 years) from Arabic-speaking countries living in Germany. Participants reported on pre-migration trauma, post-migration discrimination, perceived injustice, and depressive and post-traumatic stress disorder (PTSD) symptoms. A subsample of 67 participants underwent a 10-min electrocardiogram to assess resting HRV. Results revealed that pre-migration trauma was linked to increased PTSD symptoms, while post-migration discrimination was associated with higher depressive symptoms. Perceived injustice mediated the relationship between discrimination and mental health outcomes, with greater perceived discrimination being associated with higher perceived injustice, which in turn was related to both increased depressive and PTSD symptoms. These findings held after controlling for age and sex. No mediating effect of HRV was found, potentially due to limited statistical power. In conclusion, our study emphasizes the psychological burden of both pre- and post-migration stressors for refugees and migrants from Arabic-speaking countries. The mediation results suggest that addressing perceived injustice may be important for post-migration mental health interventions.<\/jats:p>","DOI":"10.1007\/s00702-025-03034-7","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:27:45Z","timestamp":1759940865000},"page":"1445-1456","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cumulative hardship: the role of perceived injustice in linking war-related trauma and discrimination with mental health"],"prefix":"10.1007","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7861-1723","authenticated-orcid":false,"given":"Christiane","family":"Wesarg-Menzel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Lashani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Gallistl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Engert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"3034_CR91","doi-asserted-by":"crossref","unstructured":"Berntson, G. 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