{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:13:45Z","timestamp":1791958425676,"version":"4.3.4"},"reference-count":85,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T00:00:00Z","timestamp":1495670400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Transcult Psychiatry"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>The Rohingya of Myanmar are a severely persecuted minority who form one of the largest groups of stateless people; thousands of them reside in refugee camps in southeastern Bangladesh. There has been little research into the mental health consequences of persecution, war, and other historical trauma endured by the Rohingya; nor has the role of daily environmental stressors associated with continued displacement, statelessness, and life in the refugee camps, been thoroughly researched. This cross-sectional study examined: trauma history, daily environmental stressors, and mental health outcomes for 148 Rohingya adults residing in Kutupalong and Nayapara refugee camps in Bangladesh. Results indicated high levels of mental health concerns: posttraumatic stress disorder (PTSD), depression, somatic complaints, and associated functional impairment. Participants also endorsed local idioms of distress, including somatic complaints and concerns associated with spirit possession. The study also found very high levels of daily environmental stressors associated with life in the camps, including problems with food, lack of freedom of movement, and concerns regarding safety. Regression and associated mediation analyses indicated that, while there was a direct effect of trauma exposure on mental health outcomes (PTSD symptoms), daily environmental stressors partially mediated this relationship. Depression symptoms were associated with daily stressors, but not prior trauma exposure. These findings indicate that daily stressors play a pivotal role in mental health outcomes of populations affected by collective violence and statelessness. It is, therefore, important to consider the role and effects of environmental stressors associated with life in refugee camps on the mental health and psychosocial well-being of stateless populations such as the Rohingya, living in protracted humanitarian environments.<\/jats:p>","DOI":"10.1177\/1363461517705571","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T07:12:43Z","timestamp":1495696363000},"page":"304-331","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":184,"title":["Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh"],"prefix":"10.1177","volume":"54","author":[{"given":"Andrew","family":"Riley","sequence":"first","affiliation":[{"name":"United Nations High Commissioner for Refugees (UNHCR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Varner","sequence":"additional","affiliation":[{"name":"United Nations High Commissioner for Refugees (UNHCR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ventevogel","sequence":"additional","affiliation":[{"name":"United Nations High Commissioner for Refugees (UNHCR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Taimur Hasan","sequence":"additional","affiliation":[{"name":"United Nations High Commissioner for Refugees (UNHCR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Welton-Mitchell","sequence":"additional","affiliation":[{"name":"University of Denver"},{"name":"University of Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,5,25]]},"reference":[{"issue":"3","key":"bibr1-1363461517705571","first-page":"511","volume":"23","author":"Abdelkader E.","year":"2014","journal-title":"Pacific Rim Law & Policy Journal"},{"key":"bibr2-1363461517705571","volume-title":"Harvard trauma manual: Bosnia-Herzegovina version","author":"Allden K.","year":"1998"},{"key":"bibr3-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-007534"},{"issue":"4","key":"bibr4-1363461517705571","first-page":"25","volume":"1","author":"Azad A.","year":"2013","journal-title":"Journal of Indian Research"},{"key":"bibr5-1363461517705571","unstructured":"Barry, E. (2015, July 23). A Bangladeshi town in human trafficking\u2019s grip.\n                      The New York Times\n                      . Retrieved from http:\/\/www.nytimes.com\/2015\/07\/24\/world\/asia\/bangladesh-human-trafficking.html."},{"key":"bibr6-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2003.09.024"},{"key":"bibr7-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1207\/s15327558ijbm0401_6"},{"key":"bibr8-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1108\/IJMHSC-05-2013-0001"},{"key":"bibr9-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2014.08.020"},{"key":"bibr10-1363461517705571","volume-title":"Exiled to nowhere: Burma\u2019s Rohingya","author":"Constantine G.","year":"2012"},{"key":"bibr11-1363461517705571","unstructured":"Crisp, J. (2003).\n                      No solutions in sight: The problem of protracted refugee situations in Africa\n                      (UNHCR Working Paper No. 75). Retrieved from http:\/\/www.unhcr.org\/research\/working\/3e2d66c34\/solutions-sight-problem-protracted-refugee-situations-africa-jeff-crisp.html."},{"key":"bibr12-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1002\/bs.3830190102"},{"key":"bibr13-1363461517705571","unstructured":"Drew, N., Funk, M., Pathare, S. & Swartz, L. (2004). Mental health and human rights. In WHO (with the Victorian Health Promotion Foundation & the University of Melbourne) (Eds.),\n                      Promoting mental health: Concepts, emerging evidence, practice\n                      (pp. 81\u201388). Geneva, Switzerland: World Health Organization."},{"key":"bibr14-1363461517705571","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"bibr15-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8624.2010.01462.x"},{"key":"bibr16-1363461517705571","first-page":"4","volume":"32","author":"Goris I.","year":"2009","journal-title":"Forced Migration Review"},{"key":"bibr17-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-014-0984-z"},{"key":"bibr18-1363461517705571","unstructured":"Hayes, A. F. (2012).\n                      PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling\n                      [White paper]. Retrieved from http:\/\/www.afhayes.com\/public\/process2012.pdf."},{"key":"bibr19-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1363461513481187"},{"key":"bibr20-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.03.045"},{"key":"bibr21-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1111\/maq.12204"},{"key":"bibr22-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1097\/WTF.0000000000000067"},{"key":"bibr23-1363461517705571","unstructured":"Hook, K. (2015). Peace of mind, health of body: Why the correlation of food security, physical health, and mental wellbeing holds important implications for humanitarian actors.\n                      The Journal of Humanitarian Assistance\n                      . Retrieved from http:\/\/sites.tufts.edu\/jha\/archives\/2115."},{"key":"bibr24-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1097\/WTF.0000000000000125"},{"key":"bibr25-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1363459307077541"},{"key":"bibr26-1363461517705571","unstructured":"Human Rights Watch. (2013).\n                      All you can do is pray: Crimes against humanity and ethnic cleansing of Rohingya Muslims in Burma\u2019s Arakan state\n                      . Retrieved from https:\/\/www.hrw.org\/report\/2013\/04\/22\/all-you-can-do-pray\/crimes-against-humanity-and-ethnic-cleansing-rohingya-muslims."},{"key":"bibr27-1363461517705571","volume-title":"IASC guidelines on mental health and psychosocial support in emergency settings","author":"Inter-Agency Standing Committee (IASC)","year":"2007"},{"key":"bibr28-1363461517705571","volume-title":"Recommendations for conducting ethical mental health and psychosocial research in emergency settings","author":"Inter-Agency Standing Committee (IASC) Reference Group for Mental Health and Psychosocial Support in Emergency Settings","year":"2014"},{"key":"bibr29-1363461517705571","unstructured":"The Johns Hopkins University Bloomberg School of Public Health. (2013).\n                      Design, implementation, monitoring, and evaluation of mental health and psychosocial assistance programs for trauma survivors in low resource countries: A user\u2019s manual for researchers and program implementers\n                      . Retrieved from http:\/\/www.jhsph.edu\/research\/centers-and-institutes\/research-to-prevention\/dime-manual\/DIME-MODULE-1.pdf."},{"key":"bibr30-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.111.102137"},{"key":"bibr31-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0228-9"},{"key":"bibr32-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1359105309346516"},{"key":"bibr33-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.144.4.497"},{"key":"bibr34-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1057\/978-1-137-39510-8_14"},{"key":"bibr35-1363461517705571","unstructured":"Kiragu, E., Rosi, A. L. & Morris, T. (2011).\n                      States of denial: A review of UNHCR\u2019s response to the protracted situation of stateless Rohingya refugees in Bangladesh\n                      . Retrieved from http:\/\/www.unhcr.org\/4ee754c19.pdf."},{"key":"bibr36-1363461517705571","doi-asserted-by":"crossref","unstructured":"Kirmayer, L. J., Lemelson, R. & Barad, M. (Eds.). (2007).\n                      Understanding trauma: Integrating biological, clinical, and cultural perspectives\n                      . New York, NY: Cambridge University Press.","DOI":"10.1017\/CBO9780511500008"},{"key":"bibr37-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1363461514557202"},{"key":"bibr38-1363461517705571","doi-asserted-by":"publisher","DOI":"10.2466\/pr0.2001.88.2.527"},{"key":"bibr39-1363461517705571","unstructured":"Knight, K. (2013).\n                      Analysis: How Bangladesh aid restrictions impact Rohingyas\n                      . Retrieved from http:\/\/www.irinnews.org\/fr\/report\/99157\/analysis-how-bangladesh-aid-restrictions-impact-rohingyas."},{"key":"bibr40-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.111.096222"},{"key":"bibr41-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-11-127"},{"key":"bibr42-1363461517705571","first-page":"11","volume":"32","author":"Lewa C.","year":"2009","journal-title":"Forced Migration Review"},{"key":"bibr43-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1363461514543146"},{"key":"bibr44-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1534765610388062"},{"key":"bibr45-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1037\/trm0000020"},{"key":"bibr46-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1363461508100785"},{"key":"bibr47-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.09.029"},{"key":"bibr48-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1097\/WTF.0000000000000066"},{"key":"bibr49-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199202000-00008"},{"key":"bibr50-1363461517705571","volume-title":"Measuring trauma, measuring torture: Instructions and guidance on the utilization of the Harvard Program in Refugee Trauma\u2019s versions of the Hopkins Symptom Checklist-25 (HSCL-25) and the Harvard Trauma Questionnaire (HTQ)","author":"Mollica R. F.","year":"2004"},{"key":"bibr51-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2010.06.030"},{"key":"bibr52-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-4-34"},{"key":"bibr53-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1080\/13602004.2013.826453"},{"key":"bibr54-1363461517705571","unstructured":"Prosser, S. (2006).\n                      Made in Bangladesh, mental health assessment\n                      . Unpublished manuscript."},{"key":"bibr55-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1111\/j.1939-0025.2010.01026.x"},{"key":"bibr56-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-14-206"},{"key":"bibr57-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp203"},{"key":"bibr58-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/008124631204200106"},{"key":"bibr59-1363461517705571","unstructured":"Sarfo-Mensah, A. G. (2009).\n                      Coping methods and meaning making of Liberian refugees in the Buduburam refugee camp of Ghana\n                      (Honors Scholar thesis). Retrieved from http:\/\/digitalcommons.uconn.edu\/cgi\/viewcontent.cgi?article=1113&context=srhonors_theses."},{"key":"bibr60-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1023\/B:QURE.0000018486.91360.00"},{"key":"bibr61-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1097\/WTF.0000000000000068"},{"key":"bibr62-1363461517705571","unstructured":"Szep, J. & Grudgings, S. (2013).\n                      Preying on the Rohingya\n                      (Reuters special report). Retrieved from http:\/\/graphics.thomsonreuters.com\/13\/07\/MYANMAR-ROHINGYAS.pdf."},{"key":"bibr63-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/0022146510395592"},{"key":"bibr64-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/0020764008091525"},{"key":"bibr65-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001096"},{"key":"bibr66-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1177\/1363461512475025"},{"key":"bibr67-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1080\/15562948.2011.567149"},{"key":"bibr68-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR). (2007a).\n                      Bangladesh: Analysis of gaps in the protection of Rohingya refugees\n                      . Retrieved from http:\/\/www.refworld.org\/docid\/472897120.html."},{"key":"bibr69-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR). (2007b).\n                      Refugee consultations: Bangladesh\n                      . Retrieved from http:\/\/www.refworld.org\/docid\/46f0ec002.html."},{"key":"bibr70-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR). (2012a).\n                      UNHCR Bangladesh fact sheet. February 2012. Asia-Pacific field update.\n                      Retrieved from http:\/\/reliefweb.int\/sites\/reliefweb.int\/files\/resources\/50001ae09.pdf."},{"key":"bibr71-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR). (2012b).\n                      UNHCR global appeal 2012\u20132013\n                      . Retrieved from http:\/\/www.unhcr.org\/4ec231060.html."},{"key":"bibr72-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR). (2013).\n                      Operational guidance: Mental health & psychosocial support programming for refugee operations\n                      . Retrieved from http:\/\/www.refworld.org\/docid\/53a3ebfb4.html."},{"key":"bibr73-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR). (2016).\n                      Separated by the sea\n                      . Retrieved from http:\/\/tracks.unhcr.org\/2016\/02\/separated-by-the-sea\/."},{"key":"bibr85-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR). (2017). UNHCR seeks equal treatment for all Rohingya in Bangladesh. Retrieved from http:\/\/www.unhcr.org\/news\/latest\/2017\/3\/58cfac434\/unhcr-seeks-equal-treatment-rohingya-bangladesh.html."},{"key":"bibr74-1363461517705571","unstructured":"United Nations High Commissioner for Refugees (UNHCR) & Action Contre La Faim. (2011).\n                      Annual nutrition report: Kutupalong and Nayapara refugee camps, Bangladesh\n                      . Retrieved from https:\/\/www.wfp.org\/sites\/default\/files\/Annual%20Report%202011.pdf."},{"key":"bibr75-1363461517705571","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2014.966067"},{"key":"bibr76-1363461517705571","unstructured":"Ventevogel, P. (2016).\n                      Borderlands of mental health: Explorations in medical anthropology, psychiatric epidemiology and health systems research in Afghanistan and Burundi\n                      (Doctoral thesis). Retrieved from http:\/\/hdl.handle.net\/11245\/1.541314."},{"key":"bibr77-1363461517705571","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-007-0161-8"},{"key":"bibr78-1363461517705571","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.15.156919"},{"key":"bibr79-1363461517705571","unstructured":"World Food Programme (WFP), Government of the People\u2019s Republic of Bangladesh (GOB), & United Nations High Commissioner for Refugees (UNHCR). (2012).\n                      Joint assessment mission: Myanmar refugees in Cox\u2019s Bazar District, Bangladesh\n                      . Retrieved from http:\/\/www.unhcr.org\/en-us\/protection\/health\/555c8c459\/bangladesh-joint-assessment-mission-2012.html?query=bangladesh%20fact%20sheet."},{"key":"bibr80-1363461517705571","volume-title":"mhGAP Mental Health Gap Action Progamme: Scaling up care for mental, neurological, and substance abuse disorders","author":"World Health Organization (WHO)","year":"2010"},{"key":"bibr81-1363461517705571","volume-title":"Building back better: Sustainable mental health care after emergencies","author":"World Health Organization (WHO)","year":"2013"},{"key":"bibr82-1363461517705571","volume-title":"Guidelines for the management of conditions specifically related to stress","author":"World Health Organization (WHO)","year":"2013"},{"key":"bibr83-1363461517705571","unstructured":"World Health Organization (WHO). (2014).\n                      WHO Quality of Life-BREF (WHOQOL-BREF).\n                      Retrieved from http:\/\/www.who.int\/substance_abuse\/research_tools\/whoqolbref\/en\/."},{"key":"bibr84-1363461517705571","volume-title":"Assessing mental health and psychosocial needs and resources: Toolkit for major humanitarian settings","author":"World Health Organization (WHO), &amp; United Nations High Commissioner for Refugees (UNHCR)","year":"2012"}],"updated-by":[{"DOI":"10.1177\/1363461518795735","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T00:00:00Z","timestamp":1534896000000}}],"container-title":["Transcultural Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1363461517705571","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1363461517705571","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1363461517705571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T21:57:44Z","timestamp":1740866264000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1363461517705571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,25]]},"references-count":85,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1177\/1363461517705571"],"URL":"https:\/\/doi.org\/10.1177\/1363461517705571","relation":{},"ISSN":["1363-4615","1461-7471"],"issn-type":[{"value":"1363-4615","type":"print"},{"value":"1461-7471","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,25]]}}}