Attachment, emotion regulation, and their roles in refugee post-traumatic stress and post-migration living difficulties

Background: Upon arrival in the host country, refugees and asylum seekers (RAS) experience a range of post-migration living difficulties (PMLD), which are often linked to psychological symptoms such as post-traumatic stress (PTS). Initial research suggests that attachment insecurity partly explains the association between PMLD and psychological symptoms in RAS. However, the mechanisms through which attachment insecurity may act as a mediator are not well understood, though emotion dysregulation is one of the potential candidates.Objectives: This study investigated (1) whether attachment insecurity (i.e. anxiety and avoidance) mediate the association between PMLD and PTS, and (2) whether this mediation model can be extended to emotion dysregulation.Methods: 134 treatment-seeking RAS living in Switzerland completed questionnaires assessing PMLD, attachment insecurity, emotion dysregulation, and PTS. Two models were tested: (1) a parallel mediation analysis with attachment anxiety and avoidance as mediators, and (2) a serial mediation analysis with attachment anxiety as the first and emotion dysregulation as the second mediator.Results: First, PMLD was indirectly associated with PTS through attachment anxiety but not avoidance. Second, the association between PMLD and PTS was further explained by a pathway through attachment anxiety and emotion dysregulation.Conclusions: Although this study is limited by its cross-sectional design, we identified attachment anxiety and emotion dysregulation as potential mechanisms explaining how PMLD affects symptoms of PTS in RAS. Systematically assessing attachment style and addressing emotion regulation may therefore help improve treatment of refugee and asylum-seeking patients. Attachment anxiety but not avoidance mediated the relationship between post-migration living difficulties and post-traumatic stress through emotion dysregulation in treatment-seeking refugees and asylum seekers.Attachment and emotion regulation are important psychological processes to consider when studying refugee mental health.Systematically assessing attachment style and addressing emotion regulation may help improve treatment of refugee and asylum-seeking patients. Antecedentes: A su llegada al pa & iacute;s de acogida, los refugiados y solicitantes de asilo (RAS por sus siglas en ingl & eacute;s) experimentan una serie de dificultades en la vida posterior a la migraci & oacute;n (PMLD por sus siglas en ingles), que a menudo est & aacute;n relacionadas con s & iacute;ntomas psicol & oacute;gicos como el estr & eacute;s postraum & aacute;tico (PTS por sus siglas en ingles). Las primeras investigaciones sugieren que el apego inseguro explica en parte la asociaci & oacute;n entre PMLD y s & iacute;ntomas psicol & oacute;gicos en los RAS. Sin embargo, no se conocen bien los mecanismos a trav & eacute;s de los cuales el apego inseguro puede actuar como mediador, aunque la desregulaci & oacute;n de las emociones es uno de los posibles candidatos.Objetivos: Este estudio investig & oacute; (1) si el apego inseguro (es decir, la ansiedad y la evitaci & oacute;n) median la asociaci & oacute;n entre el PMLD y el PTS, y (2) si este modelo de mediaci & oacute;n puede extenderse a la desregulaci & oacute;n emocional.M & eacute;todos: 134 RAS que buscaban tratamiento y que viv & iacute;an en Suiza completaron cuestionarios que evaluaban el PMLD, el apego inseguro, desregulaci & oacute;n emocional y el PTS. Se probaron dos modelos: (1) un an & aacute;lisis de mediaci & oacute;n paralelo con apego ansioso y evitativo como mediadores, y (2) un an & aacute;lisis de mediaci & oacute;n en serie con apego ansioso como primer mediador y desregulaci & oacute;n emocional como segundo mediador.Resultados: En primer lugar, PMLD se asoci & oacute; indirectamente con PTS a trav & eacute;s de del apego ansioso, pero no evitativo. En segundo lugar, la asociaci & oacute;n entre PMLD y PTS se explic & oacute; adem & aacute;s por una v & iacute;a a trav & eacute;s del apego ansioso y la desregulaci & oacute;n emocional.Conclusiones: Aunque este estudio est & aacute; limitado por su dise & ntilde;o transversal, identificamos el apego ansioso y la desregulaci & oacute;n emocional como mecanismos potenciales que explican c & oacute;mo el PMLD afecta los s & iacute;ntomas de PTS en RAS. Por lo tanto, evaluar sistem & aacute;ticamente el estilo de apego y abordar la regulaci & oacute;n emocional puede ayudar a mejorar el tratamiento de los pacientes refugiados y solicitantes de asilo.