Transcribed in the nervous system: Semantic elements of trauma narratives are associated with anxiety symptoms in youth resettled as refugees

There are 43,400,000 refugees worldwide; half are children. To address this global public health crisis, there is a need to integrate refugee youth voices into the study of risk and resilience following forced migration. We aimed to disentangle linguistic elements of refugee youths' trauma narratives and identify biopsychosocial correlates of traumatic stress. Participants were 68 youth aged 7-17 years who resettled as refugees of Syria (M_age = 12.85) and provided trauma narratives while electrodermal activity (EDA) was recorded. A mixed-methods analytic approach combined narrative data analyzed using the Linguistic Inquiry and Word Count (LIWC) tool with psychophysiology and self-reported anxiety symptoms. In total, 61.8% of participants mentioned violence and loss in pre-resettlement narratives. Post-resettlement narratives frequently described discrimination and bullying in schools and neighborhoods. Exploratory LIWC analyses revealed social references and perception as the top semantic categories in narratives. Two-tailed Spearman correlations indicated a significant association between anxiety severity and social-related language, r = .40, and home-related language, r = .37, ps < .001. We also observed significant associations between social anxiety and space-related language, r = .36, p < .001, and baseline tonic EDA and death-related language frequency, r = -.38, p < .001. Effects did not survive correction for multiple comparisons. The design and preliminary data lay the groundwork for further understanding the qualitative stressors of youth pre- and post-resettlement but require replication in better-powered samples. Understanding the impact of civilian war trauma, forced displacement, and post-resettlement stress can inform intervention development, targeted treatment, and policy.