Healing after Genocide: A Cross-Sectional Study on Emotion-Focused Coping and Psychosocial Recovery among Yazidi Survivors

Background: A decade after the 2014 genocide, Yazidi survivors in Northern Iraq continue to face intersecting challenges of psychological distress, displacement, and inadequate access to care. While prior research has documented elevated symptom burdens, little is known about current coping preferences and structural risk factors in this population. This cross-sectional study investigates the relationships between emotion-focused coping strategies, psychotherapy access, structural vulnerabilities, and mental health symptoms among Yazidi survivors. Methods: A total of 346 Yazidi adults, both displaced and non-displaced, participated in structured interviews across various settings in the Kurdistan Region of Iraq. Participants completed validated measures of posttraumatic stress disorder, depression, and anxiety, and rated the perceived helpfulness of culturally relevant coping strategies. Statistical analyses included group comparisons, repeated-measures analysis of variance, and correlational analyses. Results: Only 36.4% of participants had any contact with mental health services, with psychotherapy rated as one of the least helpful strategies. Spiritual and internal coping mechanisms—such as prayer and belief in personal or collective strength—were perceived as most helpful. Psychotherapy use was higher among those with the greatest symptom burden. Structural vulnerability (camp residence, unstable income) significantly predicted elevated distress. Conclusion: Yazidi survivors rely primarily on culturally grounded coping strategies rooted in spirituality and community, while access to formal care remains limited and stratified. Psychosocial support must be integrated with structural assistance, justice mechanisms, and cultural traditions to foster sustainable recovery.