Social devaluation and mental health among refugees in the Middle East

<b>Background:</b> Refugees who have experienced war and persecution often suffer from psychological disorders resulting from adverse events and living conditions. Current theories of traumatic stress focus on processes resulting from threats to physical integrity, with little consideration of social stressors.<b>Objectives:</b> In this study, we proposed that perceptions of social devaluation, which include specific emotions, appraisals, physiological responses, and behavioural impulses associated with devaluation, partially mediate the relationship between stress and psychological symptoms in refugees.<b>Methods:</b> We measured social devaluation in a survey of 511 Syrian refugees living in the Kurdistan region of Iraq, and related it to social and physical stressors and symptoms of depression and post-traumatic stress.<b>Results:</b> Using structural equation modelling, we confirmed the proposed mediating role of social devaluation in the relationship between social and traumatic stressors and symptoms of posttraumatic stress and depression.<b>Conclusions:</b> This study suggests that populations experiencing high levels of adversity may develop psychopathology not only due to psychological trauma caused by physical threats, but also due to processes of social traumatisation involving perceptions of devaluation.