Cluster analysis of prolonged grief, posttraumatic stress, and depression symptoms in bereaved asylum seekers and refugees

Background: Refugees and asylum seekers (ASRs) are frequently exposed to loss in addition to a variety of other stressors and often display high levels of various psychological symptoms.Objective: The study aimed to primarily determine clusters of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression symptoms in bereaved ASRs and secondly identify predictors of cluster membership. Sociodemographic - and flight-related variables were investigated in exploratory analyses.Method: ASRs in Germany (N = 92) with interpersonal loss exposure, i.e. at least one missing or deceased relative or friend, were assessed with interview-based questionnaires for PGD, PTSD, and depressive symptoms. We used k-means cluster analysis to distinguish symptom profiles and logistic regression analyses to identify predictors of cluster membership.Results: We found a three-cluster-solution. The PGD-cluster (30%) was characterised predominantly by PGD symptoms, while the PGD/PTSD-cluster (32%) had high PGD and PTSD and moderate depressive symptoms. The resilient cluster (38%) showed low symptoms overall. insecure residence status predicted membership in the PGD and PGD/PTSD clusters relative to the resilient cluster, whilst higher attachment anxiety predicted membership in the PGD/PTSD cluster relative to the other clusters. Explorative analysis revealed duration of stay as a significant predictor.Conclusion: Findings can extend the current knowledge about different symptom profiles among bereaved ASRs in Europe. Insights to attachment - and migration-related variables distinguishing between these profiles offer starting points for interventions. Bereaved asylum seekers and refugees in Germany can be grouped into three symptom clusters: (1) predominantly prolonged grief, (2) high prolonged grief, high posttraumatic stress, and moderate depressive symptoms, and (3) low symptom load.Attachment - and migration-related variables (i.e. residence status, duration of stay, and attachment anxiety) distinguish between cluster membership.Results highlight the importance of attending to profiles and not only single categories of symptoms and attachment features in bereaved asylum seekers and refugees. Antecedentes: Los refugiados y solicitantes de asilo (ASRs) est & aacute;n frecuentemente expuestos a la p & eacute;rdida, adem & aacute;s de una variedad de otros factores estresantes, y a menudo muestran altos niveles de diversos s & iacute;ntomas psicol & oacute;gicos.Objetivo: El estudio tiene como objetivo principal determinar los grupos de s & iacute;ntomas del trastorno de duelo prolongado (PGD por sus siglas en ingles), trastorno de estr & eacute;s postraum & aacute;tico (TEPT) y depresi & oacute;n en ASRs en duelo, y secundariamente identificar los predictores de pertenencia a cada grupo. Las variables sociodemogr & aacute;ficas y relacionadas con el vuelo fueron investigadas en an & aacute;lisis exploratorios.M & eacute;todo: Se evaluaron a los ASRs en Alemania (N = 92) con exposici & oacute;n a la p & eacute;rdida interpersonal, es decir, al menos un familiar o amigo desaparecido o fallecido, mediante cuestionarios basados en entrevistas para los s & iacute;ntomas de PGD, TEPT y depresi & oacute;n. Utilizamos an & aacute;lisis de agrupamiento k-media para distinguir perfiles de s & iacute;ntomas y an & aacute;lisis de regresi & oacute;n log & iacute;stica para identificar predictores de la pertenencia a los grupos.Resultados: Encontramos una soluci & oacute;n de tres grupos. El grupo de PGD (30%) se caracteriz & oacute; predominantemente por s & iacute;ntomas de PGD, mientras que el grupo de PGD/TEPT (32%) ten & iacute;a altos s & iacute;ntomas de PGD y TEPT y s & iacute;ntomas depresivos moderados. El grupo resiliente (38%) mostr & oacute; bajos s & iacute;ntomas en general. El estado de residencia insegura predijo la pertenencia a los grupos de PGD y PGD/TEPT en comparaci & oacute;n con el grupo resiliente, mientras que un mayor apego ansioso predijo la pertenencia al grupo de PGD/TEPT en comparaci & oacute;n con los otros grupos. El an & aacute;lisis exploratorio revel & oacute; que la duraci & oacute;n de la permanencia fue un predictor significativo.Conclusi & oacute;n: Los hallazgos pueden ampliar el conocimiento actual sobre los diferentes perfiles de s & iacute;ntomas entre los ASRs en duelo en Europa. Los conocimientos sobre las variables relacionadas con el apego y la migraci & oacute;n que se distinguen entre estos perfiles ofrecen puntos de partida para intervenciones.