TY - JOUR
T1 - Post-traumatic stress, social, and physical health
T2 - A mediation and moderation analysis of Syrian refugees and Jordanians in a border community
AU - Powell, Tara M.
AU - Shin, Oe Jin
AU - Li, Shang Ju
AU - Hsiao, Yuan
N1 - Publisher Copyright:
Copyright: © 2020 Powell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/10
Y1 - 2020/10
N2 - Objectives This study examined the mediating or moderating relationship of social health on physical health and post-traumatic stress symptoms among displaced Syrians and Jordanians at high risk for physical and mental health ailments. Frequency of mental health symptoms stratified by demographic factors was also explored. We hypothesized social health would mediate and/or moderate the relationship between physical and post-traumatic stress symptoms (PTSS). Methods This cross-sectional study includes 598 adults between 18 and 75 years old recruited from three health centers in the city of Irbid, Jordan, 20 km away from the Syrian border. Posttraumatic stress symptoms (PTSS) were measured through the primary care post-traumatic stress disorder checklist. Physical and social health were assessed through the Duke Health Profile. One-way ANOVA and independent samples T-tests examined mean scores of social health, PTSS, physical health stratified by age, gender, nationality, education level, and trauma exposure. Bivariate correlations explored the relationship between social health, PTSS, and physical health. PROCESS macro tested social health as a moderator and mediator on the association of the physical health and PTSS. Results Social health moderated and mediated the relationship between physical health and PTSS. Males reported (t = 2.53, p < .05) better physical health scores than females. Those who had less than a high school education reported lower social health (F = 13.83, p < .001); higher PTSS (F = 5.83, p < .001); and lower physical health (F = 5.76, p < .01) than more educated individuals. Syrians reported significantly higher PTSS (F = 4.13, p < .05) than Jordanians, however, there was no significant differences between nationality for physical or social health. Social health was positively associated with better physical health (r = 0.10, p < .01) and negatively with PTSS (r = -.293, p < .01). Conclusions Our results support our primary hypothesis suggesting social health mediates and moderates PTSS and physical health. Secondary findings illustrate gender, educational, and income differences in physical health and PTSS.
AB - Objectives This study examined the mediating or moderating relationship of social health on physical health and post-traumatic stress symptoms among displaced Syrians and Jordanians at high risk for physical and mental health ailments. Frequency of mental health symptoms stratified by demographic factors was also explored. We hypothesized social health would mediate and/or moderate the relationship between physical and post-traumatic stress symptoms (PTSS). Methods This cross-sectional study includes 598 adults between 18 and 75 years old recruited from three health centers in the city of Irbid, Jordan, 20 km away from the Syrian border. Posttraumatic stress symptoms (PTSS) were measured through the primary care post-traumatic stress disorder checklist. Physical and social health were assessed through the Duke Health Profile. One-way ANOVA and independent samples T-tests examined mean scores of social health, PTSS, physical health stratified by age, gender, nationality, education level, and trauma exposure. Bivariate correlations explored the relationship between social health, PTSS, and physical health. PROCESS macro tested social health as a moderator and mediator on the association of the physical health and PTSS. Results Social health moderated and mediated the relationship between physical health and PTSS. Males reported (t = 2.53, p < .05) better physical health scores than females. Those who had less than a high school education reported lower social health (F = 13.83, p < .001); higher PTSS (F = 5.83, p < .001); and lower physical health (F = 5.76, p < .01) than more educated individuals. Syrians reported significantly higher PTSS (F = 4.13, p < .05) than Jordanians, however, there was no significant differences between nationality for physical or social health. Social health was positively associated with better physical health (r = 0.10, p < .01) and negatively with PTSS (r = -.293, p < .01). Conclusions Our results support our primary hypothesis suggesting social health mediates and moderates PTSS and physical health. Secondary findings illustrate gender, educational, and income differences in physical health and PTSS.
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U2 - 10.1371/journal.pone.0241036
DO - 10.1371/journal.pone.0241036
M3 - Article
C2 - 33095832
AN - SCOPUS:85094584497
SN - 1932-6203
VL - 15
JO - PloS one
JF - PloS one
IS - 10 October
M1 - e0241036
ER -