Examining primary and secondary effects of COVID-19 and PTSD in Syrian refugee adolescents in Turkey

Refugees have been identified as one group at the greatest risk of negative consequences of the COVID-19 pandemic. This exploratory study examined the primary and secondary effects of COVID-19 and posttraumatic stress disorder (PTSD) in 280 Syrian refugee adolescents (female = 124, 44.3%; male = 156, 55.7%) between the ages of 14-18 (M = 15.43, SD = +/- 1.11) with previous traumatic experiences living in Turkey. The hypotheses were: (H1) number of past traumatic experiences should be positively related to the severity of PTSD symptoms, (H2) primary and secondary COVID-19 effects should be positively related to the severity of PTSD symptoms, (H3) secondary COVID-19 effects should mediate the relationship between number of past traumatic experiences and the severity of PTSD symptoms, and (H4) number of past traumatic experiences should moderate the relationship between secondary COVID-19 effects and the severity of PTSD symptoms. The results of the study indicated that the number of previous traumatic events had an effect on the severity of PTSD. The majority of participants experienced more secondary effects than primary effects of COVID-19. Most of the secondary effects (e.g., socioeconomic stressors) of COVID-19 were related to PTSD. However, only some of the primary effects of COVID-19 (e.g., COVID-19 illness in adolescents and their family members, short-term separation from family) were related to PTSD. In addition, H3 (mediation) was confirmed and supported stress proliferation theory, but H4 (moderation) was not confirmed and did not support stress sensitization theory. In conclusion, it is important to support both socioeconomic and trauma-based interventions for refugees post-migration to reduce their socioeconomic difficulties and the likelihood that they will develop PTSD.