Abstracts
Abstract
This study explores the experiences of 70 Tibetan refugees in India (28 male, 42 female; mean age = 30.90 years; SD = 8.11) during the COVID-19 pandemic in terms of their stress, financial anxiety, perceived discrimination, dark future expectations, and resilience. Older, married, and working refugees experienced more problems but higher resilience. Female refugees reported more nervousness and stress than male refugees. Financial anxiety and dark future expectations predicted higher stress. Overall, the findings show low to moderate levels of mental health issues and high resilience among Tibetan refugees during the pandemic and highlight the importance of cultural beliefs and practices in maintaining good mental health and resilience.
Keywords:
- refugee,
- perceived stress,
- resilience,
- COVID-19,
- Tibetan
Résumé
Cette étude explore les expériences de 70 réfugié.es tibétain.es en Inde (28 hommes, 42 âge moyen = 30.90 écart-type = 8.11) pendant la pandémie de en ce qui concerne leur stress, leur anxiété financière, leur discrimination perçue, leurs attentes sombres par rapport à l’avenir et leur résilience. Les réfugié.es plus âgé.es, marié.es et occupant un emploi ont rencontré davantage de problèmes mais une plus grande résilience. Les femmes réfugiées ont signalé plus de nervosité et de stress que les hommes réfugiés. L’anxiété financière et les attentes sombres par rapport à l’avenir prédisaient un niveau de stress plus élevé. Dans l’ensemble, les résultats montrent des niveaux faibles à modérés de problèmes de santé mentale et une grande résilience chez les réfugié.es tibétain.es pendant la pandémie et soulignent l’importance des croyances et pratiques culturelles dans le maintien d’une bonne santé mentale et de la résilience.
Appendices
Bibliography
- Afridi, F., Dhillon, A., & Roy, S. (2021). The gendered crisis: Livelihoods and mental well-being in India during COVID-19 (WIDER Working Paper 65/2021). World Institute for Development Economic Research (UNU-WIDER). https://doi.org/10.35188/UNU-WIDER/2021/003-0
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). American Psychiatric Publishing, Inc.
- American Psychiatric Association. (2006, February 23). Stress weakens the immune system. https://www.apa.org/research/action/immune
- American Psychological Association. (2012, January 1). Building your resilience. https://www.apa.org/topics/resilience#
- Annis, R., Gibson, R., & Berry, J. W. (2010, October). Intercultural relations in a rural Canadian prairie city [Paper presentation]. Mi/Más Konferencia, Eger, Hungary. https://www.brandonu.ca/rdi/publication/intercultural-relations-in-a-rural-canadian-prairie-city/
- Archuleta, K. L., Dale, A., & Spann, S. M. (2013). College students and financial distress: Exploring debt, financial satisfaction, and financial anxiety. Journal of Financial Counseling and Planning, 24(2), 50–62. http://hdl.handle.net/2097/17281
- Artiles, C. (2011). Tibetan refugees’ rights and services in India. Human Rights & Human Welfare Working Papers. https://www.academia.edu/40688593/Tibetan_Refugees_Rights_and_Services_in_India
- Baker, A., & Shalhoub-Kevorkian, N. (1999). Effects of political and military traumas on children: The Palestinian case. Clinical Psychology Review, 19(8), 935–950. https://doi.org/10.1016/S0272-7358(99)00004-5
- Barbosa‐Leiker, C., Kostick, M., Lei, M., McPherson, S., Roper, V., Hoekstra, T., & Wright, B. (2013). Measurement invariance of the perceived stress scale and latent mean differences across gender and time. Stress and Health, 29(3), 253–260. https://doi.org/10.1002/smi.2463
- Bean, T. M., Eurelings-Bontekoe, E., & Spinhoven, P. (2007). Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: One year follow-up. Social Science & Medicine, 64(6), 1204–1215. https://doi.org/10.1016/j.socscimed.2006.11.010
- Bearak, M. (2016, June 1). Dalai Lama says there are “too many refugees in Europe.” Independent. https://www.independent.co.uk/news/people/dalai-lama-says-too-many-refugees-europe-a7058911.html
- Ben-Kane, Y. (2015). Perceived discrimination, identity and outgroup attitudes among Russian-speaking immigrants living in Finland [Unpublished master’s thesis]. University of Helsinki, Finland. https://helda.helsinki.fi/handle/10138/155269
- Bernstorff, D., & von Welck, H. (Eds.). (2003). Exile as challenge: The Tibetan diaspora. Orient Blackswan.
- Cairney, J., Boyle, M., Offord, D. R., & Racine, Y. (2003). Stress, social support and depression in single and married mothers. Social Psychiatry and Psychiatric Epidemiology, 38(8), 442–449. https://doi.org/10.1007/s00127-003-0661-0
- Central Tibetan Administration. (2021). Chatrel background. https://tibet.net/support-tibet/pay-green-book/
- Chatterjee, S. S., Malathesh Barikar, C., & Mukherjee, A. (2020). Impact of COVID-19 pandemic on pre-existing mental health problems. Asian Journal of Psychiatry, 51, Article 102071. https://doi.org/10.1016/j.ajp.2020.102071
- Choedon, Y. (2018, February 23). The unintended consequences of India’s policy on citizenship for Tibetan refugees. Manohar Parrikar Institute for Defence Studies and Analyses. https://idsa.in/policybrief/unintended-consequences-of-india-policy-on-citizenship-for-tibetan-refugees-ychoedon-230218
- Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp. (Eds.), The social psychology of health (pp. 31–67). Sage Publications.
- Crescenzi, A., Ketzer, E., Van Ommeren, M., Phuntsok, K., Komproe, I., & de Jong, J. T. (2002). Effect of political imprisonment and trauma history on recent Tibetan refugees in India. Journal of Traumatic Stress, 15(5), 369–375. https://doi.org/10.1023/A:1020129107279
- Cullen, W., Gulati, G., & Kelly, B. D. (2020). Mental health in the COVID-19 pandemic. QJM: An International Journal of Medicine, 113(5), 311–312. https://doi.org/10.1093/qjmed/hcaa110
- De Jong, J. (Ed.). (2006). Trauma, war, and violence: Public mental health in socio-cultural context. Springer Science & Business Media.
- Dixit, R. (2020, March 28). Northeast people battle racism amid coronavirus pandemic. The Week. https://www.theweek.in/news/india/2020/03/28/coronavirus-pandemic-fuels-racism-against-northeast-people.html
- Evans, D., Buxton, D. C., Borisov, A., Manatunga, A. K., Ngodup, D., & Raison, C. L. (2008). Shattered Shangri-la: Differences in depressive and anxiety symptoms in students born in Tibet compared to Tibetan students born in exile. Social Psychiatry and Psychiatric Epidemiology, 43(6), 429–436. https://doi.org/10.1007/s00127-008-0346-9
- Fazel, M. K., & Young, D. M. (1988). Life quality of Tibetans and Hindus: A function of religion. Journal for the Scientific Study of Religion, 229–242. https://doi.org/10.2307/1386717
- Finnerty, R., Marshall, S. A., Imbault, C., & Trainor, L. J. (2021). Extra-curricular activities and well-being: Results from a survey of undergraduate university students during COVID-19 lockdown restrictions. Frontiers in Psychology, 12, Article 647402. https://doi.org/10.3389/fpsyg.2021.647402
- Gao, J., Zheng, P., Jia, Y., Chen, H., Mao, Y., Chen, S., Wang, Y., Fu, H., & Dai, J. (2020). Mental health problems and social media exposure during COVID-19 outbreak. PLoS One, 15(4), Article e0231924. https://doi.org/10.1371/journal.pone.0231924
- Gao, X., Ren, Y., & Umar, M. (2021). To what extent does COVID-19 drive stock market volatility? A comparison between the U.S. and China. Economic Research-Ekonomska Istraživanja. Advance online publication. https://doi.org/10.1080/1331677X.2021.1906730
- Gooding, P. A., Hurst, A., Johnson, J., & Tarrier, N. (2012). Psychological resilience in young and older adults. International Journal of Geriatric Psychiatry, 27(3), 262–270. https://doi.org/10.1002/gps.2712
- Grupe, D. W., & Nitschke, J. B. (2013). Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective. Nature Reviews Neuroscience, 14(7), 488–501. https://doi.org/10.1038/nrn3524
- Hermansson, A. C., Timpka, T., & Thyberg, M. (2002). The mental health of war-wounded refugees: An 8-year follow-up. The Journal of Nervous and Mental Disease, 190(6), 374–380. https://doi.org/10.1097/00005053-200206000-00005
- Hsu, E., Davies, C. A., & Hansen, D. J. (2004). Understanding mental health needs of Southeast Asian refugees: Historical, cultural, and contextual challenges. Clinical Psychology Review, 24(2), 193–213. https://doi.org/10.1016/j.cpr.2003.10.003
- Hussain, D., & Bhushan, B. (2011). Cultural factors promoting coping among Tibetan refugees: A qualitative investigation. Mental Health, Religion & Culture, 14(6), 575–587. https://doi.org/10.1080/13674676.2010.497131
- Jackson, P. R., Stafford, E. M., Banks, M. H., & Warr, P. B. (1983). Unemployment and psychological distress in young people: The moderating role of employment commitment. Journal of Applied Psychology, 68(3), 525–535. https://doi.org/10.1037/0021-9010.68.3.525
- Jeste, D. V., Savla, G. N., Thompson, W. K., Vahia, I. V., Glorioso, D. K., Martin, A. V. S., Palmer, B. W., Rock, D., Golshan, S., Kraemer, H. C., & Depp, C. A. (2013). Association between older age and more successful aging: Critical role of resilience and depression. American Journal of Psychiatry, 170(2), 188–196. https://doi.org/10.1176/appi.ajp.2012.12030386
- Ji, D., Ji, Y.J., Duan, X.-Z., Li,-W. G., Sun, Z.-Q., Song, X.-A., Meng, Y.-H., Tang, H.-M., Chu, F., Niu, X.-X., Chen, G.-F., Li, J., & Duan, H.-J. (2017). Prevalence of psychological symptoms among Ebola survivors and healthcare workers during the 2014–2015 Ebola outbreak in Sierra Leone: A cross-sectional study. Oncotarget, 8(8), 12784–12791. https://doi.org/10.18632/oncotarget.14498
- Kadner, K. D. (1989). Resilience: Responding to adversity. Journal of Psychosocial Nursing and Mental Health Services, 27(7), 20–25. https://doi.org/10.3928/0279-3695-19890701-11
- Ketzer, E., & Crescenzi, A. (2002). Addressing the psychosocial and mental health needs of Tibetan refugees in India. In J. De Jong (Ed.), Trauma, war, and violence: Public mental health in socio-cultural context (pp. 283–315). Springer.
- Kinzie, J. D., Boehnlein, J. K., Leung, P. K., Moore, L. J., Riley, C., & Smith, D. (1990). The prevalence of posttraumatic stress disorder and its clinical significance among Southeast Asian refugees. The American Journal of Psychiatry, 147(7), 913–917. https://doi.org/10.1176/ajp.147.7.913
- Kokko, K., & Pulkkinen, L. (1998). Unemployment and psychological distress: Mediator effects. Journal of Adult Development, 5(4), 205–217. https://doi.org/10.1023/A:1021450208639
- Lewis, S. E. (2013). Trauma and the making of flexible minds in the Tibetan exile community. Ethos, 41(3), 313–336. https://doi.org/10.1111/etho.12024
- Lhewa, D., Banu, S., Rosenfeld, B., & Keller, A. (2007). Validation of a Tibetan translation of the Hopkins Symptom Checklist–25 and the Harvard Trauma Questionnaire. Assessment, 14(3), 223–230. https://doi.org/10.1177/1073191106298876
- Mahmoudi, K. M. (1992). Refugee cross-cultural adjustment: Tibetans in India. International Journal of Intercultural Relations, 16, 17–32. https://doi.org/10.1016/0147-1767(92)90003-D
- Marshall, G. N., Schell, T. L., Elliott, M. N., Berthold, S. M., & Chun, C. A. (2005). Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA, 294(5), 571–579. https://doi.org/10.1001/jama.294.5.571
- Mills, E. J., Singh, S., Holtz, T. H., Chase, R. M., Dolma, S., Santa-Barbara, J., & Orbinski, J. J. (2005). Prevalence of mental disorders and torture among Tibetan refugees: A systematic review. BMC International Health and Human Rights, 5(1), Article 7. https://doi.org/10.1186/1472-698X-5-7
- Mohindra, R., R, R.., Suri, V., Bhalla, A., & Singh, S. M. (2020). Issues relevant to mental health promotion in frontline health care providers managing quarantined/isolated COVID19 patients. Asian Journal of Psychiatry, 51, Article 102084. https://doi.org/10.1016/j.ajp.2020.102084
- Mollica, R. F., Wyshak, G., de Marneffe, D., Khuon, F., & Lavelle, J. (1987). Indochinese versions of the Hopkins Symptom Checklist–25: A screening instrument for the psychiatric care of refugees. The American Journal of Psychiatry, 144(4), 497–500. https://doi.org/10.1176/ajp.144.4.497
- Mukherjee, M. (2020, September). The pandemic and the Tibetan students. Seminar Magazine. https://www.india-seminar.com/2020/733/733_mousumi_mukherjee.htm
- Norbu, D. (2001). China’s Tibet policy. Routledge. https://doi.org/10.4324/9780203826959
- Pieh, C., O’Rourke, T., Budimir, S., & Probst, T. (2020). Relationship quality and mental health during COVID-19 lockdown. PLoS One, 15(9), Article e0238906. https://doi.org/10.1371/journal.pone.0238906
- Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. General Psychiatry, 33(2), Article e100213. https://doi.org/10.1136/gpsych-2020-100213
- Rehman, U., Shahnawaz, M. G., Khan, N. H., Kharshiing, K. D., Khursheed, M., Gupta, K., Kashyap, D., & Uniyal, R. (2021). Depression, anxiety and stress among Indians in times of COVID-19 lockdown. Community Mental Health Journal, 57, 42–48. https://doi.org/10.1007/s10597-020-00664-x
- Rosen, J. B., & Schulkin, J. (1998). From normal fear to pathological anxiety. Psychological Review, 105(2), 325–350. https://doi.org/10.1037/0033-295X.105.2.325
- Ruwanpura, E., Mercer, S. W., Ager, A., & Duveen, G. (2006). Cultural and spiritual constructions of mental distress and associated coping mechanisms of Tibetans in exile: Implications for Western interventions. Journal of Refugee Studies, 19(2), 187–202. https://doi.org/10.1093/jrs/fej018
- Sachs, E., Rosenfeld, B., Lhewa, D., Rasmussen, A., & Keller, A. (2008). Entering exile: Trauma, mental health, and coping among Tibetan refugees arriving in Dharamsala, India. Journal of Traumatic Stress, 21(2), 199–208. https://doi.org/10.1002/jts.20324
- Schmitz, P. G., & Schmitz, F. (2012). Emotional intelligence and acculturation. Behavioral Psychology, 20(1), 15–41. https://www.behavioralpsycho.com/product/emotional-intelligence-and-acculturation/?lang=en
- Servan-Schreiber, D., Le Lin, B., & Birmaher, B. (1998). Prevalence of posttraumatic stress disorder and major depressive disorder in Tibetan refugee children. Journal of the American Academy of Child & Adolescent Psychiatry, 37(8), 874–879. https://doi.org/10.1097/00004583-199808000-00018
- Shukla, M., Pandey, R., Singh, T., Riddleston, L., Hutchinson, T., Kumari, V., & Lau, J. Y. F. (2021). The effect of COVID-19 and related lockdown phases on young peoples’ worries and emotions: Novel data from India. Frontiers in Public Health, 9, Article 645183. https://doi.org/10.3389/fpubh.2021.645183
- Silove, D. (2004). Mental health problems in migrants and refugees. Australian Doctor, 14, 31–38.
- Singh, V. (2021, April 12). Northeast citizens faced racial discrimination amid COVID-19 outbreak, says govt. study. The Hindu. https://www.thehindu.com/news/national/other-states/northeast-citizens-faced-racial-discrimination-amid-covid-19-outbreak-says-govt-study/article34303162.ece
- Siqueira Reis, R., Ferreira Hino, A. A., & Romélio Rodriguez Añez, C. (2010). Perceived stress scale: Reliability and validity study in Brazil. Journal of Health Psychology, 15(1), 107–114. https://doi.org/10.1177/1359105309346343
- Siriwardhana, C., & Stewart, R. (2013). Forced migration and mental health: Prolonged internal displacement, return migration and resilience. International Health, 5(1), 19–23. https://doi.org/10.1093/inthealth/ihs014
- Smith, L. (2021, April 9). Why it’s normal to feel anxious about a post-COVID future. Patient. https://patient.info/news-and-features/why-its-normal-to-feel-anxious-about-a-post-covid-future
- Terheggen, M. A., Stroebe, M. S., & Kleber, R. J. (2001). Western conceptualizations and Eastern experience: A cross-cultural study of traumatic stress reactions among Tibetan refugees in India. Journal of Traumatic Stress, 14(2), 391–403. https://doi.org/10.1023/A:1011177204593
- The Tribune India. (2020, April 6). Anxiety over COVID-19 leads to Phagwara woman’s suicide. https://www.tribuneindia.com/news/punjab/anxiety-over-covid-19-leads-to-phagwara-womans-suicide-66466
- Torales, J., O’Higgins, M., Castaldelli-Maia, J. M., & Ventriglio, A. (2020). The outbreak of COVID-19 coronavirus and its impact on global mental health. International Journal of Social Psychiatry, 66(4), 317–320. https://doi.org/10.1177/0020764020915212
- Tribune News Service. (2020, May 18). Centre extends nationwide lockdown till May 31, new guidelines issued. The Tribune India. https://www.tribuneindia.com/news/nation/centre-extends-nationwide-lockdown-till-may-31-new-guidelines-issued-86042
- van de Weem-de Jong, M. (2004). A therapeutic training course for traumatised adolescent refugees. Intervention, 2(3), 226–230. https://www.interventionjournal.com/sites/default/files/226_230_Weem.pdf
- Vos, A., Weber, K., Jayasinghe, D., Post, L., Wilson, K., Mehta Dhawan, S., & Zademach, H. M. (2020, November 25). COVID-19 and refugees’ economic opportunities, financial services and digital inclusion. International Rescue Committee. https://reliefweb.int/sites/reliefweb.int/files/resources/improvingfinancialhealth-r3.pdf
- Wagnild, G. (2009). A review of the Resilience Scale. Journal of Nursing Measurement, 17(2), 105–113. https://doi.org/10.1891/1061-3749.17.2.105
- Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1(2), 165–178.
- Walen, H. R., & Lachman, M. E. (2000). Social support and strain from partner, family, and friends: Costs and benefits for men and women in adulthood. Journal of Social and Personal Relationships, 17(1), 5–30. https://doi.org/10.1177/0265407500171001
- Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), Article 1729. https://doi.org/10.3390/ijerph17051729
- Wang, H., Xia, Q., Xiong, Z., Li, Z., Xiang, W., Yuan, Y., Liu, Y., & Li, Z. (2020). The psychological distress and coping styles in the early stages of the 2019 Coronavirus Disease (COVID-19) epidemic in the general mainland Chinese population: A web-based survey. PLoS One, 15(5), Article e0233410. https://doi.org/10.1371/journal.pone.0233410
- Weine, S. M., Razzano, L., Brkic, N., Ramic, A., Miller, K., Smajkic, A., Bijedic, Z., Boskailo, E., Mermelstein, R., & Pavkovic, I. (2000). Profiling the trauma related symptoms of Bosnian refugees who have not sought mental health services. The Journal of Nervous and Mental Disease, 188(7), 416–421. https://doi.org/10.1097/00005053-200007000-00004
- World Health Organization. (2020, January 30). WHO Director-General’s statement on IHR Emergency Committee on Novel Coronavirus (2019-nCoV). https://www.who.int/director-general/speeches/detail/who-director-general-s-statement-on-ihr-emergency-committee-on-novel-coronavirus-(2019-ncov)
- Worldometers. (2020). COVID-19 coronavirus pandemic. https://www.worldometers.info/coronavirus/
- Wu, S. M., & Amtmann, D. (2013). Psychometric evaluation of the perceived stress scale in multiple sclerosis. International Scholarly Research Notices, 2013, Article 608356. https://doi.org/10.1155/2013/608356
- Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020). The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical Science Monitor, 26, Article e923549. https://doi.org/10.12659/MSM.923549
- Yu, H., Li, M., Li, Z., Xiang, W., Yuan, Y., Liu, Y., Li, Z., & Xiong, Z. (2020). Coping style, social support and psychological distress in the general Chinese population in the early stages of the COVID-19 epidemic. BMC Psychiatry, 20(1), 1–11. https://doi.org/10.1186/s12888-020-02826-3
- Zaleski, Z. (1996). Future anxiety: Concept, measurement, and preliminary research. Personality and Individual Differences, 21(2), 165–174. https://doi.org/10.1016/0191-8869(96)00070-0
- Zaleski, Z., Sobol-Kwapinska, M., Przepiorka, A., & Meisner, M. (2019). Development and validation of the Dark Future Scale. Time & Society, 28(1), 107–123. https://doi.org/10.1177/0961463X16678257