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Background: War and forced migration expose refugees to trauma and ongoing stress, often contributing to long-term psychological consequences. Typically, trauma exposure is assessed cumulatively; yet, trauma type may better predict psychological outcomes. This study examined the differential impact of cumulative trauma and trauma subtypes (victimization, death threat, accidental/injury) on postmigration trajectories of posttraumatic stress and anxiety in refugees., Method: Seventy-seven Syrian (88.3%) and Iraqi (9.1%) adult refugees self-reported prior trauma exposure and psychological symptoms at time of arrival in the United States and 2 years post. Linear mixed-effects modeling was performed to assess for associations between trauma variables and symptom trajectories. Models using cumulative trauma as a predictor were compared to models including the three trauma subtype variables as predictors, using pseudo- R ² values to compare variance explained between the two methods of trauma measurement., Results: Linear mixed-effects modeling indicated that prior exposure to victimization predicted progressively worsening posttraumatic stress disorder (PTSD) symptoms over time postmigration ( b = .97, SE = .45, t = 2.14, p = .036). Cumulative trauma also predicted increasing PTSD symptoms ( b = .124, SE = .06, t = 2.09, p = .041), but explained less variance than victimization (9% vs. 18.1%). Direct effects of cumulative trauma ( p = .009) and victimization ( p = .002) on anxiety severity emerged; however, anxiety symptoms did not change over time depending on prior trauma exposure. Accidents/injuries and death threats did not predict PTSD or anxiety., Conclusions: These findings can be leveraged toward focused identification of those at highest risk for progressive illness postmigration, thus providing empirical guidance for allocation of interventions and resources for refugees. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Trauma exposure-a contributor to psychological risk for refugee youth-is typically assessed using cumulative indices; however, recent findings indicate that trauma type may better predict psychological outcomes. This study investigated the utility of two methods of classifying trauma exposure-cumulative trauma and exposure to specific types of trauma (i.e., trauma subtypes)-in predicting the severity of symptoms related to posttraumatic stress disorder (PTSD) and anxiety for refugee youth., Method: 96 Syrian and Iraqi youth resettled as refugees in the United States self-reported trauma exposure and psychological symptoms. Multiple regression was used to assess the variance in symptom severity explained by specific trauma subtypes (i.e., victimization, death threat, and accidental/injury) as compared to cumulative trauma scores., Results: Multiple regression models predicting PTSD revealed cumulative trauma ( b = 0.07; p = .004) and death threat trauma ( b = 0.16; p = .001) as significant predictors of PTSD symptom severity; notably, death threat trauma was the only subtype associated with PTSD and explained more variance than cumulative trauma scores (10.3% and 8.4%, respectively). Cumulative trauma, but no specific trauma subtype, was associated with anxiety ( b = .03; p = .043); however, this relation did not survive correction for multiple comparisons., Conclusion: Focused trauma assessment-particularly consideration of death threat trauma and cumulative trauma exposures-may be useful in evaluating the risk of PTSD symptoms in refugee youth, whereas symptoms related to anxiety may be driven by other factors. These findings can be leveraged toward focused identification of youth at highest risk for PTSD symptoms, to improve prevention and early intervention efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).