Longitudinal Associations Between Sources of Uncertainty and Mental Health Amongst Resettled Refugees During the COVID-19 Pandemic

Belinda J. Liddell (), Stephanie Murphy, Yulisha Byrow, Meaghan O’Donnell, Vicki Mau, Tadgh McMahon, Richard A. Bryant, Philippa Specker and Angela Nickerson
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Belinda J. Liddell: School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
Stephanie Murphy: School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
Yulisha Byrow: School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
Meaghan O’Donnell: Phoenix Australia, University of Melbourne, Carlton, VIC 3053, Australia
Vicki Mau: Australian Red Cross, Docklands, VIC 3008, Australia
Tadgh McMahon: Settlement Services International (SSI), Ashfield and College of Public Health and Medicine, Flinders University, Bedford Park, SA 5042, Australia
Richard A. Bryant: School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
Philippa Specker: School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
Angela Nickerson: School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia

IJERPH, 2025, vol. 22, issue 6, 1-18

Abstract: The COVID-19 pandemic may have disproportionately affected forcibly displaced people due to parallel uncertainties such as visa insecurity and family separation. This study explicitly examined whether different sources of uncertainty contributed in specific ways to increased psychological symptoms for refugees during the pandemic. A large cohort of 733 refugees and asylum seekers settled in Australia completed a mental health survey in June 2020 (T1) and 12 months later in June 2021 (T2). Using cross-lagged panel modelling, we tested changes in post-traumatic stress (PTS), depression and anxiety symptoms, visa status, family separation and COVID-19 uncertainty stress, and the contribution of intolerance of uncertainty (trait prospective and inhibitory), controlling for age, sex, trauma exposure, language, and time in Australia. Visa status and family separation stress at T1 predicted increased depression (bidirectional pathways) and PTS symptoms at T2 (unidirectional pathways), respectively. Visa status uncertainty at T1 was also associated with increases in COVID-19 and family separation stress at T2. Intolerance of uncertainty showed limited associations with symptoms and stressors. Findings demonstrate that different forms of refugee uncertainty had specific impacts on psychopathology during the first year of the COVID-19 pandemic. Refugees facing diverse kinds of stress may benefit from individual, community, and policy level support targeted to their specific circumstances and mental health needs during future crises.

Keywords: refugee; COVID-19; trauma; PTSD; depression; intolerance of uncertainty; family separation; visa insecurity; longitudinal (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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