Syrian Refugees' Traumatic Experiences and Couple Intimacy

Background: The tragic Syrian war created a mass exodus of citizens to neighboring countries. Syrians seeking refuge have been exposed to atrocities and trauma beyond the comprehension of most. Human rights violations associated with political displacement have been recognized as traumatizing with significant consequences to the interpersonal relationships. This study examines impact on marital lives of the traumatic-experiences endured by Syrian refugees who fled to Jordanian host-communities.

Methods: The sample gathered between March and August 2014 included 158 structured interviews (conducted in Arabic) with married adult Syrian refugees seeking services from humanitarian organizations in Jordan. Refugees reported on their current circumstances and war-experiences while exiting Syria. Traumatic impacts were assessed using the Harvard Trauma Questionnaire (HTQ), Personal Assessment of Intimacy in Relationships (PAIR), and the Primary Care PTSD Screen (PC-PTSD). Group differences were evaluated with ANOVA, significance in two-tailed tests at the 0.05 level. Multiple regressions were used to determine the impact of PTSD on intimacy scores as well as on eight dimensions of intimacy—i.e. anger, conventional, emotional, intellectual, recreational, sexual, and social intimacy. This research was approved by the Department of Human Subjects of University of California, Berkeley, and only oral consent was required.

Findings:Interviewed refugees (N=158) were 47% males, 56% females; mean age 37. They were married M=15.5 years at the age of M=22; attained M=10.25 of education, had M=4.29 children, and lived in one household with M=6.26 members. 71% came to Jordan with their spouses. 85% described their economic status as low and very low.

94% of the refugees were exposed to war experiences. 43% screened positive on the PTSD scale. Overall intimacy scores were low, i.e. on average refugees neither agreed nor disagreed with positive assessments of their intimate relationships, scoring M= 2.4 (±1.1) of a possible five on average. Intimacy scores were lower for refugees who screened positive on the PTSD (M=1.95 (±65)) and PC-PTSD (M=2.01(±68)) compared to the ones screening negative, respectively (M=2.23 (±66)), (M=2.28, SD=0.61). Furthermore, the higher the PTSD symptoms reported, the lower the couples’ intimacy, whereas the higher the years of education and economic status, the higher the couples’ intimacy.

The regression analyses indicated that overall intimacy scores were associated with screening positive for PTSD even after controlling for gender, education, income, age, and the number of children in the household. Intimacy scores, age of marriage, attitudes towards mental illness and unmet needs of the participants (R² = .16, Adj. R² = .13; F= 4.36, df = 6,132, P<0.001). Considering each of the dimensions of intimacy after adjusting for the aforementioned control variables, PTSD seemed to have its significant negative impacts in four areas: conventional (b= -.39, p = .034), emotional (b= -.37, p = .055), recreational (b= -.35, p = .006), and sexual (b= -.34, p = .014) intimacy.

Interpretation: It is essential to better address the overwhelming impact of PTSD on Syrian refugees’ interpersonal relationships.

Funding: Mack Center on Mental Health and Social Conflict.