THE SILENT STRUGGLE: THE IMPACT OF POST-TRAUMATIC STRESS DISORDER (PTSD) ON THE SOCIAL INTEGRATION OF LEBANESE REFUGEES IN DANISH SOCIETY
Keywords:
PTSD, social integration, Lebanese refugees, Denmark, Ager and Strang framework, structural factors, language acquisition, social networks, refugee mental health, qualitative researchAbstract
This study examines how Post-Traumatic Stress Disorder (PTSD) is associated with social integration experiences among Lebanese refugees living in Denmark. The research adopts a qualitative exploratory design based on semi-structured interviews with 50 participants, including a small subgroup of Armenian-Lebanese individuals. The analysis is guided by Ager and Strang’s (2008) framework, which conceptualises social integration as a multidimensional process encompassing structural, social, linguistic, and cultural dimensions.
The findings indicate that PTSD-related cognitive and emotional difficulties may be associated with variations in participants’ engagement in language learning, employment, and social participation. These experiences are situated within broader structural conditions, including labour market access, institutional frameworks, immigration policies, and perceived discrimination, which together appear to shape integration trajectories.
The results further suggest that social integration is shaped through the interaction of psychological, social, and structural factors rather than through any single determinant. Family relationships and wider social networks are identified as important sources of support and resilience; however, their availability and impact vary across individuals and contexts.
The study is exploratory in nature and does not establish causal relationships. Instead, it provides context-sensitive insights into how trauma-related experiences and structural conditions may interact in shaping the lived experiences of integration among refugees. The findings contribute to trauma-informed and structurally aware approaches to refugee integration and support policy development aimed at improving social inclusion.
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1. Acheson, D. T., Gresack, J. E., & Risbrough, V. B. (2012). Hippocampal dysfunction effects on context memory: Possible etiology for posttraumatic stress disorder. Neuropharmacology, 62(2), 674–685. https://doi.org/10.1016/j.neuropharm.2011.04.029
2. Ager, A., & Strang, A. (2008). Understanding integration: A conceptual framework. Journal of Refugee Studies, 21(2), 166–191. https://doi.org/10.1093/jrs/fen016
3. Bakker, L., Dagevos, J., & Engbersen, G. (2014). The importance of resources and security in the socio-economic integration of refugees: A study on the impact of length of stay in asylum accommodation and residence status on socio-economic integration for the four largest refugee groups in the Netherlands. Journal of International Migration and Integration, 15(3), 431–448. https://doi.org/10.1007/s12134-013-0296-2
4. Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology: An International Review, 46(1), 5–68.
5. Bhugra, D. (2004). Migration and mental health. Acta Psychiatrica Scandinavica, 109(4), 243–258. https://doi.org/10.1111/j.1600-0447.2004.00312.x
6. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
7. Bryant, R. A., Nickerson, A., Morina, N., & Liddell, B. (2023). Posttraumatic stress disorder in refugees. Annual Review of Clinical Psychology, 19, 413–436.
8. https://doi.org/10.1146/annurev-clinpsy-080921-080359
9. Creswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods approaches (2nd ed.). Sage.
10. Daroff, R. B., & Aminoff, M. J. (Eds.). (2014). Encyclopedia of the neurological sciences (2nd ed.). Academic Press.
11. Delhey, J. (2004). European social integration: From convergence of countries to transnational relations between peoples (WZB Discussion Paper No. SP I 2004 201). Wissenschaftszentrum Berlin für Sozialforschung.
12. Esser, H. (2006). Migration, Language and Integration: The social conditions and consequences of migrants’ language acquisition (AKI Research Review 4). Berlin: Social Science Research Center Berlin (WZB), Intercultural Conflicts and Societal Integration Unit (AKI).
13. Fazel, M., Wheeler, J., & Danesh, J. (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet (London, England), 365(9467), 1309–1314. https://doi.org/10.1016/S0140-6736(05)61027-6
14. Fink, G. (2014). Posttraumatic stress disorder: Introduction to special issue. Journal of Trauma Treatment, 4, 1–6.
15. Hynie, M. (2018). The social determinants of refugee mental health in the post-migration context: A critical review. The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie, 63(5), 297–303. https://doi.org/10.1177/0706743717746666
16. Kar, N. (2011). Cognitive behavioral therapy for the treatment of post traumatic stress disorder: A review. Neuropsychiatric Disease and Treatment, 7(1), 167–181. https://doi.org/10.2147/NDT.S10389
17. Kvale, S., & Brinkmann, S. (2009). InterViews: Learning the craft of qualitative research interviewing (2nd ed.). SAGE Publications.
18. Li, C. Q., Zhang, Y., Wang, W., Zhou, T., Yu, X., & Tao, H. (2022). Altered hippocampal volume and functional connectivity in patients with Cushing’s disease. Brain and Behavior, 12(6), e2507. https://doi.org/10.1002/brb3.2507
19. Lindert, J., von Ehrenstein, O. S., Priebe, S., Mielck, A., & Brähler, E. (2009). Depression and anxiety in labor migrants and refugees: A systematic review and meta-analysis. Social Science & Medicine, 69(2), 246–257. https://doi.org/10.1016/j.socscimed.2009.04.032
20. López Ibor, J. J., Christodoulou, G., Maj, M., Sartorius, N., & Okasha, A. (Eds.). (2005). Disasters and mental health. John Wiley & Sons.
21. Lund, M., Sørensen, J. H., Christensen, J. B., Ølholm, A. (2008). MTV Om Behandling Og Rehabilitering Af PTSD – herunder Traumatiserede Flygtninge. Region Syddanmark.
22. Morse, J. M. (2018). Reframing rigor in qualitative inquiry. In N. K. Denzin & Y. S. Lincoln (Eds.), The SAGE handbook of qualitative research (5th ed., pp. 796–817). SAGE.
23. Portes, A. (1998). Social capital: Its origins and applications in modern sociology. Annual Review of Sociology, 24, 1–24.
24. Putnam, R. D. (2000). Bowling alone: The collapse and revival of American community. Simon & Schuster.
25. Schick, M., Zumwald, A., Knöpfli, B., Nickerson, A., Bryant, R. A., Schnyder, U., Müller, J., & Morina, N. (2016). Challenging future, challenging past: The relationship of social integration and psychological impairment in traumatized refugees. European Journal of Psychotraumatology, 7(1), Article 28057. https://doi.org/10.3402/ejpt.v7.28057
26. Schouler-Ocak, M. (Ed.). (2015). Trauma and migration: Cultural factors in the diagnosis and treatment of traumatised immigrants. Springer International Publishing.
27. Schweitzer, R. D., Melville, F., Steel, Z., & Lacherez, P. (2006). Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Australian & New Zealand Journal of Psychiatry, 40(2), 179–187. https://doi.org/10.1080/j.1440-1614.2006.01766.x
28. Silverman, D. (2006). Interpreting qualitative data (3rd ed.). Sage.
29. Svendsen, G. (2001). Traumatiserede flygtninge og socialt arbejde: En inspirationsbog til sagsbehandlere i det kommunale integrationsarbejde. Dansk Flygtningehjælp.
30. Tossutti, L. S. (2009). Canadian cities and global migration: Comparing local responses to demographic change. APSA 2009 Toronto Meeting Paper.
31. Wingenfeld, K., & Wolf, O. T. (2014). Stress, memory, and the hippocampus. Frontiers of Neurology and Neuroscience, 34, 109–120. https://doi.org/10.1159/000356423
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