Forced migration experiences, mental well-being, and nail cortisol among recently settled refugees in Serbia

Refugees are exposed to a wide breadth of traumatic and psychosocially stressful experiences that have long-term implications for their health and resilience. Most prior research on this topic has focused on long-settled refugee populations, as opposed to those who find themselves in more intermittent transitional stages of the forced migration process. Specifically, few studies have explored how refugees' experiences during their recently completed journeys correlate with their mental well-being or physiological profiles that are responsive to psychosocial stress and trauma. Using data from recently settled refugees in Serbia (n = 111), our study helps address this existing gap by examining the associations between refugees’ experiences during their arduous journeys, fingernail cortisol concentrations (CORT), and self-reports of psychosocial stress and PTSD symptomology. We found that refugees who reported experiencing longer journeys had higher recent perceived stress as well as poorer well-being and physical health. Refugees who experienced trauma during their journeys also reported higher recent perceived stress and tended to have higher CORT than those who did not experience trauma. In addition, we also observed sex differences in mental health and CORT profiles. Women tended to report poorer mental well-being and physical health and also had lower CORT compared to men. While longitudinal research is needed, our correlative findings are consistent with the notion that reducing exposure to extreme trauma and stress by establishing safe migration pathways for people fleeing hardship could potentially help attenuate forced relocation-related illnesses and improve health outcomes among refugees as they await resettlement.