Researcher:
Kurt, Gülşah

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Gülşah

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Kurt

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Kurt, Gülşah

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2021 - 202210

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    Traumatic experiences, acculturation, and psychological distress among Syrian refugees in Turkey: the mediating role of coping strategies
    (Pergamon-Elsevier Science Ltd, 2021) Acar, İbrahim Hakkı; Yurtbakan, Taylan; Uygun, Ersin; Department of Psychology; N/A; N/A; Department of Psychology; Kurt, Gülşah; İlkkurşun, Zeynep; Acar, Büşra; Acartürk, Ceren; Teaching Faculty; Master Student; PhD Student; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; College of Social Sciences and Humanities; N/A; N/A; N/A; 39271
    Turkey hosts the largest number of refugees in the world. So far, many studies investigated the mental health problems among Syrian refugees in Turkey and other hosting countries. However, little attention has been paid to the acculturation process of Syrian refugees in Turkey. A crosssectional study was conducted with 409 Syrian refugees in Mardin, Turkey. Results showed that traumatic experiences depleted problem-focused, emotion-focused, and maladaptive coping strategies. Emotion-focused coping strategies mediated the relationship between traumatic experiences and maintenance of the heritage culture and adoption of the destination culture. To conclude, our findings underscore the importance of traumatic experiences and emotion-focused coping strategies for integration of Syrian refugees in Turkey. Psychosocial interventions enhancing emotion-focused coping capacities might mitigate the adverse impact of traumatic experiences on integration. We discussed the strengths and limitations of the study considering the current literature.
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    “Doing What Matters in Times of Stress” to decrease psychological distress during Covid-19: a rammed controlled pilot trial
    (Wolters Kluwer Medknow Publications, 2022) Uygun, Ersin; Karaoğlan Kahiloğulları, Akfer; Department of Psychology; Department of Psychology; N/A; Acartürk, Ceren; Kurt, Gülşah; İlkkurşun, Zeynep; Faculty Member; Teaching Faculty; Master Student; Department of Psychology; College of Social Sciences and Humanities; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; 368619; N/A
    Despite the increasing psychological distress during Covid-19, utilisation of face-to-face psychological interventions decreased profoundly. The aim of this study involving two parallel, two-armed pilot randomised controlled trials was to examine the effectiveness of a guided self-help intervention "Doing What Matters in Times of Stress" (DWM) in decreasing psychological distress in Turkish and Syrian participants. Seventy-four Turkish nationals and 50 Syrian refugee adults with psychological distress were randomly allocated to a DWM group or wait-list control group. The primary outcome measure was the Patient Health Questionnaire 9 postintervention. Secondary outcome measures were the Generalised Anxiety Disorder Scale, posttraumatic stress disorder (PTSD) Checklist for DSM-5, Generalized Self-Efficacy Scale and Acceptance and Action Questionnaire-II postintervention. Although this study was not powered to detect a significant effect for DWM postassessment between DWM and the control group, results showed a significant improvement in depression symptoms among Turkish participants in the DWM group (d = 0.46) and in PTSD symptoms among Syrian participants in the DWM group (d = 0.67) from pre- to postintervention assessment. These results indicate the potential of DWM to decrease mental health problems during the pandemic and importance of a fully powered, definitive controlled trial to examine its effectiveness both for the host community and refugees to reduce psychological distress during Covid-19.
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    Caring for carers: a virtual psychosocial supervision intervention to improve the quality and sustainability of mental health and psychosocial support in humanitarian contexts
    (Cambridge University Press (CUP), 2022) Wells, R.; Alokoud, M.; Beetar, A.; Eldardery, H.; Elshazly, M.; Faruk, O.; Ginem, M. R.; Hadzi-Paylovic, D.; Jahan, S.; Joshi, R.; Klein, L.; Kurdi, L.; Mastrogiovanni, C.; Mozumder, M.; Lekkeh, S.; Nemorin, S.; Perry, K. Nicholson; Orabi, M.; Qasim, J.; Steel, Z.; Utah, H.; Uygun, E.; Wong, S.; Yan, L. (Fischer); Yousselr, R. Said; Zarate, A.; Rosenbaum, S.; Department of Psychology; N/A; N/A; Department of Psychology; N/A; Acartürk, Ceren; Almeamari, Fatima; İlkkurşun, Zeynep; Kurt, Gülşah; Tavakol, Mehri; Faculty Member; Master Student; Master Student; Teaching Faculty; Other; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; College of Social Sciences and Humanities; N/A; 39271; N/A; N/A; 368619; N/A
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    PublicationOpen Access
    Group problem management plus (PM plus) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial
    (BioMed Central, 2022) Uygun, E.; Yurtbakan, T.; Adam Troian, J.; Şenay, I; Bryant, R.; Cuijpers, P.; Kiselev, N.; McDaid, D.; Morina, N.; Nişancı, Z.; Park, A. L.; Sijbrandij, M.; Ventevogel, P.; Fuhr, D. C.; Department of Psychology; Acartürk, Ceren; İlkkurşun, Zeynep; Kurt, Gülşah; Faculty Member; Master Student; Teaching Faculty; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; N/A; N/A
    Background: Syrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an effective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul,Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-effectiveness of the intervention. Methods: refugees with psychological distress (Kessler Psychological Distress Scale, K10 > 15) and impaired psychosocial functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0> 16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (n = 24) or E-CAU only (n = 22). gPM+ comprised of five weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identified problems (Psychological Outcomes Profiles, PSYCHLOPS) were included as secondary outcomes. A modified version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses. Results: there were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an effect. No significant difference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found. Conclusions: gPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe intervention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCT.
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    PublicationOpen Access
    Scalable psychological interventions for Syrian refugees in Europe and the Middle East: STRENGTHS study protocol for a prospective individual participant data meta-analysis
    (BMJ Publishing Group, 2022) de Graaff, A.M.; Cuijpers, P.; Akhtar, A.; Alkneme, M.S.; Aoun, M.; Awwad, M.; Bawaneh, A.Y.; Brown, F.L.; Bryant, R.; Burchert, S.; Carswell, K.; Drogendijk, A.; Engels, M.; Fuhr, D.C.; Hansen, P.; van 't Hof, E.; Giardinelli, L.; Hemmo, M.; Hessling, J.M.; Jordans, M.J.D.; Kiselev, N.; Knaevelsrud, C.; Martinmaki, S.; McDaid, D.; Morina, N.; Naser, H.; Park, A.L.; Pfaltz, M.C.; Roberts, B.; Schick, M.; Schnyder, U.; Spaaij, J.; Steen, F.; Taha, K.; Uygun, E.; Ventevogel, P.; Whitney, C.; Witteveen, A.B.; Sijbrandij, M.; STRENGTHS consortium; Department of Psychology; Acartürk, Ceren; İlkkurşun, Zeynep; Kurt, Gülşah; Faculty Member; Master Student; Teaching Faculty; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; N/A; N/A
    Introduction: The World Health Organization's (WHO) scalable psychological interventions, such as Problem Management Plus (PM+) and Step-by-Step (SbS) are designed to be cost-effective non-specialist delivered interventions to reduce symptoms of common mental disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). The STRENGTHS consortium aims to evaluate the effectiveness, cost-effectiveness and implementation of the individual format of PM+ and?its group version (gPM+), as well as of the digital SbS intervention among Syrian refugees in seven countries in Europe and the Middle East. This is a study protocol for a prospective individual participant data (IPD) meta-analysis to evaluate (1) overall effectiveness and cost-effectiveness and (2) treatment moderators of PM+, gPM+ and?SbS with Syrian refugees. Methods and analysis: Five pilot randomised controlled trials (RCTs) and seven fully powered RCTs conducted within STRENGTHS will be combined into one IPD meta-analytic dataset. The RCTs include Syrian refugees of 18 years and above with elevated psychological distress (Kessler Psychological Distress Scale (K10>15)) and impaired daily functioning (WHO Disability Assessment Schedule 2.0 (WHODAS 2.0>16)). Participants are randomised into the intervention or care as usual control group, and complete follow-up assessments at 1-week, 3-month and 12-month follow-up. Primary outcomes are symptoms of depression and anxiety (25-item Hopkins Symptom Checklist). Secondary outcomes include daily functioning (WHODAS 2.0), PTSD symptoms (PTSD Checklist for DSM-5) and self-identified problems (PSYCHLOPS). We will conduct a one-stage IPD meta-analysis using linear mixed models. Quality of evidence will be assessed using the GRADE approach, and the economic evaluation approach will be assessed using the CHEC-list. Ethics and dissemination: Local ethical approval has been obtained for each RCT. This IPD meta-analysis does not require ethical approval. The results of this study will be published in international peer-reviewed journals.
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    PublicationOpen Access
    The psychological impacts of COVID-19 related stressors on Syrian refugees in Turkey: The role of resource loss, discrimination, and social support
    (Elsevier, 2021) Javanbakht, A.; Uygun, E.; Karaoğlan Kahıloğulları, A.; Department of Psychology; Acartürk, Ceren; İlkkurşun, Zeynep; Kurt, Gülşah; Faculty Member; Master Student; Teaching Faculty; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; N/A; N/A
    COVID-19 does not leave behind refugees. They are disproportionately affected during the current pandemic. The present study aimed to investigate the psychological impacts of COVID-19 related stressors -resource loss and perceived discrimination during the COVID-19 pandemic- on Syrian refugees in Turkey. Further, the buffering role of perceived social support against the detrimental impacts of such stressors was examined. An online cross-sectional study was conducted between September-October 2020. A sample of 345 Syrian refugees in Turkey completed the questions about demographic characteristics, resource loss and perceived discrimination during the pandemic, perceived social support, and depressive and anxiety symptoms. A high level of depressive and anxiety symptoms was reported in our sample. Resource loss and perceived discrimination during the pandemic significantly and positively predicted depressive and anxiety symptoms. Perceived social support acted as a buffer against the detrimental effect of resource loss on mental health. For those with higher perceived social support, resource loss during the pandemic did not significantly predict depressive and anxiety symptoms. The results indicate the detrimental role of COVID-19 related stressors on refugee mental health. Social support is an important protective factor for mental health amidst the pandemic. Our findings highlight the importance of considering the precarious conditions of refugees in all COVID-19 responses and communications.
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    PublicationOpen Access
    Cultural adaptation of a low-intensity group psychological intervention for Syrian refugees
    (Medknow Publications, 2021) Akhtar, A.; Engels, M.; Bawaneh, A.; Bird, M.; Bryant, R.; Cuijpers, P.; Hansen, P.; Al-Hayek, H.; Sijbrandij, M.; Underhill, J.; Department of Psychology; Acartürk, Ceren; İlkkurşun, Zeynep; Kurt, Gülşah; Faculty Member; Master Student; Teaching Faculty; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; N/A; N/A
    Given the increasing use of low-intensity psychological interventions in humanitarian mental health and psychosocial support work, more attention is needed to strengthen the intersection between evidence-based interventions and cultural contextualisation. Undertaking the process of cultural adaptation ensures the appropriateness and acceptability of psychological interventions in these contexts. We present the process and results of conducting a cultural adaptation for the Group Problem Management Plus (GroupPM+) intervention, for Syrian refugees across two contexts; Jordan in camp settings and Turkey in urban settings. The first step of the adaptation was to conduct a rapid qualitative assessment following the Design, Implementation, Monitoring and Evaluation model proceeded by cognitive interviews and a workshop designed to apply changes according to the Bernal framework. Based on the results, a total of 82 changes were proposed across the intervention manual, training, supervision and implementation protocols. Changes ranged from minor amendments to terminology to broader changes to how metaphors, stories and illustrations are presented during the intervention. Additionally, two substantial adaptations were suggested: (1) the addition of a session designed to enhance family engagement, and (2) the development of a male case study. Changes were incorporated prior to the implementation of the GroupPM+ intervention in Jordan and Turkey.
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    PublicationOpen Access
    Effectiveness of a WHO self-help psychological intervention for preventing mental disorders among Syrian refugees in Turkey: a randomized controlled trial
    (Wiley, 2022) Uygun, E.; Carswell, K.; Tedeschi, F.; Batu, M.; Anttila, M.; Au, T.; Baumgartner, J.; Churchill, R.; Cuijpers, P.; Becker, T.; Koesters, M.; Lantta, T.; Nosè, M.; Ostuzzi, G.; Popa, M.; Purgato, M.; Sijbrandij, M.; Turrini, G.; Välimäki, M.; Walker, L.; Wancata, J.; Zanini, E.; White, R.G.; van Ommeren, M.; Barbui C.; Department of Psychology; Acartürk, Ceren; İlkkurşun, Zeynep; Kurt, Gülşah; Faculty Member; Master Student; Teaching Faculty; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; N/A; N/A; N/A
    Refugees are at high risk of developing mental disorders. There is no evidence from randomized controlled trials (RCTs) that psychological interventions can prevent the onset of mental disorders in this group. We assessed the effectiveness of a self-help psychological intervention developed by the World Health Organization, called Self-Help Plus, in preventing the development of mental disorders among Syrian refugees experiencing psychological distress in Turkey. A two-arm, assessor-masked RCT was conducted in two Turkish areas. Eligible participants were adult Syrian refugees experiencing psychological distress (General Health Questionnaire ?3), but without a diagnosis of mental disorder. They were randomly assigned either to the Self-Help Plus arm (consisting of Self-Help Plus combined with Enhanced Care as Usual, ECAU) or to ECAU only in a 1:1 ratio. Self-Help Plus was delivered in a group format by two facilitators over five sessions. The primary outcome measure was the presence of any mental disorder assessed by the Mini International Neuropsychiatric Interview at six-month follow-up. Secondary outcome measures were the presence of mental disorders at post-intervention, and psychological distress, symptoms of post-traumatic stress disorder and depression, personally identified psychological outcomes, functional impairment, subjective well-being, and quality of life at post-intervention and six-month follow-up. Between October 1, 2018 and November 30, 2019, 1,186 refugees were assessed for inclusion. Five hundred forty-four people were ineligible, and 642 participants were enrolled and randomly assigned to either Self-Help Plus (N=322) or ECAU (N=320). Self-Help Plus participants were significantly less likely to have any mental disorders at six-month follow-up compared to the ECAU group (21.69% vs. 40.73%; Cramer's V = 0.205, p<0.001, risk ratio: 0.533, 95% CI: 0.408-0.696). Analysis of secondary outcomes suggested that Self-Help Plus was not effective immediately post-intervention, but was associated with beneficial effects at six-month follow-up in terms of symptoms of depression, personally identified psychological outcomes, and quality of life. This is the first prevention RCT ever conducted among refugees experiencing psychological distress but without a mental disorder. Self-Help Plus was found to be an effective strategy for preventing the onset of mental disorders. Based on these findings, this low-intensity self-help psychological intervention could be scaled up as a public health strategy to prevent mental disorders in refugee populations exposed to ongoing adversities.
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    PublicationOpen Access
    Estimated prevalence rates and risk factors for common mental health problems among Syrian and Afghan refugees in Türkiye
    (Cambridge University Press (CUP), 2022) Ventevogel, P.; Akbıyık, N.; Erşahin, M.; Department of Sociology; Department of Psychology; Acartürk, Ceren; Kurt, Gülşah; Ekhtiari, Maryam; İlkkurşun, Zeynep; Faculty Member; Teaching Faculty; Master Student; Department of Sociology; Department of Psychology; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; N/A; N/A; N/A
    Background: Türkiye hosts 4 million refugees and asylum seekers, with Syrians and Afghans being among the largest refugee groups in country. There are limited comparative data on the conflict- and displacement-related experiences of these groups and the relation with mental health status. Aims: to assess the mental health status of Syrians and Afghans in Türkiye, identify risk factors and explore to what extent differences in mental health conditions are related to potentially traumatic events and post-displacement stressors. Method: two parallel online survey studies were conducted between April and June 2021 among 798 Syrians and 785 Afghans in Türkiye. Data were collected on sociodemographic characteristics, traumatic events (Harvard Trauma Questionnaire), post-displacement stressors (Post-Migration Living Difficulties Checklist), symptoms of depression and anxiety (Hopkins Symptoms Checklist-25) and post-traumatic stress disorder (PTSD) (Post-Traumatic Stress Disorder Checklist for DSM-5, short form). Results: for Syrian and Afghan participants respectively, estimated prevalence rates were: 41.1% and 50.3% for depression; 39.6% and 41% for anxiety; and 41.6% and 46.5% for PTSD. In both groups, significant predictors were female gender, exposure to potentially traumatic events, and structural and socioeconomic post-displacement stressors. Additional risk factors were older age for Afghans and higher education for Syrians. Conclusions: self-reported symptoms of common mental health problems are highly prevalent among Syrian and Afghan refugees and associated with a wide range of risk factors. After controlling for conflict- and displacement-related experiences, Afghans reported higher anxiety symptoms than Syrians, which is likely related to their legal status in Türkiye.
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    PublicationOpen Access
    Resilience of people with chronic medical conditions during the COVID-19 pandemic: a 1-year longitudinal prospective survey
    (BioMed Central, 2022) Tarsitani, L.; Pinucci, Irenea; Tedeschi, Federico; Patanè, Martina; Papola, Davide; Palantza, Christina; Björkenstam, Emma; Bryant, Richard; Burchert, Sebastian; Davisse-Paturet, Camilleh; Díaz-García, Amandai Farrel, Rachel; Fuhr, Daniela C.; Hall, Brian J.l; Huizink, Anja C.; Lam, Agnes Iok Fongo; Leijen, Ingmar; Mittendorfer-Rutz, Ellenor; Morina, Naser; Panter-Brick, Catherine; Purba, Fredrick Dermawan; Quero, Soledad; Seedat, Soraya; Setyowibowo, Hari; van der Waerden, Judith; Pasquini, Massimo; Sijbrandij, Marit; Barbui, Corrado; Department of Psychology; Acartürk, Ceren; Kurt, Gülşah; Faculty Member; Teaching Faculty; Department of Psychology; College of Social Sciences and Humanities; 39271; N/A
    Backgrounds: individuals with chronic medical conditions are considered highly exposed to COVID-19 pandemic stress, but emerging evidence is demonstrating that resilience is common even among them. We aimed at identifying sustained resilient outcomes and their predictors in chronically ill people during the first year of the pandemic. Methods: this international 4-wave 1-year longitudinal online survey included items on socio-demographic characteristics, economic and living situation, lifestyle and habits, pandemic-related issues, and history of mental disorders. Adherence to and approval of imposed restrictions, trust in governments and in scientific community during the pandemic were also investigated. The following tools were administered: the Patient Health Questionnaire, the Generalized Anxiety Disorder scale, the PTSD Checklist DSM-5, the Oslo Social Support Scale, the Padua Inventory, and the Portrait Values Questionnaire. Results: one thousand fifty-two individuals reporting a chronic condition out of 8011 total participants from 13 countries were included in the study, and 965 had data available for the final model. The estimated probability of being "sustained-resilient" was 34%. Older male individuals, participants employed before and during the pandemic or with perceived social support were more likely to belong to the sustained-resilience group. Loneliness, a previous mental disorder, high hedonism, fear of COVID-19 contamination, concern for the health of loved ones, and non-approving pandemic restrictions were predictors of not-resilient outcomes in our sample. Conclusions: we found similarities and differences from established predictors of resilience and identified some new ones specific to pandemics. Further investigation is warranted and could inform the design of resilience-building interventions in people with chronic diseases.