Understanding psychological responses to trauma among refugees: the importance of measurement validity in cross-cultural settings

Refugees from the current conflict in Syria have been exposed to a variety of stressors known to increase the risk of mental distress. These may include witnessing atrocities as well as dealing with the challenges of surviving in the displacement context. As a vast array of organisations rush to address mental health outcomes among Syrians, the scientific and conceptual validity of psychological tools used to assess and treat mental health difficulties becomes of paramount importance. Many psychological tools for assessing trauma have been validated in western contexts, but not among Syrians. This paper outlines three errors of reasoning which undermine the validity of psychological methods in cross-cultural contexts, including assuming that western psychiatric categories are universal constructs which can be applied in any context and failing to take contextual factors into account. Qualitative research may help us to better understand culturally specific conceptions of mental health. It is only once we have a solid understanding of how mental distress is understood and expressed among Syrian refugees that we can support effective interventions to alleviate it. The strengthening of indigenous health systems can help promote culturally appropriate mental health care.