Understanding postmigration stress in forcibly displaced people in Austria: Study protocol of a 14-day ambulatory assessment study

Introduction: Postmigration stress has been recognised as a significant factor negatively impacting the psychological well-being of forcibly displaced people (FDP), even independently of pre-migration trauma exposure. However, there is no study yet investigating its detrimental effects on psychological and somatic indicators of mental health in the daily life of FDP. Here, we present a study protocol to investigate the impact of postmigration stress in the daily lives of Arabic- and Farsi-speaking FDP living in Austria, using an ambulatory assessment (EMA) design.

Methods: Sixty Arabic- and Farsi-speaking adult FDPs with a maximum of three years of stay in Austria will complete daily questionnaires on smartphones for 14 days. Participants will be prompted to report experienced postmigration stressors, perceived momentary stress levels, transdiagnostic symptoms of psychological distress, and positive and negative affect, at three fixed timepoints each day (i.e. 11 am, 3 pm, and 7 pm). In addition to subjective stress assessment, participants will provide saliva samples to measure somatic stress system functioning, indicated by salivary cortisol and alpha-amylase. Furthermore, participants will be asked to complete a self-initiated end-of-day questionnaire before going to bed. Our hypotheses will be tested using multilevel analysis and biochemical analyses of the human probes.

Discussion: This study will advance understanding of how postmigration stress affects psychological and somatic aspects of mental health in FDP. Using a multimodal EMA approach, findings may guide the development of scalable, smartphone-based, just-in-time interventions for this highly mobile, underserved population.