Table Of ContentIndividual difference predictors of well-being
among displaced persons who live under
stressful conditions
Thesis submitted for the degree of
Doctor of Philosophy
At the University of Leicester
By
Izaddin Ahmad Aziz
School of Neuroscience, Psychology, and Behavior
University of Leicester
2017
The Abstract
Individual difference predictors of well-being among displaced persons who live under stressful
conditions
Izaddin A. Aziz
Background
The common concern surrounding the poor level of displaced life is that it might
cause harmful psychological conditions. Another concern of displacement is the impact of
conflict and the ability to survive in adverse situations. The reasons for conducting this
thesis were developed through the literature review, and noticing a lack of studies that
assess psychological issues such as well-being, resilience, prejudice and forgiveness among
Syrian refugees and Iraqi displaced persons comprehensively.
Research aims
In particular, the studies address three issues that are fundamental to understanding
how the thesis is structured. The first issue is essential in examining how war has affected
individuals’ well-being in short and long term of life engagement of the refugees. The
second issue investigates the impact of the displacement situation on prejudices and the
possibility of forgiveness after conflict and violence between groups of people. The final
issue involves identifying the factors that might help individuals to survive and face any
potentially harmful situation.
Methods
The overall research sample includes 1,256 individuals of both genders. For
collecting the data, self-report questionnaires and objective measures were used.
Results
The results show that the research samples indicated poor levels of quality of life,
well-being, forgiveness and resilience. Importantly, these findings reveal the significant
role played by positive relation domains of psychological well-being in improving
resilience and forgiveness. The research has also has shown that the psychological health
domain of quality of life recorded the highest significant associations with resilience and
psychological well-being. To Sum up, this thesis illustrates the importance of positive
social relations, lower prejudice and greater resilience in predicting mental health states.
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Declaration
For the scientific credibility, I am declaring that this thesis has been composed and
organized by myself, under standard terms of supervision has been carried out. I submitted
as an original piece of work. Moreover, I am declaring that this thesis has not been
submitted to any other institution or for any other degree.
2017
Izaddin A. Aziz
Study 1 is reported in:
Aziz IA, Hutchinson CV, Maltby J. (2014) Quality of life of Syrian refugees living in
camps in the Kurdistan Region of Iraq. PeerJ 2:e670 https://doi.org/10.7717/peerj.670
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Acknowledgement
First, thanks to God that make me able to finish my thesis. I owe lots of appreciation
to my both extraordinary supervisors Prof. John Maltby and Dr Claire Hutchinson for
the incredible support all the time with presenting invaluable help and constructive advice
throughout this process. With their encouragement they made a daunting task appear
attainable. I am proud and very grateful to have had them as supervisors. Moreover, I want
to express my thankfulness and gratefulness to my Wife Sumaya for her support during my
study.
I would like to thank the Ministry of Higher Education and Scientific Research of
Kurdistan region of Iraq for supporting me and making this Ph.D. initially possible.
Additionally, I would like to present my thankfulness and appreciation to the Neuroscience,
Psychology, and behavioural school. I am also grateful to all the Ph.D. students, lecturers,
and support staff within the School of Psychology who made my academic life so
enjoyable.
Special thanks to Mr. Zaito Siyani from UNAMI, Mr. Hemin Hassan from
Democratic, and Human Right Institutes (DHRI), Mr. Hoger Shekha, Miss. Ramzya
Ameen, and Mr. Nzar Abdul-Aziz from Public Aid Organization (PAO), Miss. Skala Lotfi
from REACH organization, Mr. Adnan Fadhil Khaleel from Lebanese French University
Dr, Salah S. Sarteep from Salahaddin University, Mr. Zuber Sharif, Mr. Shwan Sherzad,
Mr. Eadin Yosif and Mr. Ian Kilpatrick for supporting me and being helpful to make my
work easier.
Last but not the least, I would like to express sincere thanks to all the research
samples who participated in my studies and shared their profound experiences so willingly
for their cooperation, without that this research would never have been a reality.
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Contents
The Abstract ............................................................................................................................ 1
Declaration .............................................................................................................................. 2
Acknowledgement .................................................................................................................. 3
List of Tables .......................................................................................................................... 9
List of figures ........................................................................................................................ 11
Chapter One .......................................................................................................................... 13
The thesis structure ............................................................................................................... 13
1.1. Thesis Overview .......................................................................................................... 13
1.2. Part A: Global armed conflict and displacement life conditions ................................. 13
1.3. Part B: The effect of conflict on prejudice and forgiveness ........................................ 15
1.4. Part C: Surviving from adverse situation and well-being ........................................... 19
1.5. Summary ..................................................................................................................... 21
Part A .................................................................................................................................... 23
Presenting an overview of the effect of armed conflict on well-being ................................. 23
Chapter Two ......................................................................................................................... 24
Overview of global armed conflict and the psychological well-being of refugees .............. 24
2.1. Introduction ................................................................................................................. 24
2.2. Definition of refugees .................................................................................................. 25
2.3. Forced migration and the global refugee crisis ........................................................... 25
2.4. Syrian refugees ............................................................................................................ 27
2.5. The needs and physical and psychological support of refugees .................................. 29
2.6. Displacement and quality of life ................................................................................. 30
2.7. The research aims of Part A (Chapters Three and Four) ............................................. 32
Chapter Three ....................................................................................................................... 34
Quality of life of Syrian refugees living in camps in the Kurdistan Region of Iraq ............. 34
3.1. Abstract. ................................................................................................................. 34
3.2. Introduction ............................................................................................................ 35
3.3. The Research Method ............................................................................................ 37
3.3.1. The research sample ........................................................................................ 37
3.3.2. The measures .................................................................................................. 37
3.3.3. Data Analysis .................................................................................................. 38
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3.4. Ethics ...................................................................................................................... 38
3.5. The results .............................................................................................................. 39
3.6. Discussion .............................................................................................................. 42
Chapter Four ......................................................................................................................... 44
The association between psychological quality of life scores and psychological well-being
among Syrian refugees .......................................................................................................... 44
4.1. Abstract .................................................................................................................. 44
4.2. Introduction ............................................................................................................ 45
4.3. Method ................................................................................................................... 52
4.3.1. The research sample ........................................................................................... 52
4.3.2. Measures ............................................................................................................. 53
4.3.2.1. Psychological quality of life ........................................................................... 53
4.3.2.2. Psychological well-being ................................................................................ 53
4.3 Ethics ...................................................................................................................... 54
4.4 Results .................................................................................................................... 54
4.4.1 Descriptive statistics ........................................................................................... 54
4.4.2 Bivariate correlation ........................................................................................... 55
4.4.3 Multiple regression ............................................................................................. 56
4.5 Discussion .............................................................................................................. 58
4.6 Conclusion.............................................................................................................. 60
Part B .................................................................................................................................... 62
An overview of the psychological perspectives of the conflict effect on prejudice and
forgiveness. ........................................................................................................................... 62
Chapter Five .......................................................................................................................... 63
The psychological perspectives of the conflict effects on prejudice and forgiveness .......... 63
5.1. Introduction ................................................................................................................. 63
5.2. Overview of Internally Displaced Persons .................................................................. 64
5.4.1. Realistic Conflict Theory ................................................................................ 67
5.4.2. Relative Deprivation Theory .......................................................................... 68
5.4.3. Social Identity Theory .................................................................................... 69
5.4.4. Integrated Threat Theory ................................................................................ 69
Chapter Six ........................................................................................................................... 78
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Exploring the association between Explicit and Implicit Prejudice with Psychological Well-
Being among two different nationalities ............................................................................... 78
6.1. Abstract .................................................................................................................. 78
6.2. Introduction ............................................................................................................ 79
6.3. Method ................................................................................................................... 81
6.3.1. The research sample ........................................................................................... 81
6.3.2. Measures ............................................................................................................. 81
6.3.2.1. Prejudice measure ........................................................................................... 81
a. Explicit measure ........................................................................................................ 82
b. Implicit measure ........................................................................................................ 82
c. The Implicit-association Test design ......................................................................... 84
a. The procedure ............................................................................................................ 86
6.3.2.2. Psychological Well-being ............................................................................... 88
6.4. Ethics ...................................................................................................................... 88
6.5. Results .................................................................................................................... 89
6.5.1. Descriptive statistic ............................................................................................ 89
6.5.2. One sample T.test ............................................................................................... 90
6.5.3. Independent sample T.test .................................................................................. 91
6.5.4. Bivariate correlations .......................................................................................... 94
6.5.5. Multiple regressions ........................................................................................... 98
6.6. Discussion ............................................................................................................ 101
6.7. Conclusion............................................................................................................ 105
Chapter Seven ..................................................................................................................... 107
Exploring the association between intrapersonal forgiveness and psychological well-being
among internally displaced people in the Kurdistan region of Iraq .................................... 107
7.1. Abstract ................................................................................................................ 107
7.2. Introduction .......................................................................................................... 108
7.3. Method ................................................................................................................. 110
7.3.1. The research sample ......................................................................................... 110
7.3.2. Measures ........................................................................................................... 111
7.3.2.1. Forgiveness ................................................................................................... 111
7.3.2.2. Psychological well-being .............................................................................. 112
7.4. Ethics .................................................................................................................... 112
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7.5. Results .................................................................................................................. 113
7.5.1. Hurt experience ................................................................................................ 113
7.5.2. Descriptive statistic .......................................................................................... 114
7.5.3. One sample T.test ............................................................................................. 114
7.5.4. Bivariate correlation ......................................................................................... 115
7.5.4.1. Correlation of hurt experience with forgiveness and psychological well-being
domains 115
7.5.4.2. Correlation between forgiveness and psychological well-being domains .... 116
7.5.5. Multiple regression analysis ............................................................................. 119
7.6. Discussion ............................................................................................................ 121
7.7. Conclusion............................................................................................................ 123
Part C .................................................................................................................................. 124
Investigating resilience and people’s ability to survive from harmful situations and how it is
associated with well-being .................................................................................................. 124
Chapter Eight ...................................................................................................................... 125
A general review of resilience, surviving adverse situations and well-being. .................... 125
8.1. Introduction ............................................................................................................... 125
8.2. Definitions of Resilience ........................................................................................... 126
8.3. The Theoretical Background of Resilience ............................................................... 127
8.4. Resilience as a trait the EEA Resilience Holling Model ........................................... 129
8.5. Resilience and life stress ........................................................................................... 130
8.6. Displacements conditions and resilience ................................................................... 132
8.7. Resilience and Well-Being ........................................................................................ 133
8.8. The Aim of Part C ..................................................................................................... 136
Chapter Nine ....................................................................................................................... 138
Exploring the association between quality of life and EEA resilience among Syrian
refugees ............................................................................................................................... 138
9.1. Abstract ..................................................................................................................... 138
9.2. Introduction .......................................................................................................... 139
9.3. Method ................................................................................................................. 141
9.3.1. The Research Sample .................................................................................... 141
9.3.2. Measures ....................................................................................................... 142
9.4. Ethics .................................................................................................................... 142
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9.5. Results .................................................................................................................. 143
9.5.1. Descriptive Statistics ..................................................................................... 143
9.5.2. One sample T.test ......................................................................................... 143
9.5.3. Bivariate Correlation ..................................................................................... 144
9.5.4. Multiple Regressions .................................................................................... 147
9.6. Discussion ............................................................................................................ 150
9.7. Conclusion............................................................................................................ 152
Chapter Ten ......................................................................................................................... 153
An investigation of the association between the EEA Resilience model and Psychological
well-being among Iraqi internationally displaced persons in the Kurdistan region of Iraq 153
10.1. Abstract ..................................................................................................................... 153
10.2. Introduction ............................................................................................................... 154
10.3. Method ....................................................................................................................... 156
10.3.1. The research sample ...................................................................................... 156
10.3.2. Measures ....................................................................................................... 156
10.3.2.1. EEA Resilience ......................................................................................... 156
10.3.2.2. Psychological Well-being ......................................................................... 157
10.4. Ethics ......................................................................................................................... 157
10.5. Results ....................................................................................................................... 157
10.5.1. Descriptive statistic ....................................................................................... 157
10.5.2. One sample T.test ......................................................................................... 158
10.5.3. Bivariate correlations .................................................................................... 158
10.5.4. Multiple regression ....................................................................................... 162
10.6. Discussion ................................................................................................................. 164
10.7. Conclusion ................................................................................................................. 167
Chapter Eleven .................................................................................................................... 168
Overview, Research Summary and Discussion of Findings, Implications and Future
Research, Research Limitations and Challenges, and Conclusion ..................................... 168
11.1. Overview .......................................................................................................... 168
11.2. Summary and discussion of findings ................................................................ 169
11.3. Implications and future research ...................................................................... 182
11.4. Research limitations and challenges ................................................................. 184
11.5. Conclusions ...................................................................................................... 185
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List of Tables
Table 1 Mean (SD) score comparisons for WHOQOL-BREF domain scores (range 4–20)
between Kurdistan refugees and adults across 23 countries (n = 11,830) from
Skevington et al. (2004). ....................................................................................... 39
Table 2 Mean (SD) score comparisons for WHOQOL-BREF raw scores between Syrian
refugees residing in Kurdistan and refugees residing in West Africa .................... 40
Table 3 Mean (SD) score comparisons for WHOQOL-BREF transformed scores (0–100)
between Syrian refugees residing in Kurdistan and refugees residing in the Gaza
strip. ........................................................................................................................ 41
Table 4: Psychological well-being domains, considering high and low scores for feelings 46
Table 2: Cronbach’s alpha score obtained in the domains of psychological quality of life
and psychological well-being ................................................................................. 54
Table 6: Pearson’s correlation coefficient between psychological well-being and
psychological quality of life ................................................................................... 55
Table 7 Male and female correlation and Z-Score of significance of the difference between
the Correlations of psychological quality of life and psychological well-being
components according to gender. ........................................................................... 56
Table 8 Regression analysis with psychological quality of life as a dependent variable, and
gender, age, education, marital status, health, and illness status, and psychological
well-being as predictor variables ............................................................................ 57
Table 9 Cronbach's alpha, Score obtained in Self-report and Implicit tests of Prejudice and
psychological well-being domains ......................................................................... 89
Table 10 One sample T-Test of explicit prejudice and psychological well-being ............... 90
Table 11 Independent sample t-test of explicit prejudice between Arab and Kurdish
nationality ............................................................................................................... 91
Table 12 Independent sample t-test of implicit prejudice between Arab and Kurdish
nationality, the first task is related to concept recognition ..................................... 91
Table 13 independent sample t-test of implicit prejudice between Arab and Kurdish
nationality, the third task combined with pleasant and unpleasant attributes. ....... 92
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