The social ecology of displacement: a mixed-method analysis of stressors, trauma and coping in Northern Sri Lanka

War survivors encounter chronic stressors, which can negatively impact mental health above and beyond direct exposure to war-related trauma. The purpose of the current study was to investigate the relationship of coping with chronic stressors and war exposure in post-conflict

Northern Sri Lanka. Using a two study, mixed-method sequential exploratory design, the aim of study 1 (qualitative) was to explore how stressors are conceptualized and the impact of stressors on coping through interviews with adult war survivors (N=53). Using a phenomenological lens for analysis and grounded in the daily stressors framework and families of coping theory, a

social ecological model of stressors and coping is proposed. Participants shared that chronic and systemic stressors permeate daily life and impact on psychological wellbeing. Common coping strategies included support-seeking, problem-solving, helplessness, and escape. The goal of study 2 (quantitative) was to refine the social ecological model of stressors and coping with a sample of 1015 adult participants who were part of a larger epidemiological study. Secondary data analysis was conducted using data from a demographic and displacement history questionnaire, the Stressful Life Events Checklist, and the Harvard Trauma Questionnaire.

Structural equation modeling (SEM) was applied to understand the relationship between stressors, trauma symptom severity (TSS), and the role of social support as a coping mechanism. The social ecological model of stressors and coping identified in study 1 was refined through exploratory and confirmatory factor analyses in study 2, resulting in four stressor constructs: 1)

Personal Safety Concerns; 2) War Exposure Losses; 3) Financial Loss and Hardship, and 4) Personal Hardships. SEM results indicated that War Exposure Losses and Financial Loss and Hardship stressors were positively related to TSS whereas Personal Hardship was negatively

related to TSS, suggesting resilience in situations of chronic adversity. Findings from this study further highlighted that available social support may be less effective for individuals who have experienced particular stressors such as Financial Loss and Hardship. Findings from this study can inform a framework of traumatic stress that transcend the traditional emphasis on direct

exposure to war-related violence to also consider chronic stressors and coping mechanisms in post-conflict settings.

Keywords: chronic stressors, posttraumatic stress disorder, Sri Lanka, post-conflict, mixed-method research.

Keywords: chronic stressors, posttraumatic stress disorder, Sri Lanka, post-conflict, mixed-method research.