Abstract
Forced displacement is a significant public health issue and is associated with decreased social and economic opportunities and limited access to health care. This mixed methods study sought to better understand how populations with a refugee life experience understand exposures to traumas and stressors throughout the life-course and how these exposures relate to mental health later in life. A survey was administered to older Bhutanese with a refugee life experience to assess their past exposures to traumas and stressors. Latent class analysis (LCA) was used to identify subgroups of trauma exposures and assess their association with symptoms of post-traumatic stress disorder (PTSD). A subgroup of the survey participants was then interviewed, and narrative thematic analysis was used to examine how participants understood and made sense of their life experiences and traumas. The findings from the two sources of data were then integrated. The LCA identified four classes of exposure to traumas and stressors, which were associated with symptoms of PTSD later in life. The narrative thematic analysis identified four typologies of narratives, revealing the diverse ways that study participants understood their life journeys and attempted to cope with past traumas. Interestingly, the traumas and stressors that were identified through the survey were not necessarily aligned with the narrative typologies. Our findings indicate the need for caution when attempting to assess the mental health and need for health interventions using only one data source. Future studies could incorporate longitudinal data collection on post-resettlement stressors as well as PTSD symptoms over time to provide better insight into post-traumatic growth within this population.