Pre-treatment Predictors of Islamic Trauma Healing: Demographic and Social-Cognitive Predictors of PTSD and Depression Outcomes in Somali Refugees

Over 120 million people have been forcibly displaced worldwide, with Muslim refugees comprising a substantial proportion. High rates of pre-migration trauma and post-migration stressors have been linked to worse mental health outcomes such as PTSD and depression. Conventional evidence-based treatments such as prolonged exposure and cognitive processing therapy often require substantial training and resources, and face cultural barriers—such as stigma, language, and distrust in the Western medicine system—that limit utilization. Furthermore, conventional treatments do not traditionally incorporate faith; a key aspect of many trauma survivor's lives. Islamic Trauma Healing (ITH) is a lay-led, faith-based group intervention integrating cognitive–behavioral techniques and Islamic principles to address the mental health impact of trauma in Muslim refugees. The initial randomized control trial was conducted with a sample of adult Somali refugees who resettled in two different locations in the United States. The proposed study is a secondary analysis of a completed randomized controlled trial (Zoellner et al., 2024) which investigates pre-treatment demographic factors and psychosocial variables as predictors of both baseline PTSD and depression severity as well as PTSD and depression symptom change following the ITH intervention. Machine learning models, specifically, random forest plots will be used to understand which variables have predictive ability for PTSD and depression severity both at baseline and at follow-up. Due to the limited sample size for machine learning models, multilevel models are also proposed as secondary data analysis.