Coping Strategies and Stress Among Resettled Bhutanese Adults in Massachusetts

Stress associated with attempts to integrate into a new culture is directly linked to mental health outcomes among refugees. However, there is a paucity of literature on how refugees cope to reduce their stress. This study assessed the association between coping strategies and perceived stress among resettled Bhutanese adults in Western Massachusetts. A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20-65 years residing in Massachusetts. Coping was measured with the 32-item Tobin Coping-Strategies Inventory-Short Form (CSI-SF). The 32-item CSI-SF includes 8 subscales: problem-solving, cognitive-structuring, express-emotions, social-contact, problem-avoidance, wishful thinking, self-criticism, and social-withdrawal, each with 4 items. Four composite constructs were created from subscales, namely, problem-focused engagement (problem solving + cognitive structuring), emotion-focused engagement (express emotions + social contact), problem-focused disengagement (problem avoidance + wishful thinking), and emotion-focused disengagement (self-criticism + social withdrawal). Perceived stress was measured with the 10-item Cohen Perceived Stress Scale. Associations of coping scores with perceived stress score (PSS) were assessed using multiple linear-regression analyses adjusting for sociodemographic, and lifestyle factors. The coping scores of 4 subscales were inversely associated with PSS including problem solving (β = −0.430, p ≤ .0001), cognitive structuring (β = −0.416, p = .0002), express emotions (β = −0.292, p = .004), and social contact (β = −0.448, p ≤ .0001). Two composite constructs of subscales, namely, problem-focused (β = −0.236, p ≤ .0001) and emotion-focused (β = −0.199, p = .0003) engagement coping strategies were inversely associated with PSS. Greater use of problem- or emotion-focused engagement coping strategies was associated with reduced PSS among Bhutanese, suggesting that problem-focused or emotion-focused stress management interventions hold promise for stress reduction among resettled Bhutanese. Public Policy Relevance Statement Little is known about specific coping responses that refugees undertake when contending with their life problems in a new cultural environment. This study identified greater use of problem- or emotion-focused engagement coping strategies to be associated with reduced stress among refugees, suggesting that problem-focused or emotion-focused stress management intervention