For the next set of analyses, we performed a moderation analysis in PROCESS. It was aimed to check hypothesis 4 on the moderation effect of religiosity on distress levels. (see table 5).

Table 5. Moderation effect of religiosity on the relationships between discrimination and distress

	Moderation estimates	Simple slope Estimates
Variables	SE	Estimate	Z	p	SE	Estimate	Z	p
Discrimination	.08	.14	1.83	.05
Religiosity	.32	-.84	-2.64	.01
Discrimination ? Religiosity	.35	-.78	-2.25	.02
Religiosity (Average)					.086	.08	.93	.35
Religiosity Low (-1SD)					.19	.39	1.99	.05
Religiosity High (+1SD)					.11	-.23	-2.17	.03

The analysis showed a significant association between Discrimination and Distress level - ASCL (p= .05), whereas Religiosity showed a significant negative association with Distress (p= .01). At the same time, the relationships between Discrimination and Religiosity had a significant negative association with Distress - ASCL (p = .02). For a visual representation, see Figure 1.

The next step was to check whether Discrimination would affect Distress level (ASCL) at different levels of Religiosity. The results are reported under the Simple slope Estimates column in Table 5.

The results obtained show that Discrimination is positively associated with ASCL when Religiosity is low (p= .05). Concurrently, Discrimination has a negative association with ASCL when Religiosity is high (p= .03).

Figure 1 reflects the relationships of Discrimination and Religiosity on Distress level (ASCL).

Figure1. Relationships of Discrimination and Religiosity predicting Distress (ASCL)

The graph in figure 1 illustrates the relation between Discrimination and Distress when Religiosity is high (+1SD) and when Religiosity is low (-1SD). Thus, the performed analysis confirm hypothesis 4 that “The positive relation between perceived discrimination and distress will be weakened by religiosity”.

Further we investigated Hypothesis 5 positing that “The positive relation between perceived discrimination and distress will be weakened by education level”.

Please see table 6 for the results.

Table 6. Moderation effect of education on relationships between discrimination and distress

	Moderation estimates	Simple slope Estimates
Variables	SE	Estimate	Z	p	SE	Estimate	Z	p
Discrimination	.08	.14	1.83	.05
Education level	.04	.01	.28	.78
Discrimination ? Education	.04	.07	1.96	.05
Religiosity (Average)					.08	.15	1.92	.06
Religiosity Low (-1SD)					.11	.00	-.04	.97
Religiosity High (+1SD)					.11	.30	2.78	.01

Education level showed a positive moderation effect on the relationships between Discrimination and Distress (ASCL), p= .05, which suggest that higher degree of Education (+1SD) increases the negative effect of Discrimination resulting in higher Distress (ASCL) p= .01. A lower level of Education (-1SD) however, did not show any significance, p= .97.

Please also see figure 2 reflecting the relationships of Discrimination and Education level on Distress (ASCL).

Figure 2. Relationships of Discrimination and Education level predicting Distress (ASCL)

Interview results.

In addition to statistical analyses, interviews with five respondents and community leaders were conducted. The interviews supported the results we obtained in statistical analysis and contributed to better understanding of findings. We interviewed five refugees of Afghan origin: 2 male and 3 female participants who lived in Russia for four years and more. Two female and one male participant had their documents under the consideration of the court and the other two participants had a Russian passport and were represented as community leaders. See table 7 for the interview respondents demographics.

Table 7. Interview respondents socio- demographic data

N	Gender	Age	Education	Years in Russia	Legal status
R1	female	21	Secondary school	4	Under consideration of the court
R2	female	19	Secondary school	4	Under consideration of the court
R3	male	24	Incomplete higher education	4	Under consideration of the court
R4	female	32	Secondary school	14	Russian passport
R5	male	49	Tertiary	30	Russian passport

The interview consisted of 16 questions and contained items like: “Do you feel that you're treated differently because of your ethnicity?” and “What do you think helps you and other refugees from your country to sustain a normal life?”. Interview decodings were used in the discussion section.

afghan refugee distress discrimination

4. Discussion

The current study attempted to analyze the relationships between variables of discrimination, religiosity, social support, legal status, education and distress level of Afghan refugees living in Russia. Overall, our hypotheses were partly supported, and we found a moderating effect of religiosity and education level on interactions between Discrimination and Distress (ASCL).

First, we studied the relationships between social support variables and distress (ASCL) using multiple hierarchical regression model. After that, we checked if religiosity and education level could buffer the effect of discrimination on distress level in the current sample.

The first hypothesis positing that “Higher social support from family members will be negatively related with distress” was supported in correlation analysis but was rejected in the hierarchical regression model, which was unexpected. According to previous studies, families are usually the most important source of social support for refugees with traditional cultures (see Aloud & Rathur, 2009; Awad, Martinez, & Amer, 2013; Beitin & Aprahamian, 2014). The regression analysis in the current research, however, only supported hypothesis two which posited that “Higher levels of Social support from significant others will be related with less distress.”. It is important to mention that under Significant other it could be a family member, friend or perhaps someone from the host community. In this regard these are the four items of significant other variables that showed the biggest prediction in refugees distress level: 1) There is a special person who is around when I am in need. 2) There is a special person with whom I can share my joys and sorrows. 3) I have a special person who is a real source of comfort to me. 4) There is a special person in my life who cares about my feelings. We used a multidimensional scale to measure social support - MSPSS (Zimet, Dahlem, Zimet, & Farley, 1988) which provided us with elaborate options of questions which helped to identify the main source of social support for the participants of the current study. Outcomes of the current research are consistent with findings of other studies related to refugees and social support (Cohen et al., 2000; Jurcik, 2014; Rtan, Dooley & Benson, 2008; Schweitzer et al., 2006; ). However, a finer analysis in the current research allowed us to see a more detailed picture of the Social support variable (i.e. divided to family, friends and significant others). In the current research, a unified variable itself (PSS) showed correlations with many variables (see correlation table 3), however, examining individual components of MSPSS revealed that the largest predictor of reduced distress for the current sample was having a special person for support. In the interviews performed the respondents referred to social support from Russians as coping for discrimination they experinece:

“I know other good people [referring to Russians] who always support me and my family: volunteers, social workers who we meet.” R1

or “I never had problems with my Russian friends regarding my background. In every country there are people who do not like anyone.” R4

Based on the interviews we may presume that by “significant others” the respondents meant local Russians, however more detailed investigation should be done studying this concept more carefully.

The third hypothesis stating that “Perceived discrimination will be positively related with distress” was supported. Discrimination in the current research mainly referred to perceived discrimination and consisted of more general questions of being treated differently because of a national background or were threatened or attacked because of being an Afghan. The mean score we obtained (M=1.9, SD = .97, min 1, max 5 ) was below average. Despite medium discrimination rate, it showed a significant association with the level of distress (ASCL), suggesting that discrimination plays a significant role in refugees' psychological well-being, which was confirmed in the other studies as well (see Alemi & Stempel, 2018 for example). The statistical results were confirmed in a small interview we conducted.

To the question related to discrimination and “Do you feel or have you ever felt that you have been treated differently because of your ethnicity?” all the participants answered positively and expressed mild discrimination experiences. One of participants response was

[“It happens sometimes but I do not even pay much attention to it because there are different people in this world”.] R2 or the answer regarding discrimination during employment process:

[“It happened many times to me, even when I obtained a refugee status, the employer did not hire me. They said, they do not know such documents, they need a Russian passport”]. R5

Thus often only a Russian passport can guarantee access to the legal job market.

Also participants expressed discrimination when using the public transport or in a clinic:

[“When my father went to a hospital with me they did not accept us because we did not have the residency. If a person does not have documents, sometimes even ambulances would just leave, even if a person has severe symptoms. It is really painful”]. R1

In addition, the respondent's younger sister could not attend school for two years since they have arrived in Russia, even though school attendance is secured by Russian constitution for every child. Thus, discrimination in finding a job, schooling or logistic difficulties when moving around the city could become not only a source of distress, but also an obstacle on the way of refugees' acculturation process. It could force them to choose marginalization or segregation as an acculturation strategy, rather than integration (Rudmin, 2003). It is more difficult to integrate into a host society if you have a limited number of contacts with the host community. Afghan diaspora in Russia is a very tightly knit community (Zotova, 2007). They know each other and try to support each other, but perhaps it is not enough to integrate.

Hypothesis four stating that “The positive relation between perceived discrimination and distress will be weakened by religiosity” was supported. In the current study higher religiosity weakend the relation between perceived discrimination and distress, manifesting as a buffer in such relations. Also we found significant effect when religiosity was low, i.e. lower religiosity strengthen the relation between perceived discrimination and distress. In the current research, we obtained a relatively high mean score on the religiosity measure (CRS; M=4.5, max=5; SD= .80), suggesting that spiritual aspect of religion plays an important role among Afghan refugees living in Russia, as well as in other countries (see Sulaiman-Hill & Thompson, 2012; Alemi et al., 2014). Some studies also found that participants in different countries referred to religious rituals to cope with psychological worries, for example over, “Thinking too much” symptom It is a cultural symptom of distress caused by different stressors including worries over loneliness, thoughts about home country, being unemployed etc. as well as other stressors and also as a source of social support (De Anstiss et al., 2010; Sulaiman-Hill & Thompson, 2012; Alemi et al., 2014).

The moderation effect of religion was also studied before and it showed a positive coping role during the adjustment period (Ross et al., 2009) and it played a healing role for Somali adolescents living in the US (Heidi et al., 2010). On the other hand, it could also have a negative effect and increase prejudice towards refugees (Deslandes & Anderson, 2019 ).

In the current research religiosity played a role of coping for Afghan refugees and it moderated the effect of discrimination on distress; notably, when religiosity was low distress levels increased. In this matter it is important to note that we used a scale (CRS; Huber& Huber, 2012), which referred more to spirituality of the respondent, rather than to religion as an ethnic component. According to the interviews held, we found that not all the participants follow all the religious rituals, however, many still express the importance of religious celebrations and gatherings. For some individuals and families, religion plays a bigger role than for others. Thus, one of the respondents stated:

[“Our faith is very important for us as well as trust in God. It helps us to overcome difficulties because we know it was meant to be like that and God is with us”] R1.

Religious gatherings are also popular among females. During the current study, participants confirmed that they often gather for different celebrations: both for religious and secular reasons. For the religious holidays, they also tend to visit each other and recite the Qur'an rather than going to the mosque. Thus, the current study finds that religion connected with spirituality plays a buffering role and a source of coping for the Afghan refugees living in Russia.

Further we studied the hypothesis five positing that “The positive relation between perceived discrimination and distress will be weakened by education level”, which was rejected.

The findings we got were not expected and we tried to understand the reasons for such an outcome.

No studies were conducted on Afghan refugees in Russia and many factors require more research including the associations of education level and its effect on mental health. According to the literature review regarding the flow of Afghan refugees to Russia we found that many of those who came with the first and the second wave, were highly educated. Despite that, not many could find employment which required a high qualification (partly due to a long process of obtaining permanent residence status). Thus, people with a higher degree were involved in jobs requiring low qualifications, experiencing downward migration. In general, education level is associated with a lower level of distress and a quicker integration in the host country (Alemi, James, Siddiq & Montgomery, 2015; Sulaiman-Hill & Thompson, 2012). However, downward migration, discontent with a job may increase distress levels and lower psychological well-being of an individual (Close et al., 2016). In Afghanistan these educated participants may have held a high job position, but in Russia they cannot find such jobs, reflecting a form of “downward migration.” (Krahn et al, 2000). According to UNESCO (2017), the literacy rate in Afghanistan is 43% (55.48% percent for males and 29.8 % for females). Therefore educated people are highly valued in Afghanistan and normally hold a higher position in the society. However when migrating they lose their status. In contrast, those with lower education would not experience downward migration as for them their occupation probably has not changed and life conditions perhaps have slightly improved. The current study revealed that higher education level of participants increased the relation between discrimination and distress. Perhaps more educated participants perceive more discrimination because they are face it more often in Russia, or perhaps integration difficulties affect their psychological well-being in a greater extent. Nevertheless, at this point, there is not enough data to develop firm conclusions and this question requires more investigation. A further study should be done on a larger sample including in depth qualitative interviews.

Another factor in the current study, which is linked to Discrimination is legal status. We tried to range legal statuses by the legal rights refugees obtain when they hold one or another document (e.g. passport, asylum seeker status etc). According to literature review, in Russia only refugee status allows a person to work legally or to use the healthcare system (FL 4528-1, 1993; Troitsky, 2019); however it takes many years to obtain it and meanwhile asylum seekers and not yet legalized refugees live without such rights. In the current study we found a significant negative relationship between legal status and discrimination. The higher status refugees held, the less perceived discrimination they reported. Another finding with legal status is that it showed very strong relationships with Russian language proficiency. The reason for that could be that when refugees have legal status, they can move around the city and take Russian classes. Or fluency in Russian may help to navigate better the bureaucracy and obtain documents faster. Another confound could be the years spent in Russia (i.e., the longer asylum seekers live in the country, the more solid legal status they get). Learning the language in a new country is vital and also accelerates the acculturation process. Such a point of view is confirmed by other studies as well (Berry, 2007; Schwartz et al., 2010; Phillimore, 2010). Thus, legal status is a key factor which defines if newcomers can learn a language, find their place in a new society, and acculturate faster.

Based on the study, we made a schematic illustration of the findings we obtained.



Figure 3

5. Limitations

As this was a first attempt to study Afghans in Russia, we encountered some unexpected difficulties when conducting research.

The first limitation was that we had to discard 14% of surveys, because the respondents invalidated the survey. For example, respondents would check the same row (e.g. fully agree) for an entire page in the survey, even if this meant they could fully agree that they felt both happy in Russia and sad in Russia. Perhaps the respondents did not understand the purpose of the study and were afraid to express themselves. Many participants were not familiar with completing questionnaires, therefore we had to monitor if all the questions in the questionnaire were answered. Other reasons might include low literacy levels and distrust of authorities.

The second limitation was that the research with vulnerable samples is usually done in clinical settings or with social workers who are trusted by refugee families. Only when the questionnaire was given to the respondent by an Afghan social worker, they would agree to fill it, despite the reward they get.

Also, often research is funded which makes it possible to have additional translators and social workers. In this research, however, we had limited access to interpreters. Interpreters were available to us only at the offices of an NGO. A significant portion of questionnaires were distributed to the respondents who came to the NGO to deal with their legal or humanitarian issues, i.e. they did not come specifically to fill up the questionnaire. The interpreter would explain the procedures, but could not stay with the respondents the entire time they were filling out the questionnaire. Nevertheless, we tried to reach each participant to explain the importance of honest answers and the results we will get.

Also important, many participants expressed their concern over the religiosity questions: some of respondents asked the reason for the research, whereas others withdrew from the study (around 10%) at this point in the survey. Perhaps they did not trust us and were afraid to be persecuted for their answers.

A third limitation is that this is a correlational study not an experimental design, therefore we cannot clearly disentangle cause from effect or rule out third variables or confounds. For instance, does religiosity lead to well-being or does well-being lead people to become more religious?

Finally, the majority of respondents (around 60%) were the people who came for legal assistance, but it does not necessarily represent the whole sample of Afghan refugees. For further studies we would recommend reaching out to refugees from other settings. In this study we had limited access to a wider range of refugees in the current study.

6. Future research direction

There are several recommendations we would like to mention in direction for future research. Firstly, when analyzing discrimination we included items related to perceived discrimination, however to have a deeper understanding of discrimination we would recommend to include institutional discrimination items, for example such items as access to job market for legal refugees and asylum seekers, access to healthcare system (including emergency), access to schools. During the investigation we came across the literature and we had a few interviews with social workers who suggested that discrimination may occur in institutional levels as well, despite the refugees/asylum seekers legality (see MIPEX, 2015; Troitsky, 2017).Second, we had interesting findings regarding the role of religiosity as a buffer between discrimination and distress. It needs further investigation in the current sample of refugees as well as in other refugees' groups. Third, education level and downward migration phenomenon among refugees and migrants should be studied more thoroughly in the Russian settings, as well as their effect on distress and psychological well-being among refugees and migrants. Finally, future studies should pay more attention to the legal status of refugees and migrants in Russia. Perhaps legal status does not show a direct effect to distress (see table 3), however it may be a strong confounder in other variables, such as employment, language proficiency, acculturation and others that affect distress and well-being of refugees. Another phenomenon which is tightly connected with legal status is a state of uncertainty. The years living in uncertainty may greatly affect refugee mental health (El-Shaarawi, 2015). Thus, more investigation in this area is needed.

Conclusion

This is the first quantitative psychological study conducted on a sample of Afghan refugees living in Russia. Refugees' and asylum seekers' experiences living in Russia are different from the countries where most of the research is conducted. This first study examines discrimination and the resulting distess levels, as well as resilience factors that help refugees in Russia maintain high levels of well-being. The study reveals that religiosity and education levels moderate the distress experienced from discrimination, which warrants further research in Russia.

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73. Porter M., Haslam N. (2005). Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA, 294(5), 602-612.

74. Posselt M., Eaton H., Ferguson M., Keegan D., Procter N. (2018). Enablers of psychological well-being for refugees and asylum seekers living in transitional countries: A systematic review. Health & Social Care in the Community.

75. Presidential decree (2012). The concept of state migration policy of the Russian Federation for the period until 2025. Kontseptsiys gosudarstvennoy migratsionnoy politiki Rossyiskoy Federatsii na period do 2025 goda.

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79. Reesp, S. (2003). Refuge or Retrauma? The Impact of Asylum Seeker Status on the Wellbeing of East Timorese Women Asylum Seekers Residing in the Australian Community. Australasian Psychiatry,11(1_suppl).

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84. Schwartz S.J., Unger J.B., Zamboanga B.L., Szapocznik J. (2010). Rethinking the concept of acculturation: Implications for theory and research. American Psychologist, 65(4), 237-251. doi: 10.1037/a0019330

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Appendix A

Questionnaire in English

1. How old are you?

1) 18-24 years old

2) 25-34 years old

3) 35-44 years old

4) 45-54 years old

5) Over 55

2. What is your sex?

1) Male

2) Female

3. What is your marital status?

1) Single (never married)

2) Married

3) Divorced

4) Widowed

4. What is the highest level of schooling that you have obtained?

1) No schooling

2) Some grade/primary school

3) Completed grade/primary school

4) Some high/secondary school

5) Completed high/secondary school

6) Some technical, community college

7) Completed technical, community college

8) Some university

9) Completed university

10) Post graduate degree

11) Don't know

5. Here are some questions about languages. Please answer by checking the answer that applies best.

a. How well do you:

	Not at all	A little	Somewhat	Fairly well	Very well
Understand Dari?
speak Dari?
read Dari?
write Dari?

b. How well do you:

	Not at all	A little	Somewhat	Fairly well	Very well
Understand Pashto?
speak Pashto?
read Pashto?
write Pashto?

c. How well do you:

	Not at all	A little	Somewhat	Fairly well	Very well
understand Russian?
speak Russian?
read Russian?
write Russian?

6. How religious do you believe you are?

I'm an atheist ______

I'm indifferent to religion _________

I can accept the idea of a higher force

I am a believer _____________

I am a believer and I am trying to follow the rituals of my religion

7. Are you currently employed?

Yes, I am legally employed

Yes, I am employed illegally

No, I am unemployed

8. What work did you used to do in your home country?

1) Unskilled: such as farm labour, food service, house cleaner

2) Skilled work: such as technician, carpenter, hairdresser, seamstress

3) White collar (office) work: such as clerk, salesperson, secretary, small business

4) Professional: doctor, lawyer, teacher, business executive

5) I was a student

6) I was retired

7) I was a housewife

8) I was unemployed

9) Other (specify): _________________________

9. What work do you do currently (in Russia)?

1) Unskilled: such as farm labour, food service, house cleaner

2) Skilled work: such as technician, carpenter, hairdresser, seamstress

3) White collar (office) work: such as clerk, salesperson, secretary, small business

4) Professional: doctor, lawyer, teacher, business executive

5) I was a student

6) I was retired

7) I was a housewife

8) I was unemployed

9) Other (specify): _________________________

10. Which of the following most accurately describes your family's current income level?

1) We live on this income without experiencing financial problem

2) This income is basically enough for us

3) Living with such an income is quite difficult

4) Living with such an income is very difficult

5) It is difficult to answer this question.

11. When did you arrive in Russia? (Please specify the year)

12. Please specify your residence status

1) I withhold a Russian passport

2) I hold an asylum seeker status (which lasts one year)

3) I hold a refugee status

4) My documents are under consideration of the court

5) I have a student visa

6) I have a business visa/working visa

7) None of the above

13. Perceived Discrimination

When people with different backgrounds are together, one may sometimes feel unfairly treated. The following questions are about these kinds of experiences.

	Strongly disagree	Somewhat disagree	Not sure/ neutral	Somewhat agree	Strongly agree
I think that others have behaved in an unfair or negative way towards my national group
I don't feel accepted by Russians
I feel that Russians have something against me
I have been teased or insulted because of my national background
I have been threatened or attacked because of my national background

14. (MSPSS)We are interested in how you feel about the following statements. Read each statement carefully. Indicate how you feel about each statement.

	Very strongly disagree	Strongly Disagree	Mildly Disagree	Neutral	Mildly Agree	Strongly Agree	Very strongly agree
There is a special person who is around when I am in need.								SO
There is a special person with whom I can share my joys and sorrows.								SO
My family really tries to help me.								Fam
I get the emotional help and support I need from my family.								Fam
I have a special person who is a real source of comfort to me.								SO
My friends really try to help me.								Fri
I can count on my friends when things go wrong.								Fri
I can talk about my problems with my family.								Fam
I have friends with whom I can share my joys and sorrows.								Fri
There is a special person in my life who cares about my feelings.								SO
My family is willing to help me make decisions.								Fam
I can talk about my problems with my friends.								Fri
I feel supported by Russians
I feel supported by my own ethnic group

15. (CRS) Please read the following questions and respond to the option that best matches your opinion

	not at all	not very much	Moderately	quite a bit	very much so
To what extent do you believe that God or something divine exists?
To what extent do you believe in an afterlife (e.g. immortality of the soul)?
How often do you try to connect to the divine spontaneously when inspired by daily situations?
How often do you experience situations in which you have the feeling that God or something divine is present?
How important is personal prayer for you?

16. (ASCL) Please think about the last 2 weeks for each of the following questions. For each question, please select the best answer. You can point to the cup that best describes your answer. The empty cup means “never”, the next cup means 1 day each week, the middle cup means 2-3 days each week, the next cup means 4-5 days each week, and the full cup means “everyday”.

	never	1 day/ week	2-3 day/ week	4-5 days/ week	everyday
During the last 2 weeks, how many times have you cried?
During the last 2 weeks, how many times have you had a lack of appetite?
During the last 2 weeks, how many times have you ...

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