**1. Introduction**

Since 2011, more than 511,000 Syrians have lost their lives to armed conflict and more than 12 million others have been forced from their homes due to the civil war and the penetration of ISIS forces into Syria. To date, more than 5.6 million of those in need have sought refuge outside Syria, mostly in neighboring countries [1]. In fleeing for their lives, refugees face many other stressors related to their war experiences. They seek to resettle in a new country while having to learn a new language. They also face poverty and a lack of resources, which place them at additional risks of violence, discrimination, and social isolation [2].

Based on the salutogenic model [3,4], the present study sought to explore the coping resources of and common mental-health problems (including anxiety, depression, and somatization) among refugee women who have fled Syria to Greece. Specifically, we aimed to examine the roles of educational levels and the time spent in the refugee camp in these women's adaptation to life in a new country. Based on these sociodemographic factors, we compared the women in terms of several dimensions, namely, a personal sense of coherence (SOC), a community sense of coherence (ComSOC), exposure to the armed conflict, appraisal of danger in the war zone, and whether they had received aid from any of a variety of organizations. In addition, we also wanted to further understand the variables that could explain mental health and adaptation among refugees.

#### *1.1. Refugee Women*

In times of conflict, women are characterized as powerless victims. During the civil war in Syria, women have faced forms of structural violence from the Syrian regime. Inequalities are emphasized and this affects the ways in which Syrian women experience the process of becoming a refugee. Overall, Syrian women and refugee Syrian women, in particular, are affected by systems of power that marginalize them and their voices [5].

As refugees, these women have been exposed to multiple forms of insecurity and violence. Moreover, a lack of adequate housing adds an additional layer of insecurity and vulnerability to their lives. Some studies have reported that these women face gender-biased violence [6,7]. The lack of suitable housing and access to sanitary facilities also affect the women's physical and mental health and well-being [6]. Indeed, some studies have indicated that women refugees are an especially vulnerable population, with high rates of depression and other mental-health problems [7].

#### *1.2. Experiences of War*

Direct exposure to the war in Syria have led the participants in this study to flee their homes and become refugees. Exposure to war events refers to the individuals' experience of bombs falling and damaging their neighborhoods and surroundings, as well as harm caused to their acquaintances as a result of the war [8]. This type of exposure to violence is likely to increase the risk of psychological problems such as anxiety, depression, and somatization, especially during the first stage of migration [9]. However, results of studies regarding the cumulative exposure to violent political events are inconclusive [10]. While some research on refugees has shown associations between exposure (i.e., the number of events and their intensity) and various psychological problems [11], other studies that have examined war experiences (e.g., one's community being attacked by rockets/bombs, the experience of someone an individual knows being hurt as result of the war, the experience of having a relative hurt as a result of the war, having been hurt as result of the war, and having had one's home damaged as result of the war) have indicated that the number of events is not the most significant predictor of post-traumatic stress or other internalizing or externalizing psychological problems [12]. In other work, coping resources such as SOC have been shown to mediate the relationship between exposure to war events and stress-related reactions [13]. Thus, it seems important to evaluate the role of these factors in the context of women refugees, in order to understand their adjustment to life in a new country after having experienced and fled from war.

#### *1.3. Appraisal of Danger*

The primary appraisal is the evaluation of the original threat in order to estimate the current threat, and the secondary appraisal is the assessment of the resources one has in order to deal with the stressor [14]. The evaluation of whether a situation represents a threat or a challenge determines the level of arousal and which of the coping resources one has in his/her repertoire that will be drawn upon to deal with the situation [15]. Studies that have examined this variable in the context of war and terror have shown that women are more vulnerable and report more feelings of danger as compared to men [16]. Research has shown that these feelings seem to be an independent predictor of a variety of mental-health symptoms. That is, the stronger the feelings of danger, the higher the threat appraisal and the more intense the mental-health symptoms [8].

#### *1.4. Receiving Aid*

There is a debate as to whether humanitarian aid that focuses mainly on material and social support and is funded by a variety of organizations with political agendas actually benefits the refugees who receive it, or whether it harms or does not affect them. Indeed, most studies in this domain lack empirical evaluations [17]. One study that tried to evaluate whether humanitarian aid mitigates or exacerbates the effects of war on stress reactions was based on two interviews and did not draw a clear conclusion. Additionally, despite the problematic idea of organizations driven by external interests, that work did not suggest relying solely on the refugees' needs and priorities [18]. A recent study showed that receiving aid from any of a variety of organizations did not play a significant role in reducing psychological problems among refugee youth and had only a moderate relationship with their expectations [12]. The present study tries to add additional knowledge to fill this lacuna in the research by examining the role of aid from a variety of organizations in reducing psychological problems among refugee women.

#### *1.5. The Salutogenic Model and Sense of Coherence (SOC)*

The secondary appraisal facilitates the exploration of the resources available to the individual to deal with a stressful situation. In this study, we examined the coping resource of SOC, which is rooted in the salutogenic model [3] and is an important concept in positive psychology [19]. The salutogenic model looks for functions of positive qualities rather than healing from sickness [19,20]. Thus, the present study focuses on coping and resilience resources rather than risk factors. The main construct of this model, SOC, is an enduring tendency to see the world as more or less comprehensible, manageable, and meaningful [4]. In accordance with the salutogenic theory, a person with a strong SOC will be more likely to evaluate a particular stimulus as neutral [19]. Therefore, an individual with a strong SOC is less likely than one with a weak SOC to perceive stressful situations as threatening and anxiety-provoking. SOC determines the ability of individuals to use resources that are available to them to promote their well-being [21]. Moreover, SOC includes components that consolidate resilience and enhance subjective mental health [19]. Indeed, numerous studies have shown that SOC may be considered a protective factor that helps to moderate and mediate stress experiences (e.g., [22,23]). Furthermore, Evans and Davis [22] showed that the ways in which SOC acts through family, community, and cultural dimensions can aid successful coping and reduce stress among marginalized and minority ethnic groups.
