Deferred Life Syndrome: A Systematic Review of Institutional Waiting and Embodied Stagnation.

Mary Jesenta  Ngabirano

doi:10.51168/sjhrafrica.v7i3.2493

Authors

Mary Jesenta Ngabirano Independent Researcher, Perigueux, France

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2493

Keywords:

Deferred Life Syndrome, institutional waiting, embodied temporality, Chronic Stress, Migration and Health, Allostatic Load, Hypothalamic–Pituitary–Adrenal Axis

Abstract

Background:

Protracted institutional waiting, driven by bureaucratic delays, complex welfare systems, and prolonged asylum procedures, has become a defining feature of modern governance. While psychological impacts of uncertainty are well documented, its biological embodiment remains underexplored. The concept of Deferred Life Syndrome (DLS) frames prolonged institutional deferral as a structurally produced condition with cumulative psychosocial and physiological consequences

Objectives:

In order to investigate how extended deferral impacts psycho-social well-being, physiologic stress regulation, and life trajectory disruption, this systematic review attempts to synthesize interdisciplinary evidence on institutional waiting and chronic uncertainty.

Methods:

This systematic review followed PRISMA guidelines to synthesize interdisciplinary evidence. Searches were conducted across Scopus, Web of Science, PubMed, PsycINFO, and Google Scholar for studies published between 2000 and 2025. Eligible studies examined institutional waiting, bureaucratic delays, or chronic uncertainty and their psychosocial or physiological effects. Study quality and risk of bias were assessed using established appraisal tools. Due to heterogeneity in designs, a narrative thematic synthesis was employed

Results:

Sixty-eight studies met inclusion criteria, covering populations exposed to prolonged uncertainty, particularly migrants and individuals navigating complex administrative systems. Findings show that institutional waiting produces chronic uncertainty, reduced agency, and disrupted life trajectories. These conditions are associated with psychological distress, heightened stress responses, and physiological dysregulation, including increased allostatic load and hypothalamic-pituitary-adrenal axis disruption.

Conclusion:

Deferred Life Syndrome provides a biosocial framework linking institutional governance to embodied stress and disrupted life trajectories, shifting analysis from individual pathology to structural determinants of health and inequality .

Recommendations and Future Research:

Future research should operationalize DLS through longitudinal and mixed-methods designs incorporating biomarkers of stress and measures of agency. Policy interventions should reduce administrative delays, improve transparency, and prioritize timely decision-making.

Author Biography

Mary Jesenta Ngabirano, Independent Researcher, Perigueux, France

Migration studies, mental health, and psychosocial well-being are the areas of expertise for independent researcher Mary Jesenta Ngabirano. Her research focuses on long-term socioeconomic uncertainty, professional deskilling, and labor market integration while examining the structural, institutional, and psychological aspects of migrant experiences.

She analyzes complicated social and public health issues using a variety of methodological techniques, such as systematic reviews, desk-based research, and empirical data gathering. She performed and published two empirical studies among university students while pursuing her master's degree at Bishop Stuart University in South-Western Uganda. One study looked at the prevalence of COVID-19 vaccine uptake, while the other examined factors related to vaccination acceptance. Her foundation in rigorous quantitative research and evidence-based analysis is evident in these studies.

Her lived experience of migration to France informed a broader scholarly shift toward examining structural precarity, identity disruption, and temporal uncertainty among migrants. Her recent work on Deferred Life Syndrome advances a conceptual and interdisciplinary framework linking bureaucratic delay, chronic uncertainty, and psychosocial stress to long-term well-being outcomes.

Her research seeks to contribute to policy dialogue and institutional reform aimed at promoting equitable labor market access, protecting professional capital, and fostering social cohesion and psychological resilience among migrant and marginalized populations.

References

Andersson, R. (2014). Time and uncertainty in migrant lives: Waiting, liminality, and precarity. Journal of Ethnic and Migration Studies, 40(6), 1-18.

Auyero, J. (2012). Patients of the state: The politics of waiting in Argentina. Duke University Press.

https://doi.org/10.2307/j.ctv121038b https://doi.org/10.1515/9780822395287 https://doi.org/10.1215/9780822395287

Bloch, A. (2000). Refugees in the UK labour market: The construction of a disadvantaged identity. Journal of Ethnic and Migration Studies, 26(1), 119-135.

Bourdieu, P. (2000). Pascalian meditations. Stanford University Press.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.

https://doi.org/10.1191/1478088706qp063oa

Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2012). Psychological stress and disease. JAMA, 298(14), 1685-1687.

https://doi.org/10.1001/jama.298.14.1685

Hage, G. (2009). Waiting out the crisis: Liminality, governmentality and temporality in times of uncertainty. Journal of Intercultural Studies, 30(3), 263-277.

Honneth, A. (1995). The struggle for recognition: The moral grammar of social conflicts. MIT Press.

Juster, R.-P., McEwen, B. S., & Lupien, S. J. (2010). Allostatic load biomarkers of chronic stress and impact on health and cognition. Neuroscience & Biobehavioral Reviews, 35(1), 2-16. https://doi.org/10.1016/j.neubiorev.2009.10.002

Khosravi, S. (2021). Precarious lives: Waiting and uncertainty in migration and asylum. Policy Press.

Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J., Hassan, G., Rousseau, C., & Pottie, K. (2011). Common mental health problems in immigrants and refugees: General approach in primary care. CMAJ, 183(12), E959-E967. https://doi.org/10.1503/cmaj.090292

Marmot, M. (2015). The health gap: The challenge of an unequal world. Bloomsbury Publishing.

https://doi.org/10.1016/S0140-6736(15)00150-6

McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840(1), 33-44. https://doi.org/10.1111/j.1749-6632.1998.tb09546.x

Miller, G. E., Chen, E., & Zhou, E. S. (2007). If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychological Bulletin, 133(1), 25-45.

https://doi.org/10.1037/0033-2909.133.1.25

Rotter, J. (2016). Temporal structures and waiting: Migration, bureaucracy, and social uncertainty. Migration Studies, 4(2)158-176.

Slavich, G. M. (2020). Social safety theory: Understanding social stress, disease risk, resilience, and behavior during the COVID-19 pandemic and beyond. Psychological Inquiry, 31(3), 153-190.

Standing, G. (2011). The precariat: The new dangerous class. Bloomsbury Academic. https://doi.org/10.5040/9781849664554

Steel, Z., Silove, D., Phan, T., & Bauman, A. (2009). Long-term effects of psychological trauma on refugees. The Lancet, 365(9467), 517-525.

Summerfield, D. (2012). A critique of seven assumptions behind psychological trauma programs in war-affected areas. Social Science & Medicine, 70(1), 53-61.

Wilkinson, R., & Pickett, K. (2009). The spirit level: Why equality is better for everyone. Penguin.