Negotiating identity at the intersection of family legacy and present time life conditions: A qualitative exploration of central issues connected to identity and belonging in the lives of children of refugees

Psycho-social Stressors Experienced by Young war Refugees in Developed Countries: A Scoping Review

BACKGROUND

Refugees escaping political unrest and war are an especially vulnerable group. Arrival in high-income countries (HICs) is associated with a 'new type of war', as war refugees experience elevated rates of psycho-social and daily stressors.

PURPOSE

The purpose of this scoping review is to examine literature on psycho-social stressors amongst young war refugees in HICs and impact of stressors on intergenerational transmission of trauma within parent-child dyads. The secondary objectives are to identify the pre-migration versus post-migration stressors and provide a basis to inform future research projects that aim to lessen the burden of stress and inform evidence-based improvements in this population.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review Extension (PRISMA-ScR) guided the reporting of this review that was performed using a prescribed scoping review method. Extracted from five databases, 23 manuscripts published in 2010 or later met the inclusion criteria.

RESULTS

Three themes emerged: pre-migration stressors, migration journey stressors and uncertainty, and post-migration stressors. While post-migration environments can mitigate the health and well-being of war refugees, socio-cultural barriers that refugees often experience at the host country prevent or worsen their psycho-social recovery.

CONCLUSION

To assist the success of war refugees in HICs, therapeutic interventions must follow an intersectional approach and there needs to be a wider application of trauma informed models of care. Findings of this review may help inform future intervention studies aiming to improve the psycho-social health of this population.

"I Have No Capacities That Can Help Me": Young Asylum Seekers in Norway and Serbia - Flight as Disturbance of Developmental Processes

Most studies on refugee populations are organized around trauma-related issues and focus on explaining pathological factors. Few studies are anchored in general developmental psychology with the aim of exploring normal age-specific developmental tasks and how the special circumstances associated with forced migration can influence how developmental tasks are negotiated. This study is part of a larger mixed method study seeking to identify resilience-promoting and resilience-inhibiting factors, on individual and contextual levels, among asylum seekers and refugees on the move (passing through Serbia) and settled in reception centers in Norway. A strategic sample of 20 adolescent and young adult refugees/asylum seekers during flight in Serbia (10) and after arrival in Norway (10) was chosen from a sample of 178 refugees interviewed in depth in Serbia and at receptions centers in Norway. The sample reflects the focus of this paper, which is to explore adolescent and young adult refugees/asylum seekers' psychological and social needs and resources during flight to and after arrival in the host country, including how developmental tasks are negotiated. Through qualitative analysis, experiences associated with the developmental changes the participants experienced before, during, and after flight are contextualized. Their sense of self, their relationships with their families and their perceptions of their situation as adolescents or young adults in a highly unpredictable situation are presented in the light of relevant theory and findings from similar refugee studies. All the participants have fled from dangerous and intolerable situations in their home countries. They describe extreme dangers during flight in contexts that are unpredictable and where they feel lonely and unsupported. Most have unmet psychosocial needs and have received little support or help for their mental health issues during flight or after arrival in Norway. Suggestions for interventions and resilience-promoting actions are given based on the findings of the study.

The 10-year course of mental health, quality of life, and exile life functioning in traumatized refugees from treatment start

Refugee patients with severe traumatic experiences may need mental health treatment, but treatment results vary, and there is scarcity of studies demonstrating refugees' long-term health and well-being after treatment. In a 10-year naturalistic and longitudinal study, 54 multi-origin traumatized adult refugee patients, with a background of war and persecution, and with a mean stay in Norway of 10.5 years, were recruited as they entered psychological treatment in mental health specialist services. The participants were interviewed face-to-face with multiple methods at admittance, and at varying points in time during and after psychotherapy. The aim was to study the participants' trajectories of symptoms of post-traumatic stress, anxiety and depression, four aspects of quality of life, and two aspects of exile life functioning. Linear mixed effects analyses included all symptoms and quality of life measures obtained at different times and intervals for the participants. Changes in exile life functioning was investigated by exact McNemar tests. Participants responded to the quantitative assessments up to eight times. Length of therapy varied, with a mean of 61.3 sessions (SD = 74.5). The participants improved significantly in symptoms, quality of life, and exile life functioning. Improvement in symptoms of posttraumatic stress, anxiety, and depression yielded small effect sizes (r = .05 to .13), while improvement in quality of psychological and physical health yielded medium effect sizes (r = .38 and .32). Thus, long-time improvement after psychological therapy in these severely traumatized and mostly chronified refugee patients, was more notable in quality of life and exile life functioning than in symptom reduction. The results imply that major symptom reduction may not be attainable, and may not be the most important indication of long-term improvement among refugees with long-standing trauma-related suffering. Other indications of beneficial effects should be applied as well.