1
|
Anisman H, Doubad D, Asokumar A, Matheson K. Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience. Neurosci Biobehav Rev 2024; 165:105859. [PMID: 39159733 DOI: 10.1016/j.neubiorev.2024.105859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 08/06/2024] [Accepted: 08/15/2024] [Indexed: 08/21/2024]
Abstract
Anisman, H., Doubad, D., Asokumar, A. & Matheson, K. Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience. NEUROSCI BIOBEHAV REV, XXXX. Immigration occurs between countries either to obtain employment, for family reunification or to escape violence and other life-threatening conditions. Refugees and asylum seekers are often obligated to overcome a uniquely challenging set of circumstances prior to and during migration. Settlement following immigration may pose yet another set of stressors related to acculturation to the host country, as well as financial insecurity, discrimination, language barriers, and social isolation. Here we discuss the multiple consequences of immigration experiences, focusing on the health disturbances that frequently develop in adults and children. Aside from the psychosocial influences, immigration-related challenges may cause hormonal, inflammatory immune, and microbiota changes that favor psychological and physical illnesses. Some biological alterations are subject to modification by epigenetic changes, which have implications for intergenerational trauma transmission, as might disruptions in parenting behaviors and family dysfunction. Despite the hardships experienced, many immigrants and their families exhibit positive psychological adjustment after resettlement. We provide information to diminish the impacts associated with immigration and offer strength-based approaches that may foster resilience.
Collapse
Affiliation(s)
- H Anisman
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada.
| | - D Doubad
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
| | - A Asokumar
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
| | - K Matheson
- Carleton University, Department of Neuroscience, Ottawa, Ontario K1S 5B6, Canada
| |
Collapse
|
2
|
Burgund Isakov A, Markovic V. Systematic Review of Trauma-Informed Approaches and Trauma-Informed Care for Forced Migrant Families: Concepts and Contexts. TRAUMA, VIOLENCE & ABUSE 2024:15248380241266161. [PMID: 39126194 DOI: 10.1177/15248380241266161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
In the past decade, there has been a significant increase in the forced migrant and refugee population in Europe. As the journey to arrive at the country of destination is mostly irregular, research has shown that forced migrants survive a number of traumatic experiences trying to reach safety and ensure the well-being of themselves and their families. Since research shows that exposure to traumatic experiences refugee and migrant families endure on their journey is severe, a systematic literature review was conducted to understand the concept of trauma-informed approaches for migrant and refugee families. A total of seven research databases have been a part of this study, and the search resulted in 45 papers that were analyzed and their results presented. The following inclusion criteria were considered: (a) migrant/refugee families living with their children and (b) migrant/refugee families approaching care (health, social, educational, legal). Inclusion criteria refer to phenomenological studies, consider trauma/resilience of migrant/refugee families, include studies that are published in English language only; published literature only; 2013 onwards, and only full-text studies. The results of this analysis imply that papers are more focused on the experiences of trauma than on the approaches to treat it. However, this analysis did result in identifying approaches, interventions, and tools in working with trauma refugee and migrant families. Trauma-informed approaches for forced migrant families require a culturally adapted response provided across all sectors of family support to refugees and migrants.
Collapse
Affiliation(s)
| | - Violeta Markovic
- University of Belgrade, Faculty of Political Science, Belgrade, Serbia
| |
Collapse
|
3
|
Sloover M, Stoltz SEM, van Ee E. Parent-Child Communication About Potentially Traumatic Events: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:2115-2127. [PMID: 37946404 PMCID: PMC11155229 DOI: 10.1177/15248380231207906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Social support plays an important role in children's well-being after experiencing a potentially traumatic event (PTE). One such source of support is the parent-child relationship, specifically by discussing the event. However, current literature provides no consensus on whether parents and children communicate about PTEs, in what way they might communicate and how this affects the child. Hence the goal of the current study is threefold, to explore: (a) whether parents and children communicate about PTEs, (b) what this communication looks like, and (c) how this affects children's well-being. These questions are answered by means of a systematic literature review. Articles were eligible for inclusion if it was an empirical study on communication between parents and children about a PTE that the child (under 18 years) had experienced. Initial searches in electronic databases provided 31,233 articles, of which 26 were deemed eligible for inclusion. Results show that most parents and children have discussed PTEs, but that this may depend on cultural background. What the parent-child communication looks like depends on various factors such as, age of the child, tone, and child's initiation of discussion. Parental post-traumatic stress symptoms seem to negatively impact communication. The results of the impact of communication are less clear-cut, but it seems to have a predominantly positive effect on the child's well-being, depending on parental sensitivity. Clinicians should be watchful for parental symptoms of post-traumatic stress disorder and can focus on promoting parental sensitivity and responsiveness when discussing PTEs with their child or on creating a joint narrative within families.
Collapse
Affiliation(s)
| | | | - Elisa van Ee
- Radboud University Nijmegen, The Netherlands
- Psychotraumacentrum Zuid Nederland, Reinier van Arkel, s-Hertogenbosch, The Netherlands
| |
Collapse
|
4
|
Riggs E, Gartland D, Szwarc J, Stow M, Paxton G, Brown SJ. Resilience and Positive Wellbeing Experienced by 5-12-Year-Old Children with Refugee Backgrounds in Australia: The Childhood Resilience Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:627. [PMID: 38791841 PMCID: PMC11121680 DOI: 10.3390/ijerph21050627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/06/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
Refugee research tends to be deficit based and focused on the risks threatening positive adaptation and wellbeing. High rates of mental (and physical) health issues have been reported for refugee adults and children, including intergenerational trauma. This study uses the new Child Resilience Questionnaire (CRQ), co-designed with refugee background communities, to describe resilience and positive wellbeing experienced by children of refugee-background. The Childhood Resilience Study (CRS) recruited 1132 families with children aged 5-12 years in Victoria and South Australia, Australia. This included the recruitment of 109 families from 4 refugee background communities: Assyrian Chaldean (Iraq, Syria), Hazara (Afghanistan), Karen (Burma, Thailand) and Sierra Leonean families. CRQ-parent/caregiver report (CRQ-P/C) scores were categorised into 'low', 'moderate' and 'high'. The child's emotional and behavioural wellbeing was assessed with the Strengths and Difficulties Questionnaire, with positive wellbeing defined as <17 on the total difficulties score. Tobit regression models adjusted for a child's age. The CRQ-P/C scores were not different for boys and girls of refugee background. Children of refugee-background (n = 109) had higher average CRQ-P/C scores than other CRS children (n = 1023) in the personal, school and community domains, but were lower in the family domain. Most children with 'high' resilience scores had positive wellbeing for both children of refugee-background (94.6%) and other CRS children (96.5%). Contrary to common stereotypes, children of refugee-background show specific individual, family, school and cultural strengths that can help them navigate cumulative and complex risks to sustain or develop their positive wellbeing. A better understanding as to how to build strengths at personal, family, peer, school and community levels where children are vulnerable is an important next step. Working in close collaboration with refugee communities, schools, policy makers and key service providers will ensure the optimal translation of these findings into sustainable practice and impactful public policy.
Collapse
Affiliation(s)
- Elisha Riggs
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (E.R.); (S.J.B.)
- Department of General Practice, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (E.R.); (S.J.B.)
- Department of Pediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Josef Szwarc
- Victorian Foundation for Survivors of Torture, Melbourne, VIC 3056, Australia; (J.S.); (M.S.)
| | - Mardi Stow
- Victorian Foundation for Survivors of Torture, Melbourne, VIC 3056, Australia; (J.S.); (M.S.)
| | - Georgia Paxton
- Immigrant Health Service, Royal Children’s Hospital, Melbourne, VIC 3052, Australia;
| | - Stephanie J. Brown
- Intergenerational Health, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (E.R.); (S.J.B.)
- Department of General Practice, University of Melbourne, Melbourne, VIC 3052, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| |
Collapse
|
5
|
Kevers R, de Smet S, Rober P, Rousseau C, De Haene L. Silencing or silent transmission? An exploratory study on trauma communication in Kurdish refugee families. FAMILY PROCESS 2024. [PMID: 38566251 DOI: 10.1111/famp.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/23/2023] [Accepted: 12/19/2023] [Indexed: 04/04/2024]
Abstract
Trauma communication in refugee families is increasingly recognized as an important relational dynamic influencing psychosocial well-being, yet studies exploring interactional dynamics and meaning making at play in intra-family trauma communication remain scarce. This article reports on a qualitative study with Kurdish refugee families including parents (N = 10) and children (N = 17) resettled in Belgium, aiming to explore practices on trauma communication within refugee family relationships. In a multiple-phased qualitative design, semi-structured family interviews and participant observation administered in the homes of the participant families are followed by parental interviews involving a tape-assisted recall procedure to investigate observed intergenerational trauma communication and parent-child interactions. Data analysis shows parents and children seldom explicitly talked about the families' lived experiences of trauma. This silence was especially related to parental wishes to avoid their children's future involvement in violence. However, findings also indicate how the intra-family transmission of memories of collective violence occurs in many subtle ways. Four modes of indirect trauma communication could be distinguished: (1) focusing on the repetition of violence in the present; (2) transmission of the collective trauma history; (3) family storytelling; and (4) interaction with meaningful objects of the past. These findings shed light onto the interwoven nature of personal-familial and collective trauma and loss and illuminate the meanings of silence and disclosure in the context of the Kurdish diaspora. In the final section, we discuss our findings and outline its clinical implications for family therapeutic practices in refugee trauma care.
Collapse
Affiliation(s)
- Ruth Kevers
- Parental and Special Education Research Unit, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- PASO, UPC KU Leuven University Psychiatric Center, Kortenberg, Belgium
| | - Sofie de Smet
- Parental and Special Education Research Unit, Faculty of Psychology and Educational Sciences and Faculty Clinical Centre PraxisP, University of Leuven, Leuven, Belgium
| | - Peter Rober
- Interfaculty Institute of Family and Sexuality Studies, University of Leuven, Leuven, Belgium
| | - Cécile Rousseau
- Division of Social and Cultural Psychiatry, McGill University, Montréal, Quebec, Canada
| | - Lucia De Haene
- Parental and Special Education Research Unit, Faculty of Psychology and Educational Sciences and Faculty Clinical Centre PraxisP, University of Leuven, Leuven, Belgium
| |
Collapse
|
6
|
Bachem R, Levin Y, Yuval K, Langer NK, Solomon Z, Bernstein A. Complex posttraumatic stress disorder in intergenerational trauma transmission among Eritrean asylum-seeking mother-child dyads. Eur J Psychotraumatol 2024; 15:2300588. [PMID: 38190253 PMCID: PMC10776052 DOI: 10.1080/20008066.2023.2300588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
Background: Traumatic stress among forcibly displaced people has a variety of adverse consequences beyond individual mental health, including implications for poor socioemotional developmental outcomes for their children post-displacement.Objective: This study explored the intergenerational transmission of maternal ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) and depression among asylum-seeking mothers for their children's internalizing and externalizing difficulties.Method: Participants were 127 trauma-affected Eritrean mothers of preschool-aged children in Israel. The severity of child difficulties was compared between mothers with probable ICD-11 CPTSD (94.5% comorbid depression), ICD-11 PTSD (48.5% comorbid depression), unimorbid depression, and healthy mothers, using multivariate analyses of variance, while controlling for children's direct exposure to adverse life experiences.Results: Probable ICD-11 CPTSD and PTSD were present in 23.6% and 26.0% of mothers, respectively. Relative to maternal PTSD, CPTSD was significantly and strongly associated with elevated child internalizing symptoms (d = 2.44) and marginally significantly, although strongly, associated with child externalizing symptoms (d = 1.30). Post-hoc exploratory analyses documented that, relative to maternal PTSD and depression, CPTSD and depression comorbidity was marginally significantly but strongly associated with child internalizing (SMD = .67), but not externalizing symptoms (SMD = .35).Conclusions: Findings implicate maternal CPTSD and comorbid depression in child socio-emotional development and inform clinical assessment, prevention, and intervention to attenuate poor development among children in unstable post-displacement settings.
Collapse
Affiliation(s)
- Rahel Bachem
- Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Yafit Levin
- School of Social Work, Ariel University, Ariel, Israel
| | - Kim Yuval
- Observing Minds Lab, Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Nora Korin Langer
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
| | - Zahava Solomon
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
- the I-Core Research Center for Mass Trauma, Tel-Aviv, Israel
| | - Amit Bernstein
- Observing Minds Lab, Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
7
|
Wang X, Huang J, Yang X, Liu Z, Zhou X. Trajectories of parental posttraumatic stress disorder and children's mental health following Super Typhoon Lekima: The mediating role of feeling of safety. J Adolesc 2023; 95:1590-1602. [PMID: 37530099 DOI: 10.1002/jad.12228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/07/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION Several studies have examined the impact of parents' posttraumatic stress disorder (PTSD) on their children's mental health, but few have evaluated the role of parents' specific PTSD trajectories. The aim of this study was to assess the mechanisms underlying distinct trajectories of parental PTSD that affect children's PTSD and depression through the feeling of safety. METHODS The final sample comprised 242 dyads of parents and their children who experienced Super Typhoon Lekima in 2019. All participants were surveyed at three time points after the typhoon: 3 months (T1), 15 months (T2), and 27 months (T3). Parental PTSD symptoms at three time points and children's PTSD, depression, and feeling of safety at T3 were analyzed. RESULTS Four parental PTSD trajectories were identified: recovery, resilience, delayed, and coping. Compared with the resilient group, children of parents with delayed PTSD trajectories reported higher levels of depression at T3, while children of parents in the coping group were more likely to experience severe PTSD at T3. Children of parents in the recovery group, with a reduced feeling of safety, exhibited more severe depression and PTSD at T3, whereas children of parents in the delayed group were at an increased risk of PTSD at T3. CONCLUSIONS These findings highlight the heterogeneity of parental PTSD trajectories following natural disasters and their distinct effects on children's PTSD and depression. Furthermore, feeling of safety emerges as a crucial mechanism in this process.
Collapse
Affiliation(s)
- Xuan Wang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Jiali Huang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Xima Yang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Zhengyi Liu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| |
Collapse
|
8
|
Hoffman SJ, Fredkove WM. Using a Constructivist-Oriented Modified Grounded Theory Approach in the Study of Intrafamily Trauma Communication Process in War-Affected Families: A Methodologic Example. ANS Adv Nurs Sci 2023:00012272-990000000-00077. [PMID: 37498059 PMCID: PMC10818002 DOI: 10.1097/ans.0000000000000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Grounded theory methodology is frequently applied in health research, yet studies contending with contextual constraints may require a more pragmatic approach, including potential methodologic divergence and modifications of method choice and application. Dissemination of a detailed documentation and justification of methodologic choices, and specific method modifications and/or innovations, are uncommon in extant literature; however, a more expansive approach to such reporting has the potential to enhance research practices, increase transparency, and contribute to the ongoing discourse around research approaches and rigor. Here, we articulate our methodologic decision-making and methods, including modifications, as applied to the qualitative strand of an explanatory mixed-methods study. The primary aim of this article is to contribute to the discourse and collective learning around methodology and method choices and modifications by presenting one approach to applying a constructivist-oriented, modified version of grounded theory analytic methods through a worked qualitative study example.
Collapse
|
9
|
Hoffman SJ, Vukovich MM, Fulkerson J, Gewirtz A, Robertson CL, Fredkove WM, Gaugler J. The Impact of Parent Torture and Family Functioning on Youth Adjustment in War-Affected Families: A Path Analysis Describing Intergenerational Trauma and the Family System. JOURNAL OF FAMILY NURSING 2023:10748407231164747. [PMID: 37029558 DOI: 10.1177/10748407231164747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The direct exposure to physical or psychological trauma from torture or war leads to well-documented individual health consequences. Less understood are the inclusive and intergenerational effects of war trauma on family systems and youth adjustment. The purpose was to examine mechanisms in war-affected families that explained the significant emotional and behavioral consequences of intergenerational trauma in youth through the use of multiple methods. Quantitative assessments of maternal and paternal caregivers and youth characterized associations between parent torture, parent mental health distress, parent physical health problems, family functioning, and youth adjustment. Narrative statements further contextualized processes through which the trauma of a parent impacted youth and family systems. The research was conducted in partnership with local, refugee-serving community-based organizations. The study sample included parents and youth in 96 Karen families, originating from Burma in Southeast Asia, who had been resettled to the United States through the U.S. Refugee Admissions Program. Path analysis results indicated that parent torture (β = -0.173) had statistically significant negative direct effects on youth adjustment. Parent torture had a negative indirect effect on youth adjustment through the mental health (β = -0.345) and physical health problems of parents (β = -0.305), and youth gender (β = 0.126) and trauma exposure of youth (β = -0.048). Family functioning type demonstrated a positive direct effect on youth adjustment (β = 0.449). Family type had an indirect effect on youth adjustment through youth gender (β = 0.142), youth trauma exposure (β = -0.165), parent physical health problems (β = -0.202), and parent mental health (β = 0.509). The current study developed and tested the first model of intergenerational trauma's effects on the adjustment of Karen refugee youth. Results emphasize that individual recovery from torture must be accompanied by adjunct interventions focused on family systems and youth adjustment, to holistically address intergenerational sequala of trauma.
Collapse
|
10
|
Paoletti P, Perasso GF, Lillo C, Serantoni G, Maculan A, Vianello F, Di Giuseppe T. Envisioning the future for families running away from war: Challenges and resources of Ukrainian parents in Italy. Front Psychol 2023; 14:1122264. [PMID: 37008874 PMCID: PMC10050883 DOI: 10.3389/fpsyg.2023.1122264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/13/2023] [Indexed: 03/17/2023] Open
Abstract
Since February 2022, 7.8 million people have left Ukraine. In total, 80% are women and children. The present quali-quantitative study is the first in Italy to (i) describe the adaptation challenges and the resources of refugee parents and, indirectly, of their children and (ii) investigate the impact of neuropsychopedagogical training on their wellbeing. The sample includes N = 15 Ukrainian parents (80% mothers, mean age = 34 years) who arrived in Italy in March and April 2022. The parents participated in neuropsychopedagogical training within the program Envisioning the Future (EF): the 10 Keys to Resilience. Before the training, participants completed an ad hoc checklist to detect adjustment difficulties. After the training, they responded to a three-item post-training questionnaire on the course and to a semi-structured interview deepening adaptation problems, personal resources, and the neuropsychopedagogical training effects. Participants report that since they departed from Ukraine, they have experienced sleep, mood, and concentration problems, and specific fears, which they also observed in their children. They report self-efficacy, self-esteem, social support, spirituality, and common humanity as their principal resources. As effects of the training, they report an increased sense of security, quality of sleep, and more frequent positive thoughts. The interviews also reveal a 3-fold positive effect of the training (e.g., behavioral, emotional-relational, and cognitive-narrative).
Collapse
Affiliation(s)
| | - Giulia Federica Perasso
- Research Institute for Neuroscience Education and Didactics, Fondazione Patrizio Paoletti, Assisi, Italy
- *Correspondence: Giulia Federica Perasso
| | - Carmela Lillo
- Research Institute for Neuroscience Education and Didactics, Fondazione Patrizio Paoletti, Assisi, Italy
| | - Grazia Serantoni
- Research Institute for Neuroscience Education and Didactics, Fondazione Patrizio Paoletti, Assisi, Italy
| | - Alessandro Maculan
- Department of Philosophy, Sociology, Pedagogy, and Applied Psychology, University of Padua, Padua, Italy
| | - Francesca Vianello
- Department of Philosophy, Sociology, Pedagogy, and Applied Psychology, University of Padua, Padua, Italy
| | - Tania Di Giuseppe
- Research Institute for Neuroscience Education and Didactics, Fondazione Patrizio Paoletti, Assisi, Italy
| |
Collapse
|
11
|
Baumgarten LG, Johansen M, Winther H. Holistic movement activities with refugee families: the importance of attachment processes. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2022. [DOI: 10.1080/17432979.2022.2148743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Maise Johansen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Helle Winther
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
12
|
Bager L, Laursen TM, Palic S, Nordin L, Høgh Thøgersen M. Adverse childhood experiences among children of parents who are refugees affected by trauma in Denmark: a register-based cohort study. THE LANCET PUBLIC HEALTH 2022; 7:e825-e833. [DOI: 10.1016/s2468-2667(22)00194-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 12/17/2022] Open
|
13
|
Cai J, Lee RM. Intergenerational Communication about Historical Trauma in Asian American Families. ADVERSITY AND RESILIENCE SCIENCE 2022; 3:233-245. [PMID: 35692379 PMCID: PMC9170877 DOI: 10.1007/s42844-022-00064-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 12/01/2022]
Abstract
Little is known about how Asian American families, as well as other racially marginalized families, communicate about ethnic and racial group histories, particularly regarding historical trauma. Unlike personal trauma, historical trauma refers to distressing or life-threatening events which members of a group with a shared social identity experience together and pass on to their descendants. It has been studied in a variety of groups and contexts, notably in Holocaust survivors and their families and in Native American communities. The concept has seen limited application to Asian American groups, despite its relevance to their unique and shared lived experiences. For instance, the majority of Asian Americans have immigrated from countries across Asia that have been profoundly affected by war and political upheaval in the past century. Research on historical trauma among Asian Americans has focused primarily on refugees who fled the US wars in Southeast Asia, with some research on Japanese Americans who were incarcerated during World War II. Historical trauma related to other major events, such as the India/Pakistan Partition, the Chinese Civil War and Cultural Revolution, the Korean War, and the Sri Lankan Civil War, have not been examined among Asian Americans. A lack of recognition of these historical traumas within families and communities, as well as in the psychological literature, may mask important pre-migration history effects on Asian American families across generations. In this paper, we consider how historical trauma impacts Asian American individuals, families, and communities. We also examine the role of intergenerational communication in historical trauma and in Asian American families and communities. Finally, we discuss historical trauma among Asian Americans within the framework of radical healing, particularly how intergenerational communication about historical trauma can raise critical consciousness, facilitate ethnic-racial identity development, and reinforce ethnic-racial socialization.
Collapse
Affiliation(s)
- Jieyi Cai
- University of Minnesota, Twin Cities, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455 USA
| | - Richard M. Lee
- University of Minnesota, Twin Cities, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455 USA
| |
Collapse
|
14
|
Kelstrup L, Carlsson J. Trauma-affected refugees and their non-exposed children: A review of risk and protective factors for trauma transmission. Psychiatry Res 2022; 313:114604. [PMID: 35580432 DOI: 10.1016/j.psychres.2022.114604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 01/12/2023]
Abstract
The rates of posttraumatic stress syndrome (PTSD) are high among refugee populations. At the same time, evidence is emerging of intergenerational transmission of psychopathology. The objective of this study was to examine the current knowledge on risk and protective factors for adverse mental health outcomes in the non-exposed offspring of trauma-affected refugees. A systematic search was undertaken from 1 January 1981 to 5 February 2021 (PubMed, Embase, PSYCInfo). Studies were included if they reported on families of trauma-exposed refugee parents and mental health outcomes in their non-exposed children. The search yielded 1415 results and twelve articles met inclusion criteria. The majority of studies emphasized the negative effects of parental mental health symptoms. There was substantial evidence of an association between parental PTSD and increased risk of psychological problems in offspring. Parenting style was identified as both a potential risk and protective factor. Risk/protective factors at the individual and family level were identified, but findings were inconclusive due to sample sizes and study designs. There is a need for evidence-based interventions aimed at improving child outcomes, especially by improving parental mental health and reinforcing parenting skills. Future research should aim to incorporate broader aspects of child development.
Collapse
Affiliation(s)
- Laura Kelstrup
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| |
Collapse
|
15
|
Gewirtz A, Muldrew L, Sigmarsdóttir M. Mental health, risk and resilience among refugee families in Europe. Curr Opin Psychol 2022; 47:101428. [DOI: 10.1016/j.copsyc.2022.101428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/10/2022] [Indexed: 11/03/2022]
|
16
|
Spaas C, Verbiest S, de Smet S, Kevers R, Missotten L, De Haene L. Working With the Encounter: A Descriptive Account and Case Analysis of School-Based Collaborative Mental Health Care for Refugee Children in Leuven, Belgium. Front Psychol 2022; 13:806473. [PMID: 35356344 PMCID: PMC8959124 DOI: 10.3389/fpsyg.2022.806473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Scholars increasingly point toward schools as meaningful contexts in which to provide psychosocial care for refugee children. Collaborative mental health care in school forms a particular practice of school-based mental health care provision. Developed in Canada and inspired by systemic intervention approaches, collaborative mental health care in schools involves the formation of an interdisciplinary care network, in which mental health care providers and school partners collaborate with each other and the refugee family in a joint assessment of child development and mental health, as well as joint intervention planning and provision. It aims to move away from an individual perspective on refugee children's development, toward an engagement with refugee families' perspectives on their migration histories, cultural background and social condition in shaping assessment and intervention, as such fostering refugee empowerment, equality, and participation in the host society. Relating to the first stage of van Yperen's four-stage model for establishing evidence-based youth care, this article aims to engage in an initial exploration of the effectiveness of a developing school-based collaborative mental health care practice in Leuven, Belgium. First, we propose a detailed description, co-developed through reflection on case documents, written process reflections, intervision, an initial identification of intervention themes, and articulating interconnections with scholarly literature on transcultural and systemic refugee trauma care. Second, we engage in an in-depth exploration of processes and working mechanisms, obtained through co-constructed clinical case analysis of case work collected through our practice in schools in Leuven, Belgium. Our descriptive analysis indicates the role of central processes that may operate as working mechanisms in school-based collaborative mental health care and points to how collaborative mental health care may mobilize the school and the family-school interaction as a vehicle of restoring safety and stability in the aftermath of cumulative traumatization. Our analysis furthermore forms an important starting point for reflections on future research opportunities, and central clinical dynamics touching upon power disparities and low-threshold access to mental health care for refugee families.
Collapse
Affiliation(s)
- Caroline Spaas
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Siel Verbiest
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Sofie de Smet
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Studies in Performing Arts and Media, Faculty of Arts and Philosophy, University of Ghent, Ghent, Belgium
| | - Ruth Kevers
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Lies Missotten
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Lucia De Haene
- Parenting and Special Education Research Unit, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
17
|
Berg L, Brendler-Lindquist M, de Montgomery E, Mittendorfer-Rutz E, Hjern A. Parental Posttraumatic Stress and School Performance in Refugee Children. J Trauma Stress 2022; 35:138-147. [PMID: 34275166 DOI: 10.1002/jts.22708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/08/2022]
Abstract
Refugee children in the Nordic countries have been reported to perform poorly in school and carry a high burden of familial posttraumatic stress. The present study aimed to investigate the impact of maternal and paternal posttraumatic stress on the school performance of refugee children. We used national register data on school grades at age 15-16 along with demographic and migration indicators during 2011-2017 in a population of 18,831 children in refugee families in Stockholm County, Sweden. Parental posttraumatic stress was identified in regional data from three levels of care, including a tertiary treatment center for victims of torture and war. Multivariable linear and logistic regression models were fitted to analyze (a) mean grade point averages as Z scores and (b) eligibility for upper secondary school. In fully adjusted models, children exposed to paternal posttraumatic stress had a lower mean grade point average, SD = -0.14, 95% CI [-0.22, -0.07], and higher odds of not being eligible for upper secondary education, OR = 1.37, 95% CI [1.14, 1.65]. Maternal posttraumatic stress had a similar crude effect on school performance, SD = -0.15, 95% CI [-0.22, -0.07], OR = 1.25, 95% CI [1.00, 1.55], which was attenuated after adjusting for single-parent households and the use of child psychiatric services. The effects were similar for boys and girls as well as for different levels of care. Parental posttraumatic stress had a small negative effect on school performance in refugee children, adding to the intergenerational consequences of psychological trauma.
Collapse
Affiliation(s)
- Lisa Berg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | | | - Edith de Montgomery
- Department of Public Health, Danish Institute for Migration, Ethnicity, and Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Anders Hjern
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.,Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
18
|
Dubus N. Resiliency with Forced Migrants: A Qualitative Study of Providers and Forced Migrants through a ResiliencePerspective. Behav Sci (Basel) 2022; 12:bs12020027. [PMID: 35200279 PMCID: PMC8869212 DOI: 10.3390/bs12020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/31/2021] [Accepted: 01/17/2022] [Indexed: 02/04/2023] Open
Abstract
In the last ten years, the world has experienced unprecedented, forced migration due to civil unrest, political persecution, and the ever-growing climate crisis. This is a qualitative study of the professional experiences of social workers (n = 73) working with forced migrants (n = 34) and the lived experiences of forced migrants in several countries: Germany, Greece, Iceland, Mexico, Switzerland, and the United States. Social workers reported that most of their interventions involved short-term case management that focused on securing initial housing and healthcare. Cognitive Behavioral Therapy (CBT) was the primary intervention for behavioral health issues. The recipients of these services were appreciative of the pragmatic approach of case management as it helped them meet concrete needs. When resiliency enhancing interventions were used, recipients reported a greater sense of self-control, greater optimism for the future, and less anxious symptoms. The resiliency model used is discussed. This is a possible universal approach to working with forced migrants.
Collapse
Affiliation(s)
- Nicole Dubus
- School of Social Work, College of Health and Human Science, San Jose State University, San Jose, CA 95192, USA
| |
Collapse
|
19
|
Parental post-traumatic stress and psychiatric care utilisation among refugee adolescents. Eur Child Adolesc Psychiatry 2022; 31:1953-1962. [PMID: 34146175 PMCID: PMC9663346 DOI: 10.1007/s00787-021-01827-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/13/2021] [Indexed: 01/26/2023]
Abstract
Parental psychiatric morbidity related to experiences of war and trauma has been associated with adverse psychological outcomes for children. The aim of this study was to investigate parental post-traumatic stress in relation to psychiatric care utilization among children of refugees with particular attention on the child's own refugee status, sex of both child and parents, and specific psychiatric diagnoses. This was a register study in a population of 16 143 adolescents from refugee families in Stockholm County born 1995-2000 and followed between 2011 and 2017 (11-18 years old). Parental post-traumatic stress, identified in three levels of care, was analysed in relation to child and adolescent psychiatric care use. Cox regression analysis was used to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusted for duration of residence and demographic and socioeconomic variables. Having a mother with post-traumatic stress was associated with higher psychiatric care utilization, with adjusted HR 2.44 (95% CI 1.90-3.14) among foreign-born refugee children and HR 1.77 (1.33-2.36) among Swedish-born children with refugee parents, with particularly high risks for children with less than five years of residence (HR 4.03; 2.29-7.10) and for diagnoses of anxiety and depression (HR 2.71; 2.11-3.48). Having a father with post-traumatic stress was not associated with increased HRs of psychiatric care utilization. Similar results were seen for boys and girls. Treatment for post-traumatic stress should be made available in refugee reception programmes. These programmes should use a family approach that targets both parents and children.
Collapse
|
20
|
Howard S. A Causal Model of Children's Vicarious Traumatization. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:443-454. [PMID: 33425092 PMCID: PMC7779647 DOI: 10.1007/s40653-020-00331-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/15/2020] [Indexed: 06/12/2023]
Abstract
Children may be vicariously traumatized from learning about the trauma of family and friends. To date, a causal model of children's vicarious traumatization has not been empirically validated in the literature. This paper fills the gap in the literature by reporting on the direct effect of vicarious trauma on children independent of caregiving impairment. Data for the study came from the National Survey of Children's Exposure to Violence I (NATSCEV I). This unique dataset features two indicators of vicarious trauma exposure: (1) family victimization and (2) community violence. Hierarchical multiple regression was conducted in order to control for nuisance variables such as caregiver impairment, defined as the degree of warmth or hostility; time elapsed since the trauma occurred and the study taking place; and other trauma exposure (i.e. direct and witnessed trauma). As expected, the study found evidence of a direct and positive relationship between learning about the trauma of close friends and family and children's trauma symptomatology. Both adolescents and young children were found to be vulnerable to experience vicarious traumatization, with gender and ethnicity being contributing factors. Chronological age was not found to be significant in children's vicarious traumatization. These findings support the causal model of vicarious traumatization. They demonstrate that children may be traumatized by exposure to the trauma material of others above and beyond the influence of caregiver impairment. As such, attention should be given to interventions, practices, and policies that intervene in the lives of children exposed to violence.
Collapse
Affiliation(s)
- Stephenie Howard
- School of Social Work, Howard University, Washington, DC 20059 USA
| |
Collapse
|
21
|
Sileo KM, Kershaw TS, Gilliam S, Taylor E, Kommajosula A, Callands TA. Trauma Exposure and Intimate Partner Violence Among Young Pregnant Women in Liberia. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:10101-10127. [PMID: 31625468 PMCID: PMC7778451 DOI: 10.1177/0886260519881533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner violence (IPV) is a global threat to women's health and may be elevated among those exposed to traumatic events in post-conflict settings, such as Liberia. The purpose of this study was to examine potential mediators between lifetime exposure to traumatic events (i.e., war-related trauma, community violence) with recent experiences of IPV among 183 young, pregnant women in Monrovia, Liberia. Hypothesized mediators included mental health (depression, posttraumatic stress symptoms), insecure attachment style (anxious and avoidant attachment), and attitudes indicative of norms of violence (attitudes justifying wife beating). We tested a parallel multiple mediation model using the PROCESS method with bias-corrected and accelerated bootstrapping to test confidence intervals (CI). Results show that 45% of the sample had experienced any physical, sexual, or emotional IPV in their lifetime, and 32% in the 2 months prior to the interview. Exposure to traumatic events was positively associated with recent IPV severity (β = .40, p < .01). Taken together, depression, anxious attachment style, and justification of wife beating significantly mediated the relationship between exposure to traumatic events and experience of IPV (β = .15, 95% CI = [0.03, 0.31]). Only anxious attachment style (β = .07, 95% CI = [0.03, 0.16]) and justification of wife beating (β = .05, 95% CI = [0.01, 0.16]) were identified as individual mediators. This study reinforces pregnancy as an important window for both violence and mental health screening and intervention for young Liberian women. Furthermore, it adds to our theoretical understanding of mechanisms in which long-term exposure to traumatic events may lead to elevated rates of IPV in Liberia, and points to the need for trauma-informed counseling and multilevel gender transformative public health approaches to address violence against women.
Collapse
Affiliation(s)
- Katelyn M. Sileo
- The University of Texas at San Antonio, USA
- The Center for Interdisciplinary Research at Yale University, New Haven, CT, USA
| | - Trace S. Kershaw
- The Center for Interdisciplinary Research at Yale University, New Haven, CT, USA
- Yale School of Public Health, New Haven, CT, USA
| | | | | | | | | |
Collapse
|
22
|
Cramm H, Godfrey CM, Murphy S, McKeown S, Dekel R. Experience of children growing up with a parent who has military-related post-traumatic stress disorder: a qualitative systematic review. JBI Evid Synth 2021; 20:1638-1740. [PMID: 34710888 DOI: 10.11124/jbies-20-00229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to describe the experiences of children growing up in military families whose parents have military-related post-traumatic stress disorder. INTRODUCTION Whether serving as a peacekeeper or warrior, military service is both physically and psychologically demanding, increasing exposures to potentially traumatic and morally injurious events and threats to personal safety. Those who have served in the military are at increased risk for developing post-traumatic stress disorder, which includes symptoms such as emotional numbing, withdrawal, and hyperarousal. Research has focused on the experiences of and impacts on spouses and partners of military veterans with post-traumatic stress disorder, with quantitative and synthesis studies reporting on measurable impacts on children growing up in military families where a parent is diagnosed with post-traumatic stress disorder. INCLUSION CRITERIA This review included children who are or have grown up in military families in domestically peaceful nations that deploy their armed forces to global locations of political instability, armed civil conflict, and/or natural disasters for the purposes of peacekeeping, humanitarian aid, or war, as well as parents living with post-traumatic stress disorder who speak specifically about the experience of their children. Situations of homeland conflict were excluded. The military families of interest are those with one or more parent having a diagnosis of post-traumatic stress disorder associated with military service. Traumatic experiences leading to post-traumatic stress disorder can be acquired prior to military service or through unrelated experiences, so it cannot be presumed that military service or even combat deployment, in and of itself, causes post-traumatic stress disorder. This review includes the experiences of children currently in childhood as well as adult children of a parent with current or previous military service. METHODS The following databases were first searched in August 2016 and updated in January 9, 2020: MEDLINE, Embase, Web of Science Core Collection, CINAHL, PsycINFO, AMED, ERIC, and ProQuest Dissertations and Theses Global. This review was conducted in accordance with JBI methodology for systematic reviews of qualitative evidence and with an a priori protocol published in 2018. RESULTS Twelve studies were included. The majority of the studies were published after 2006. The review represents the experiences of 139 children (n = 66) and adult children (n = 73) participants from military families in the United States, Canada, and Australia. There were four synthesized findings: i) Parental post-traumatic stress disorder creates a volatile and distressing climate within the family, eliciting a range of responses from children (86 findings across three categories); ii) Parental post-traumatic stress disorder ripples through the family system, disrupting interpersonal communication and relationships during childhood (57 findings over four categories); iii) Children can experience emotional and psychological difficulties well into adulthood (84 findings across five categories); and iv) Making sense of it all and moving beyond parental post-traumatic stress disorder can take significant time, energy, and support (74 findings across four categories). CONCLUSIONS The quality of the included studies proved to be high, giving strength to this review. Effective ways of communicating with children about the nature of both the traumatic exposure and the post-traumatic stress disorder itself must be developed. While individuals with post-traumatic stress disorder deserve appropriate interventions to alleviate symptoms and improve functioning, it is not sufficient for recovery from post-traumatic stress disorder either for the individual or for the family who has been deeply affected themselves. Prospective and longitudinal research is needed, ensuring that both the voice of the child and multiple perspectives within family systems are included and compared.
Collapse
Affiliation(s)
- Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada Bracken Health Sciences Library, Queen's University, Kingston, ON, Canada The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | | | | | | | | |
Collapse
|
23
|
Hoffman SJ, Vukovich MM, Gewirtz AH, Fulkerson JA, Robertson CL, Gaugler JE. Mechanisms Explaining the Relationship Between Maternal Torture Exposure and Youth Adjustment In Resettled Refugees: A Pilot Examination of Generational Trauma Through Moderated Mediation. J Immigr Minor Health 2021; 22:1232-1239. [PMID: 32699993 DOI: 10.1007/s10903-020-01052-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The intergenerational effects of trauma resulting from torture and war are complex and multi-faceted and have important implications for the family system. The current study aimed to identify key relationships between refugee maternal caregiver exposure to torture, mental health, and physical health with maternal-reported youth adjustment. Ninety-six Karen maternal caregivers originating from Burma and resettled in the United States participated in a cross-sectional, explanatory mixed methods study. Maternal mental health distress was found to mediate the relationship betweenmaternal torture experiences and youth adjustment, R2 = .357. Physical health problems was found to moderate the degree to which mental health distress mediated the relationship between torture and war trauma experiences and youth adjustment, R2 = .409. The current study is significant in that it enhances our mechanistic understanding of factors relevant to the intergenerational effects of trauma within families where maternal caregivers experienced trauma from torture and/or war.
Collapse
Affiliation(s)
- Sarah J Hoffman
- University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN, 55455, USA.
| | - Maria M Vukovich
- Graduate School of Professional Psychology, International Disaster Psychology Program, University of Denver, Denver, USA
| | - Abigail H Gewirtz
- Department of Family Social Sciences, University of Minnesota, Minneapolis, USA
| | - Jayne A Fulkerson
- University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN, 55455, USA
| | - Cheryl L Robertson
- University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN, 55455, USA
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, USA
| |
Collapse
|
24
|
Dalgaard NT, Bjerre K, Thøgersen MH. Twenty seven years of treating survivors of torture and organized violence - associations between torture, gender and ethnic minority status among refugees referred for treatment of PTSD. Eur J Psychotraumatol 2021; 12:1904712. [PMID: 33968329 PMCID: PMC8075081 DOI: 10.1080/20008198.2021.1904712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background: Victims of torture and organized violence are among the most vulnerable refugees. The nature of torture promotes shame, secrecy and silencing of the survivors, and there is a need for studies to provide a testimony to the experiences of survivors. Objective: To contribute to the global knowledge base by exploring the nature and frequency of different types of torture as reported by survivors and to explore potential associations between basic sociodemographic variables and the likelihood of reporting different kinds of torture and of attending treatment for PTSD. Method: This study is based on archival data from 27 years of clinical practice treating survivors of torture and organized violence (N = 1249) in a specialist outpatient clinic. Data was coded from patient files by two research assistants. Statistical analysis included independent samples t-tests, Pearson Chi Square tests and regression. Results: The study found strong associations between gender of survivors and the reporting of different kinds of torture, most strongly with respect to sexual torture. Furthermore, the study found significant differences between survivors belonging to an ethnic minority and survivors who belonged to the majority populations within their countries of origin with regards to the extent of the torture, they report being subjected to. Patients who received treatment reported more torture experiences than those who did not. Conclusions: Findings from the present study document the experiences of different torture methods as reported by survivors, and suggest that belonging to an ethnic minority population is associated with an increased risk of being subjected to more severe torture, which has implications for both research and interventions aimed at treating survivors of torture.
Collapse
Affiliation(s)
- Nina Thorup Dalgaard
- VIVE Quantitative Methods, VIVE - the Danish Center for Social Science Research, Copenhagen, Denmark
| | - Karen Bjerre
- Department of Rehabilitation, DIGNITY- Danish Institute Against Torture, Copenhagen, Denmark
| | - Marie Høgh Thøgersen
- Department of Rehabilitation, DIGNITY- Danish Institute Against Torture, Copenhagen, Denmark
| |
Collapse
|
25
|
Beck BD, Meyer SL, Simonsen E, Søgaard U, Petersen I, Arnfred SMH, Tellier T, Moe T. Music therapy was noninferior to verbal standard treatment of traumatized refugees in mental health care: Results from a randomized clinical trial. Eur J Psychotraumatol 2021; 12:1930960. [PMID: 34285768 PMCID: PMC8266250 DOI: 10.1080/20008198.2021.1930960] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Many people with refugee backgrounds suffer from trauma-related complex social and psychological problems, and compliance with standard psychological treatment tends to be low. More culturally adaptable treatment options seem to be needed. Objective: We aimed to investigate whether the music therapy method: 'trauma-focused music and imagery' (tr-MI), characterized by a particular focus on arousal and affect regulation, would be equally effective as the standard psychological talk therapies for ameliorating trauma symptoms in Danish refugees. Methods: A pragmatic, noninferiority, parallel, randomized controlled trial with six-month follow-up was carried out at three clinics for refugees in the public mental health services of the Psychiatry (DK). Seventy-four adults diagnosed with posttraumatic stress disorder (PTSD) were allocated to either music therapy sessions (tr-MI, N = 39) or psychological treatment as usual (TAU, N = 35). Western classical music, new age music, and music from the participants' own national culture were used to generate inner imagery, following a phased treatment protocol. Homework entailed listening to music. The primary outcome was the measurement of trauma symptoms by the Harvard Trauma Questionnaire, section IV (HTQ-IV); secondary measures were somatoform and psychoform dissociation (DSS-20), SDQ-20), attachment (RAAS), and well-being (WHO-5). Treatment effects reflected by primary and secondary measures were estimated using linear mixed models. Results: Tr-MI was noninferior to TAU (mean difference at follow-up HTQ-IV: 0.14, CI (-0.10; 0.38), with a - 0.3 noninferiority margin). A high dropout rate of 40% occurred in the TAU group, compared to 5% in the music therapy group. Secondary measures generated small to medium effect sizes in both groups, with significant medium effect sizes for well-being and psychoform dissociation at follow-up in tr-MI. Conclusions: Tr-MI is an innovative form of psychological treatment in refugee mental health services. Trials comparing music therapy to standardized therapy are needed to substantiate the evidence base for tr-MI therapy.
Collapse
Affiliation(s)
- B D Beck
- Institute for Communication and Psychology, Aalborg University, Aalborg, Denmark.,Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
| | - S L Meyer
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - E Simonsen
- Psychiatric Research Unit, Region Zealand; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - U Søgaard
- Psychiatric Research Unit, Region Zealand; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I Petersen
- Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - S M H Arnfred
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - T Tellier
- Psychiatric Centre North Zealand, Mental health services in the Capital Region of Denmark
| | - T Moe
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
| |
Collapse
|
26
|
Due C, Heer N, Baak M, Hanson‐easey S. “At night he cries from dreams”: Perceptions of children's psychological distress and wellbeing amongst parents with refugee or asylum seeker backgrounds in Australia. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nathaniel Heer
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melanie Baak
- School of Education, University of South Australia, Adelaide, South Australia, Australia
| | - Scott Hanson‐easey
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
27
|
Eruyar S, Vostanis P. Feasibility of group theraplay with refugee children in Turkey. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
28
|
Flanagan N, Travers A, Vallières F, Hansen M, Halpin R, Sheaf G, Rottmann N, Johnsen AT. Crossing borders: a systematic review identifying potential mechanisms of intergenerational trauma transmission in asylum-seeking and refugee families. Eur J Psychotraumatol 2020; 11:1790283. [PMID: 33062205 PMCID: PMC7534369 DOI: 10.1080/20008198.2020.1790283] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background: As displacement and forced migration continue to exhibit global growth trends, new and surviving generations of children are being born and spending their formative years in host countries. Refugee children who have not been exposed to traumatic events may still be at risk for adverse developmental and mental health outcomes via intergenerational trauma transmission. Objective: To identify and synthesize potential mechanisms of intergenerational trauma transmission in forcibly displaced families where parents have experienced direct war-related trauma exposure, but children have no history of direct trauma exposure. Methods: PRISMA systematic review guidelines were adhered to. Searches were conducted across seven major databases and included quantitative, qualitative and mixed methods literature from 1945 to 2019. The search resulted in 752 citations and 8 studies (n = 1,684) met review inclusion criteria. Results: Findings suggest that parental trauma exposure and trauma sequelae indirectly affect child well-being via potential mechanisms of insecure attachment; maladaptive parenting styles; diminished parental emotional availability; decreased family functioning; accumulation of family stressors; dysfunctional intra-family communication styles and severity of parental symptomology. Conclusion: Further research is needed to assess independent intergenerational effects and mechanisms of trauma transmission in this population.
Collapse
Affiliation(s)
- Natalie Flanagan
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,CONTEXT Research Consortium.,Spirasi, National Centre for the Rehabilitation of Victims of Torture in Ireland, Dublin, Ireland.,Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Aine Travers
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,CONTEXT Research Consortium
| | - Frederique Vallières
- CONTEXT Research Consortium.,Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Maj Hansen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,CONTEXT Research Consortium
| | - Rory Halpin
- CONTEXT Research Consortium.,Spirasi, National Centre for the Rehabilitation of Victims of Torture in Ireland, Dublin, Ireland
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin, Ireland
| | - Nina Rottmann
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Nyborg, Denmark
| | - Anna Thit Johnsen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,CONTEXT Research Consortium
| |
Collapse
|
29
|
Ajrouch KJ, Barr R, Daiute C, Huizink AC, Jose PE. A lifespan developmental science perspective on trauma experiences in refugee situations. ADVANCES IN LIFE COURSE RESEARCH 2020; 45:100342. [PMID: 36698276 DOI: 10.1016/j.alcr.2020.100342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/29/2020] [Accepted: 05/06/2020] [Indexed: 06/17/2023]
Abstract
Developmental science theory and empirical research on refugee situations requires an updated approach to the study of trauma as a multi-systemic and multilevel phenomenon. We present a theoretical framework that integrates developmental science approaches to highlight critical threats to development in situations of violent displacement. Given the complexities of displacement (causes, trajectories, and living circumstances once displaced), this theoretical model highlights the utility of an approach that recognizes the person-age-context fit in which displaced individuals live their lives and how both trauma and ongoing major disruption to daily life affects outcomes. In so doing, we aim to broaden understanding for future trauma and intervention research as well as practice with those who experience potentially traumatic events and severe disruption to their social ecology at different points in the lifespan.
Collapse
Affiliation(s)
| | - Rachel Barr
- Georgetown University, Washington DC 20057 USA.
| | - Colette Daiute
- The Graduate Center, City University New York, New York, NY 10016 USA.
| | | | - Paul E Jose
- Victoria University of Wellington, Wellington 6140 New Zealand.
| |
Collapse
|
30
|
Khan F, Eskander N, Limbana T, Salman Z, Siddiqui PA, Hussaini S. Refugee and Migrant Children’s Mental Healthcare: Serving the Voiceless, Invisible, and the Vulnerable Global Citizens. Cureus 2020; 12:e9944. [PMID: 32968603 PMCID: PMC7505673 DOI: 10.7759/cureus.9944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Millions of children are on the run worldwide, with many unaccompanied children and adolescents undertaking risky journeys to flee war, adverse circumstances, and political persecution. The grueling journey and multiple stressors faced by the refugee children, both accompanied and unaccompanied during the pre-migration, migration, and in the country of destination, increase their risk for psychiatric disorders and other medical conditions. Unaccompanied refugee migrant children have higher prevalence of mental health disorders than accompanied refugee peers. Long after reaching the host country, the refugee, migrant, and asylum-seeking juveniles continue to face adversities in the form of acculturation. In assessing medical fitness and healthcare mediations for refugees and migrant children, special consideration should be given to certain areas such as their distinct history, whether they are with their family or separated or unaccompanied, and whether they have been peddled or have been left behind.
Collapse
|
31
|
Drummond Johansen J, Varvin S. 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. J Adolesc 2020; 80:1-9. [PMID: 32044475 DOI: 10.1016/j.adolescence.2020.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Most studies on refugee populations are organized around trauma-related issues and focus on explanations of 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 that development. METHODS Using an ecological and transactional understanding of developmental trajectories, this qualitative study explored issues connected to identity formation processes in an exile context based on interviews with 6 male and 10 female children of refugees (18-26 years) who have grown up in Norway. RESULTS The findings show that family experiences of war and conflict intersect with experiences of marginalization in exile. The interaction of these experiences influences the development of individual identity in cumulative and complex ways. Many of the participants expressed feelings of isolation, disconnectedness, and a lack of belonging. Nevertheless, though the participants described growing up facing major challenges, they also searched for ways to reframe their difficult personal and family histories into meaningful experiences. CONCLUSIONS In order to provide conditions and develop interventions that can support well-being and identity development, we need a better understanding of the different forces that influence the identity development of children of refugees. By foregrounding the participants' experiences, and perspectives, we gained insight into different ways in which participants negotiate identity issues in relation to often contradictory demands and messages from family and the wider social context.
Collapse
|
32
|
Eruyar S, Maltby J, Vostanis P. How do Syrian refugee children in Turkey perceive relational factors in the context of their mental health? Clin Child Psychol Psychiatry 2020; 25:260-272. [PMID: 31648532 DOI: 10.1177/1359104519882758] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although there has been increasing attention on the impact of risk and resilience factors on refugee children's mental health, there has been limited evidence on the role of parental factors to inform interventions, and this predominantly relies on adult reports. The aim was to investigate the relationship between perceived parenting styles and attachment relationships and child mental health, as reported by 322 Syrian refugee minors aged between 8 and 17 years in Turkey. Child-rated scales included the Children Revised Impact of Event Scale-8 (CRIES-8), Strengths and Difficulties Questionnaire (SDQ), Security Scale and Egna Minnen Betraffande Uppfostran for Children (EMBU-C), and were used as measures of post-traumatic stress disorder (PTSD), general mental health problems, attachment relationships and perceived parenting styles, respectively. Children with secure maternal and paternal attachment perceived their parents as less rejecting, while children with secure paternal attachment also reported their parents as emotionally warmer. Attachment relationships significantly contributed in predicting PTSD after controlling for age and gender, while conduct problems were predicted by lack of emotional warmth, rejection and over-protection by both parents, in addition to insecure attachment relationships. Refugee children's views are essential in establishing their needs and planning interventions. These should address both the impact of trauma and current family relationships.
Collapse
Affiliation(s)
- Seyda Eruyar
- Faculty of Social Sciences and Humanities, Necmettin Erbakan University, Turkey
| | - John Maltby
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK
| | - Panos Vostanis
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK
| |
Collapse
|
33
|
Antonucci TC, Ajrouch KJ, Webster NJ, Zahodne LB. Social Relations Across the Life Span: Scientific Advances, Emerging Issues, and Future Challenges. ACTA ACUST UNITED AC 2019. [DOI: 10.1146/annurev-devpsych-121318-085212] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Accumulating evidence demonstrates the importance of social relations at all stages of life (infancy, childhood, adolescence, adulthood, and old age) and in diverse domains of life (including health and well-being). To illustrate the newest advancements in the scientific study of social relations over the life course, we address five emerging areas of importance: societal and demographic changes in family structure; effects of new technologies on social relations; the fundamental influence of context on social relations, illustrated with the sample case of health; the role of social relations in the unfortunate but pressing crisis of trauma among the increasing number of refugees worldwide; and, finally, effects of social relations on cognitive functioning in late life. Each of these areas highlights critical key concepts and methodological approaches, illustrating that the study of social relations is demanding but holds great promise for meeting the urgent needs of developmental science specifically and society generally.
Collapse
Affiliation(s)
- Toni C. Antonucci
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Kristine J. Ajrouch
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University, Ypsilanti, Michigan 48197, USA
| | - Noah J. Webster
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
| | - Laura B. Zahodne
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA
| |
Collapse
|
34
|
Goodman G, Dent VF. When I Became a Refugee, This Became My Refuge: A Proposal for Implementing a Two-Generation Intervention Using Yoga and Narrative to Promote Mental Health in Syrian Refugee Caregivers and School Readiness in Their Preschool Children. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/15289168.2019.1680939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
35
|
Hanes G, Chee J, Mutch R, Cherian S. Paediatric asylum seekers in Western Australia: Identification of adversity and complex needs through comprehensive refugee health assessment. J Paediatr Child Health 2019; 55:1367-1373. [PMID: 30868701 DOI: 10.1111/jpc.14425] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022]
Abstract
AIM Asylum seekers (ASs) report high rates of trauma and difficulty accessing health and educational services. This study aims to ascertain the needs of paediatric ASs managed by the tertiary Western Australian paediatric Refugee Health Service (RHS), including demographic features, the range of health and psychosocial issues and ongoing management challenges. METHODS An audit of multidisciplinary RHS assessments, health records and hospital admissions for new AS patients (<16 years) between July 2012 and June 2016 was undertaken. RESULTS Records for 110 ASs were reviewed (mean age 6 years, standard deviation 4.72 years). Multiple issues (medical, psychological, developmental, educational) were identified after the first tertiary assessment (median 4, interquartile range (IQR) 3-6) compared to referral sources (median 1, IQR 0-2, P < 0.001). The median number of issues per child at audit completion was 6 (IQR 4-7, P < 0.001). Multiple refugee adverse childhood experiences were identified, with all experiencing >3 (median 4, IQR 4-5). Most had detention experience (107/110, 97.2%), family separation (91/108, 84%) and interrupted education (41/46, 89.2%). The median duration of detention was 7 months (IQR 3-12.5 months) at time of initial review across multiple sites (median 2, IQR 1-3 locations). High rates of hospital interaction were evident, with 45.4% requiring hospital admission and 36% presenting to the emergency department. The median number of outpatient appointments attended per child was 5 (IQR 2-8). Parental and child mental health concerns were identified in 53.6 and 46.3%, respectively. CONCLUSIONS Paediatric ASs have complex trauma backgrounds with exposure to multiple adverse events within disrupted family units. The majority of Western Australian ASs assessed demonstrated negative health or education sequelae compounded by detention not previously identified prior to comprehensive paediatric review. Our data support the urgent removal of ASs from held detention. Ongoing holistic assessment and management engaging multidisciplinary trauma-informed paediatric refugee services to optimise health and well-being is recommended.
Collapse
Affiliation(s)
- Gemma Hanes
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Jessica Chee
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Raewyn Mutch
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.,Telethon Kids Institute, Perth, Western Australia, Australia
| | - Sarah Cherian
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.,Department of Postgraduate Medical Education, Perth Children's Hospital, Perth, Western Australia, Australia
| |
Collapse
|
36
|
Vaghri Z, Tessier Z, Whalen C. Refugee and Asylum-Seeking Children: Interrupted Child Development and Unfulfilled Child Rights. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E120. [PMID: 31671545 PMCID: PMC6915556 DOI: 10.3390/children6110120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/12/2019] [Accepted: 10/24/2019] [Indexed: 11/17/2022]
Abstract
The 21st century phenomenon of "global displacement" is particularly concerning when it comes to children. Childhood is a critical period of accelerated growth and development. These processes can be negatively affected by the many stressors to which refugee and asylum-seeking children are subjected. The United Nations Convention on the Rights of the Child (CRC) is the most ratified human rights treaty in history, with 196 States Parties (SPs). The CRC provides a framework of 54 articles outlining government responsibilities to ensure the protection, promotion, and fulfillment of rights of all children within their jurisdictions. Among these are the rights of refugee and asylum-seeking children, declared under Article 22 of the CRC. Refugee and asylum-seeking children, similarly to all other children, are entitled to their rights under the CRC and do not forgo any right by virtue of moving between borders. The hosting governments, as SPs to the CRC, are the primary duty bearers to fulfill these rights for the children entering their country. This manuscript provides an overview of the health and developmental ramification of being displaced for refugee and asylum-seeking children. Then, an in-depth analysis of the provisions under Article 22 is presented and the responsibilities of SPs under this article are described. The paper provides some international examples of strengths and shortcomings relating to these responsibilities and closes with a few concluding remarks and recommendations.
Collapse
Affiliation(s)
- Ziba Vaghri
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, BC V8P 5C2, Canada.
| | - Zoë Tessier
- School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, BC V8P 5C2, Canada.
| | - Christian Whalen
- Office of Child and Youth Advocate, Fredericton, NB E3B 5H1, Canada.
| |
Collapse
|
37
|
Dalgaard NT, Thøgersen MH, Væver MS, Montgomery E. Family violence in traumatized refugee families: A mixed methods study of mother/child dyadic functioning, parental symptom levels and children’s psychosocial adjustment. NORDIC PSYCHOLOGY 2019. [DOI: 10.1080/19012276.2019.1653221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Nina Thorup Dalgaard
- DIGNITY – Danish Institute against Torture, Bryggervangen 55, Copenhagen DK-2100, Denmark
| | - Marie Høgh Thøgersen
- DIGNITY – Danish Institute against Torture, Bryggervangen 55, Copenhagen DK-2100, Denmark
| | - Mette Skovgaard Væver
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Copenhagen K DK-1353, Denmark
| | - Edith Montgomery
- DIGNITY – Danish Institute against Torture and Danish Research Centre for Migration, Ethnicity and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, Copenhagen K DK-1014, Denmark
| |
Collapse
|
38
|
Berg L, Charboti S, Montgomery E, Hjern A. Parental PTSD and school performance in 16-year-olds - a Swedish national cohort study. Nord J Psychiatry 2019; 73:264-272. [PMID: 31134834 DOI: 10.1080/08039488.2019.1620852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim: Posttraumatic stress disorder (PTSD) in parents can have severe consequences also for their children. Prevalence of PTSD is high among refugees. Refugee children have been reported to perform poorly in school. The aim of this study was to investigate the impact of PTSD in refugee and native Swedish parents on children's school performance and to compare the impact of PTSD with that of other major psychiatric disorders. Methods: Register study where multiple regression models were used to analyse school performance in 15-16-year-olds in a national cohort (n = 703,813). PTSD and other major psychiatric disorders (bipolar, depression and/or psychotic disorders) were identified from out- and in-patient hospital care. Results: Maternal and paternal PTSD were associated with lower grades, with adjusted effects of 0.30-0.37 SD in refugee and 0.46-0.50 SD in native Swedish families. Impact of PTSD was greater than that of other psychiatric disorders and comorbidity to PTSD did not increase this impact. Although the impact of PTSD on grades was greater in children in native Swedish families, consequences with regard to eligibility to secondary education were greater for children in refugee families, where 35% of these children were ineligible. Conclusions: Parental PTSD has major consequences for children's school performance and contributes to the lower school performance in children in refugee families in Sweden. Identification and treatment of PTSD in refugee parents is important for offspring educational achievement. Psychiatric clinics and treatment centres need to have a strategy for support, including educational support, to the offspring of their patients with PTSD.
Collapse
Affiliation(s)
- Lisa Berg
- a Department of Public Health Sciences , Stockholm University , Stockholm , Sweden.,b Centre for Health Equity Studies , Stockholm University/Karolinska Institutet , Stockholm , Sweden
| | | | - Edith Montgomery
- d Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health , University of Copenhagen , Copenhagen , Denmark
| | - Anders Hjern
- b Centre for Health Equity Studies , Stockholm University/Karolinska Institutet , Stockholm , Sweden.,e Department of Medicine, Clinical Epidemiology , Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
39
|
Silwal S, Lehti V, Chudal R, Suominen A, Lien L, Sourander A. Parental immigration and offspring post-traumatic stress disorder: A nationwide population-based register study. J Affect Disord 2019; 249:294-300. [PMID: 30797121 DOI: 10.1016/j.jad.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/23/2019] [Accepted: 02/05/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the association between parental immigration status and a diagnosis of post-traumatic stress disorder (PTSD) in their offspring. METHODS This nested matched case-control study was based on a Finnish national birth cohort for 1987-2010 and cases were diagnosed with PTSD by 2012 from the Care Register for Health Care. We identified 3639 cases and 14,434 controls individually matched for gender, place and date of birth (±30 days). Conditional logistic regression analyses were conducted to examine the association between parental immigration status, parents' region of birth and time since paternal immigration, and PTSD after controlling for confounding factors. RESULTS The likelihood of being diagnosed with PTSD was significantly increased among children with an immigrant father (OR 1.8, 95% CI 1.3 - 2.4) than those with two Finnish parents and one immigrant mother. There was no significant association between having an immigrant mother or two immigrant parents and receiving a diagnosis of PTSD. The likelihood of being diagnosed with PTSD was increased if the children's fathers had migrated less than five years before their birth (OR 1.4, 95% CI 1.03 - 1.9) and if their immigrant fathers had been born in North Africa or the Middle East (OR 2.1, 95% CI 1.4 - 3.3). LIMITATIONS The sample included a heterogeneous migrant group without information on the reason for migration. The cases were identified from hospital diagnosis that may have only included severe cases. CONCLUSION The increased likelihood of a diagnosis of PTSD underlines the need for psychosocial services among second-generation immigrants.
Collapse
Affiliation(s)
- Sanju Silwal
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland.
| | - Venla Lehti
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland; Department of Psychiatry, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Roshan Chudal
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland
| | - Auli Suominen
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; Department of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Andre Sourander
- Deparment of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3 / Teutori (3. floor), 20014 Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland
| |
Collapse
|
40
|
Lee J, Kwak YS, Kim YJ, Kim EJ, Park EJ, Shin Y, Lee BH, Lee SH, Jung HY, Lee I, Hwang JI, Kim D, Lee SI. Transgenerational Transmission of Trauma: Psychiatric Evaluation of Offspring of Former "Comfort Women," Survivors of the Japanese Military Sexual Slavery during World War II. Psychiatry Investig 2019; 16:249-253. [PMID: 30934192 PMCID: PMC6444093 DOI: 10.30773/pi.2019.01.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/21/2019] [Indexed: 01/08/2023] Open
Abstract
"Comfort women" are survivors of sexual slavery by the Imperial Japanese Army during World War II, who endured extensive trauma including massive rape and physical torture. While previous studies have been focused on the trauma of the survivors themselves, the effects of the trauma on the offspring has never been evaluated before. In this article, we reviewed the first study on the offspring of former "comfort women" and aimed to detect the evidence of transgenerational transmission of trauma. In-depth psychiatric interviews and the Structured Clinical Interview for DSM-5 Axis I Disorders were conducted with six offspring of former "comfort women." Among the six participants, five suffered from at least one psychiatric disorder including major depressive disorder, panic disorder, posttraumatic stress disorder, adjustment disorder, insomnia disorder, somatic symptom disorder, and alcohol use disorder. Participants showed similar shame and hyperarousal symptoms as their mothers regarding stimuli related to the "comfort woman" issue. Increased irritability, problems with aggression control, negative worldview, and low self-esteem were evident in the children of mothers with posttraumatic stress disorder. Finding evidence of transgenerational transmission of trauma in offspring of "comfort women" is important. Future studies should include more samples and adopt a more objective method.
Collapse
Affiliation(s)
- Jeewon Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Young-Sook Kwak
- Department of Psychiatry, Jeju National University College of Medicine, Jeju, Republic of Korea
| | | | - Eun-Ji Kim
- Maumtodac Clinic, Ansan, Republic of Korea
| | - E Jin Park
- Department of Psychiatry, Incheon St. Mary's Hospital, Incheon, Republic of Korea
| | - Yunmi Shin
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Bun-Hee Lee
- Maum & Maum Clinic, Seoul, Republic of Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - Hee Yeon Jung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Inseon Lee
- Korean Women's Development Institute, Seoul, Republic of Korea
| | - Jung Im Hwang
- Korean Women's Development Institute, Seoul, Republic of Korea
| | - Dongsik Kim
- Korean Women's Development Institute, Seoul, Republic of Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| |
Collapse
|
41
|
Lau W, Silove D, Edwards B, Forbes D, Bryant R, McFarlane A, Hadzi-Pavlovic D, Steel Z, Nickerson A, Van Hooff M, Felmingham K, Cowlishaw S, Alkemade N, Kartal D, O’Donnell M. Adjustment of refugee children and adolescents in Australia: outcomes from wave three of the Building a New Life in Australia study. BMC Med 2018; 16:157. [PMID: 30176864 PMCID: PMC6122776 DOI: 10.1186/s12916-018-1124-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 07/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High-income countries like Australia play a vital role in resettling refugees from around the world, half of whom are children and adolescents. Informed by an ecological framework, this study examined the post-migration adjustment of refugee children and adolescents 2-3 years after arrival to Australia. We aimed to estimate the overall rate of adjustment among young refugees and explore associations with adjustment and factors across individual, family, school, and community domains, using a large and broadly representative sample. METHODS Data were drawn from Wave 3 of the Building a New Life in Australia (BNLA) study, a nationally representative, longitudinal study of settlement among humanitarian migrants in Australia. Caregivers of refugee children aged 5-17 (N = 694 children and adolescents) were interviewed about their children's physical health and activity, school absenteeism and achievement, family structure and parenting style, and community and neighbourhood environment. Parent and child forms of the Strengths and Difficulties Questionnaire (SDQ) were completed by caregivers and older children to assess social and emotional adjustment. RESULTS Sound adjustment according to the SDQ was observed regularly among young refugees, with 76-94% (across gender and age) falling within normative ranges. Comparison with community data for young people showed that young refugees had comparable or higher adjustment levels than generally seen in the community. However, young refugees as a group did report greater peer difficulties. Bivariate and multivariate linear regression analyses showed that better reported physical health and school achievement were associated with higher adjustment. Furthermore, higher school absenteeism and endorsement of a hostile parenting style were associated with lower adjustment. CONCLUSIONS This is the first study to report on child psychosocial outcomes from the large, representative longitudinal BNLA study. Our findings indicate sound adjustment for the majority of young refugees resettled in Australia. Further research should examine the nature of associations between variables identified in this study. Overall, treating mental health problems early remains a priority in resettlement. Initiatives to enhance parental capability, physical health, school achievement and participation could assist to improve settlement outcomes for young refugees.
Collapse
Affiliation(s)
- Winnie Lau
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Derrick Silove
- Liverpool Hospital, Sydney, NSW Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW Australia
| | - Ben Edwards
- ANU Centre for Social Research and Methods, Australian National University, Canberra, Australian Capital Territory Australia
| | - David Forbes
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW Australia
| | - Alexander McFarlane
- Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA Australia
| | | | - Zachary Steel
- School of Psychiatry, University of New South Wales, Sydney, NSW Australia
- Black Dog Institute, Sydney, NSW Australia
- St John of God Hospital Richmond, Sydney, Australia
| | - Angela Nickerson
- School of Psychology, University of New South Wales, Sydney, NSW Australia
| | - Miranda Van Hooff
- Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA Australia
| | - Kim Felmingham
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria Australia
| | - Sean Cowlishaw
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Dzenana Kartal
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Meaghan O’Donnell
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| |
Collapse
|
42
|
Grünbaum L. Transmission of complex trauma: family orientated intervention before child psychotherapy. JOURNAL OF CHILD PSYCHOTHERAPY 2018. [DOI: 10.1080/0075417x.2018.1539865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
43
|
van Os ECCC, Zijlstra AEE, Knorth EJE, Post WJW, Kalverboer MEM. Recently arrived refugee children: The quality and outcomes of Best Interests of the Child assessments. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 59:20-30. [PMID: 29996984 DOI: 10.1016/j.ijlp.2018.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/27/2018] [Accepted: 05/22/2018] [Indexed: 06/08/2023]
Abstract
Best Interests of the Child (BIC) assessments provide migration authorities with behavioral information about which interests of the child could be taken into account before a decision is made on the request for a residence permit. This study provides insight into the quality and outcomes of BIC assessments with 16 unaccompanied children (15-18 years) and 11 accompanied children (4-16 years) who have recently arrived in the Netherlands and requested asylum (N = 27). The results suggest that BIC assessments provide relevant information that enables assessors to determine the best interests of recently arrived refugee children. The inter-rater reliability of the BIC-Questionnaire, an instrument that evaluates the child-rearing environment and that is one of the components of the BIC assessment, was fairly good. The children in the sample had experienced a high number of stressful life events and a majority reported trauma related stress symptoms or other emotional problems. The quality of the child-rearing environment in the country of origin had protected their development insufficiently in the past and would not protect their development sufficiently in the future. The results show that in many cases forced return to the country of origin can put children's development at risk.
Collapse
Affiliation(s)
- E C C Carla van Os
- Department of Special Needs Education and Youth Care, University of Groningen, The Netherlands.
| | - A E Elianne Zijlstra
- Department of Special Needs Education and Youth Care, University of Groningen, The Netherlands
| | - E J Erik Knorth
- Department of Special Needs Education and Youth Care, University of Groningen, The Netherlands
| | - W J Wendy Post
- Department of Special Needs Education and Youth Care, University of Groningen, The Netherlands
| | - M E Margrite Kalverboer
- Department of Special Needs Education and Youth Care, University of Groningen, The Netherlands
| |
Collapse
|
44
|
Buch Segal L. Tattered Textures of Kinship: The Effects of Torture Among Iraqi Families in Denmark. Med Anthropol 2018; 37:553-567. [PMID: 29745732 DOI: 10.1080/01459740.2018.1462807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Drawing on ethnographic fieldwork in Denmark, primarily among Iraqi women and secondarily among Iraqi men who are either direct or indirect victims of torture, I explore how the memories of torture are distributed in the everyday lives of Danish families originating from Iraq. I argue that torture is folded into kin histories and the everyday work of bearing and resisting painful memories. Consequently, torture affects not only the mental and physical health of the singular survivor, but also the entire texture of kin relatedness around him or her, to the extent that kinship normativity may be disrupted. Leaning on the metaphor of a rugged cloth, I conclude by arguing that the way in which torture makes and unmakes kin relatedness congeals in what I term tattered textures of kinship.
Collapse
Affiliation(s)
- Lotte Buch Segal
- a Department of Anthropology , University of Copenhagen , Copenhagen , Denmark
| |
Collapse
|
45
|
Ratnamohan L, Mares S, Silove D. Ghosts, tigers and landmines in the nursery: Attachment narratives of loss in Tamil refugee children with dead or missing fathers. Clin Child Psychol Psychiatry 2018; 23:294-310. [PMID: 29260574 DOI: 10.1177/1359104517746453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To build an account of how bereaved Tamil refugee and asylum seeker children, resettled in Australia, had processed the loss of their dead or missing fathers. METHOD Phenomenological and discourse analysis was applied to attachment narratives of nine children (aged 11-17 years) and their surviving mothers in families that lost fathers in war-related circumstances. The narratives were analysed through the lens of Crittenden's Dynamic-Maturational Model of Attachment and Adaptation (DMM) and Klass' cross-cultural model of grief. RESULTS Two divergent pathways - 'burying the past' and 'reifying the past' - emerged, encompassing the children's contrasting patterns of information processing regarding loss and trauma (dismissing or preoccupying) and representation of the past (distant-buried or rich-reconstructed). Each pathway reflected a strategic compromise between the constraints and resources presented to the child by the circumstances of the loss (ambiguous or confirmed), the response of their surviving parent (stricken or stoic) and the collective narrative surrounding the loss (silenced or valorised). CONCLUSION The DMM's conceptualisation of attachment as self-protective strategies for navigating danger was helpful in explaining the contrasting adaptations of refugee children to loss and trauma. However, to understand the multivalent meanings of these adaptations, there was a need to situate child-parent attachment relationships within the wider sociocultural reconfigurations arising from contexts of political violence.
Collapse
Affiliation(s)
- Lux Ratnamohan
- 1 Psychiatry Research and Teaching Unit, Liverpool Hospital, Sydney, Australia.,2 Health Education and Training Institute, Sydney, Australia.,3 School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Sarah Mares
- 3 School of Psychiatry, University of New South Wales, Sydney, Australia.,4 Menzies School of Health Research, Darwin, Australia
| | - Derrick Silove
- 1 Psychiatry Research and Teaching Unit, Liverpool Hospital, Sydney, Australia.,3 School of Psychiatry, University of New South Wales, Sydney, Australia
| |
Collapse
|
46
|
De Haene L, Rousseau C, Kevers R, Deruddere N, Rober P. Stories of trauma in family therapy with refugees: Supporting safe relational spaces of narration and silence. Clin Child Psychol Psychiatry 2018; 23:258-278. [PMID: 29566556 DOI: 10.1177/1359104518756717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
With the sharp increase of refugees' arrival and resettlement in western communities, adequate mental health care forms a pivotal dimension in host societies' responses to those individuals and communities seeking protection within their borders. Here, clinical literature shows a growing interest in the development of family therapy approaches with refugees, in which therapeutic practice engages with the pivotal role of refugee family dynamics in posttrauma reconstruction and adaptation in resettlement and aims at supporting posttrauma reconstruction through strengthening capacities to restore safety, meaning and connectedness within family relationships. In this article, we focus on the narrative restoration of meaning as central mode of posttrauma reparation and explore its specific dynamics and relational complexities in the context of therapeutic practice with refugee families. Hereto, we integrate theoretical and clinical scholarly work on trauma narration and its intersection with empirical findings on trauma communication in refugee families. Furthermore, we develop case reflections to illustrate different processes of engaging with trauma narration in refugee family therapy. This analysis develops an understanding of the multivoiced ways in which refugee families engage with traumatic suffering through different modes of expression that may entail both narration and silence and explores how family therapeutic practices can engage and mobilize voices of narration and silence as relational stories of restoration.
Collapse
Affiliation(s)
- Lucia De Haene
- 1 Faculty of Psychology and Educational Sciences and Faculty Clinical Centre PraxisP, University of Leuven, Belgium
| | - Cécile Rousseau
- 2 Division of Social & Transcultural Psychiatry, McGill University, Canada
| | - Ruth Kevers
- 1 Faculty of Psychology and Educational Sciences and Faculty Clinical Centre PraxisP, University of Leuven, Belgium
| | - Nele Deruddere
- 1 Faculty of Psychology and Educational Sciences and Faculty Clinical Centre PraxisP, University of Leuven, Belgium
| | - Peter Rober
- 3 Faculty of Medicine and University Hospital Leuven, University of Leuven, Belgium
| |
Collapse
|
47
|
Mental health problems of Syrian refugee children: the role of parental factors. Eur Child Adolesc Psychiatry 2018; 27:401-409. [PMID: 29327258 DOI: 10.1007/s00787-017-1101-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Abstract
War-torn children are particularly vulnerable through direct trauma exposure as well through their parents' responses. This study thus investigated the association between trauma exposure and children's mental health, and the contribution of parent-related factors in this association. A cross-sectional study with 263 Syrian refugee children-parent dyads was conducted in Turkey. The Stressful Life Events Questionnaire (SLE), General Health Questionnaire, Parenting Stress Inventory (PSI-SF), Impact of Events Scale for Children (CRIES-8), and Strengths and Difficulties Questionnaire were used to measure trauma exposure, parental psychopathology, parenting-related stress, children's post-traumatic stress symptoms (PTSS), and mental health problems, respectively. Trauma exposure significantly accounted for unique variance in children's PTSS scores. Parental psychopathology significantly contributed in predicting children's general mental health, as well as emotional and conduct problems, after controlling for trauma variables. Interventions need to be tailored to refugee families' mental health needs. Trauma-focused interventions should be applied with children with PTSD; whilst family-based approaches targeting parents' mental health and parenting-related stress should be used in conjunction with individual interventions to improve children's comorbid emotional and behavioural problems.
Collapse
|
48
|
Kevers R, Rober P, De Haene L. Unraveling the Mobilization of Memory in Research With Refugees. QUALITATIVE HEALTH RESEARCH 2018; 28:659-672. [PMID: 29251552 DOI: 10.1177/1049732317746963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this article, we explore how narrative accounts of trauma are co-constructed through the interaction between researcher and participant. Using a narrative multiple-case study with Kurdish refugee families, we address how this process takes place, investigating how researcher and participants were engaged in relational, moral, collective, and sociopolitical dimensions of remembering, and how this led to the emergence of particular ethical questions. Case examples indicate that acknowledging the multilayered co-construction of remembering in the research relationship profoundly complicates existing deontological guidelines that predominantly emphasize the researcher's responsibility in sensitively dealing with participants' alleged autobiographical trauma narratives. Instead, our analysis invites qualitative researchers to engage in a continued, context-specific ethical reflection on the potential risks and benefits that are invoked in studies with survivors of collective violence.
Collapse
|
49
|
Vallières F, Hyland P, Murphy J, Hansen M, Shevlin M, Elklit A, Ceannt R, Armour C, Wiedemann N, Munk M, Dinesen C, O’Hare G, Cunningham T, Askerod D, Spitz P, Blackwell N, McCarthy A, O’Dowd L, Scott S, Reid T, Mokake A, Halpin R, Perera C, Gleeson C, Frost R, Flanagan N, Aldamman K, Tamrakar T, Louison Vang M, Sherwood L, Travers Á, Haahr-Pedersen I, Walshe C, McDonagh T, Bramsen RH. Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT). Eur J Psychotraumatol 2018; 9:1421001. [PMID: 29372015 PMCID: PMC5769806 DOI: 10.1080/20008198.2017.1421001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 12/14/2017] [Indexed: 10/27/2022] Open
Abstract
In this paper we present a description of the Horizon2020, Marie Skłodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology.
Collapse
Affiliation(s)
- Frédérique Vallières
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Philip Hyland
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- National College of Ireland, Dublin, Ireland
| | - Jamie Murphy
- Department of Psychology, Psychology Research Institute, Ulster University, Northern Ireland
| | - Maj Hansen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Mark Shevlin
- Department of Psychology, Psychology Research Institute, Ulster University, Northern Ireland
| | - Ask Elklit
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Ruth Ceannt
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Cherie Armour
- Department of Psychology, Psychology Research Institute, Ulster University, Northern Ireland
| | - Nana Wiedemann
- International Federation of the Red Cross Centre for Psychosocial Support hosted by Danish Red Cross, Copenhagen, Denmark
| | - Mette Munk
- International Federation of the Red Cross Centre for Psychosocial Support hosted by Danish Red Cross, Copenhagen, Denmark
| | - Cecilie Dinesen
- International Federation of the Red Cross Centre for Psychosocial Support hosted by Danish Red Cross, Copenhagen, Denmark
| | | | | | | | | | | | | | | | | | - Tracey Reid
- Police Service of Northern Ireland, Belfast, Northern Ireland
| | | | | | - Camila Perera
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- International Federation of the Red Cross Centre for Psychosocial Support hosted by Danish Red Cross, Copenhagen, Denmark
| | - Christina Gleeson
- Department of Psychology, Psychology Research Institute, Ulster University, Northern Ireland
- Spirasi, Dublin, Ireland
| | - Rachel Frost
- Department of Psychology, Psychology Research Institute, Ulster University, Northern Ireland
- Dublin Rape Crisis Centre, Dublin, Ireland
| | - Natalie Flanagan
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Spirasi, Dublin, Ireland
| | - Kinan Aldamman
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- International Federation of the Red Cross Centre for Psychosocial Support hosted by Danish Red Cross, Copenhagen, Denmark
| | - Trina Tamrakar
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Police Service of Northern Ireland, Belfast, Northern Ireland
| | - Maria Louison Vang
- Department of Psychology, Psychology Research Institute, Ulster University, Northern Ireland
- Danish Children’s Centres, Odense, Denmark
| | - Larissa Sherwood
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- Police Service of Northern Ireland, Belfast, Northern Ireland
| | - Áine Travers
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Probation Board of Northern Ireland, Belfast, Northern Ireland
| | - Ida Haahr-Pedersen
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- Danish Children’s Centres, Odense, Denmark
| | - Catherine Walshe
- Department of Psychology, Psychology Research Institute, Ulster University, Northern Ireland
- Dublin Rape Crisis Centre, Dublin, Ireland
| | - Tracey McDonagh
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Probation Board of Northern Ireland, Belfast, Northern Ireland
| | - Rikke Holm Bramsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
50
|
Leyendecker B, Cabrera N, Lembcke H, Willard J, Kohl K, Spiegler O. Parenting in a New Land. EUROPEAN PSYCHOLOGIST 2018. [DOI: 10.1027/1016-9040/a000316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Abstract. Immigrant parents face a double challenge in rearing their children in a foreign country. In addition to the tasks that all parents face, they must also try to find a balance between the norms and expectations of their heritage culture and those of the culture they live in. How do immigrant parents support their children and contribute to their positive adaptation? The goal of this review is to highlight selected aspects of parenting and family relationships that are strongly linked to children’s development and resilience. With regards to family processes, we underscore the contribution of fathers, the role of a potential acculturation gap between parents, and the benefit of speaking the heritage language in the family. For the connection to the world outside of the family, we highlight the advantage of having proficiency in the majority language and of parental involvement in schools. Finally, we outline the specific challenges and stressors as well as the importance of family relationships for families with refugee status. We conclude by making the case that immigrant parents should be encouraged and supported in rearing their children in a way that fosters family cohesion and reflects their heritage culture as well as the culture of the host country. This requires support and intervention programs that are not only culturally sensitive but are also two-generational and focus on mothers, fathers, and children.
Collapse
Affiliation(s)
| | - Natasha Cabrera
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Hanna Lembcke
- Department of Psychology, Ruhr-Unversität Bochum, Germany
| | | | - Katharina Kohl
- Department of Psychology, Ruhr-Unversität Bochum, Germany
| | - Olivia Spiegler
- Department of Psychology, Ruhr-Unversität Bochum, Germany
- FernUniversität Hagen, Germany
| |
Collapse
|