Stories of growing up amid violence by refugee children of war and children of battered women living in Canada

A Scoping Review of the Health of African Immigrant and Refugee Children

Migration is a growing phenomenon around the world, including within the African continent. Many migrants, especially African children, face challenges related to health and social inclusion and can face increased health risks. A systematic scoping review of available literature on the health of African migrant children across the globe was conducted to offer insight into these health risks. The review was conducted over a 15-month period from January 2019 to April 2020, yielding 6602 articles once duplicates were removed. This search included electronic databases, reference lists of articles reviewed, and searches of libraries of relevant organisations. A total of 187 studies met the inclusion criteria, of which 159 were quantitative, 22 were qualitative, and 6 used mixed methods. The findings reveal decreased health in this population in areas of nutrition, infectious diseases, mental health, birth outcomes, sexual and reproductive health, physical and developmental health, parasitic infections, oral health, respiratory health, preventative health, endocrine disorders, health care services, and haematological conditions. The findings offer insights into factors influencing the health of African immigrant and refugee children. Further studies, especially qualitative studies, are needed to determine barriers to service access after migration and to investigate other underexplored and overlooked health concerns of African migrant children, including pneumonia and child maltreatment.

Posttraumatic stress disorder and psychiatric co-morbidity: symptoms in a random sample of female Bosnian refugees

Objectives

This study investigated psychological symptoms in Bosnian women 3–4 years after their arrival in Sweden.

Methods

A simple random sample of 163 Bosnian women aged 19–59 was drawn from the Swedish populations register in 1996. The control group consisted of 392 Swedish-born women. Data were collected in face-to-face interviews. The Hopkins Symptom Checklist 25 (HSCL-25) and the Posttraumatic Symptom Scale (PTSS-10) were used to measure psychological symptoms of depression, anxiety, psychological distress, and posttraumatic stress disorder (PTSD). Unconditional logistic regression was used to estimate odds ratios (OR) for psychological symptoms after adjustment for age, country of birth, education, marital status, economic difficulties, social network, and feeling secure.

Results

The prevalence of symptoms of PTSD was 28.3% among the Bosnian women. Bosnian women had significantly higher risks of symptoms of depression, anxiety, and psychological distress than Swedish-born women. For depression the odds ratio was 9.50 among Bosnian women.

Conclusions

Psychiatric community interventions need to target Bosnian refugee women. Awareness among health-care workers who encounter these women in a clinical setting should be improved.

Psychological impact of disasters on children: review of assessment and interventions

BACKGROUND

There is a wide range of mental and behavioral sequel in children following disasters, which can last long. This review discusses the nature and extent of the psychiatric problems, their management options and process to organize the psychological interventions for affected children.

DATA SOURCES

Literatures were searched through PubMed with the words "children, disaster, psychiatry, and mental health" and relevant cross references were included in the review.

RESULTS

Proportions of children having posttraumatic symptoms or syndromal diagnoses vary in different studies depending on various factors like nature and severity of disaster, diagnostic criteria used, cultural issues regarding meaning of trauma, support available, etc. Common psychiatric manifestations among children include acute stress reactions, adjustment disorder, depression, panic disorder, post-traumatic stress disorder, anxiety disorders specific to childhood and psychotic disorders. Comorbidities and sub-clinical syndromes are also common. Most of the post-disaster mental health interventions can be provided in the community by the local disaster workers. Supportive counselling, cognitive behavior therapy, brief trauma/grief-focused psychotherapy, and play therapy are the commonly utilized methods of psychological intervention, which can be given in groups. Information about the efficacy of medications is still emerging, while many are being used and found useful.

CONCLUSIONS

Following disaster, systematic screening for psychological problems in children is suggested. An integrated approach using psycho-socio-educational and clinical interventions is expected to be effective.

Physical health outcomes of childhood exposure to intimate partner violence: a systematic review

BACKGROUND

Children exposed to intimate partner violence (IPV) are at increased risk for adverse mental and behavioral health sequelae, as has been documented by both systematic reviews and meta-analyses. Studies addressing the physical health impact of childhood IPV exposure, however, have not been summarized in a manner that might facilitate additional hypothesis-driven research and accelerate the development of targeted interventions.

METHODS

To identify a comprehensive set of articles examining the association between childhood IPV exposure and physical health, we searched online bibliographic databases including Medline, CINAHL, PsychInfo, and Sociological Abstracts using the keywords "domestic" or "intimate partner violence" and "infant," "child," or "pediatric." From >2000 articles retrieved in the initial search, we used online abstract and bibliographic information to identify 94 articles potentially meeting the inclusion criteria of studies that (1) examined a postnatal physical health outcome related to IPV exposure and (2) had a contemporaneous control group. Thorough review of these 94 published studies yielded 22 that met these inclusion criteria. The data then were abstracted independently by 2 of the authors, and differences were settled with the assistance of a third author.

RESULTS

Childhood exposure to IPV increases the likelihood of risk-taking behaviors during adolescence and adulthood and is likely associated with underimmunization. Minimal data and study limitations preclude establishing a clear connection between IPV exposure and general health and use of health services, breastfeeding, or weight gain.

CONCLUSIONS

The impact on physical health from exposure to IPV during childhood is still uncertain. Future studies should be grounded in a theoretical model that specifies how IPV exposure can affect child health, should adjust for confounders adequately, should include a community-based sample, and should be of larger scale.

Children exposed to domestic violence and child abuse: terminology and taxonomy

Three definitional issues regarding children exposed to domestic violence are examined. First, the multiple ways in which a child can be exposed to violence is discussed. A taxonomy of 10 types of exposure is proposed. Nine key characteristics of domestic violence, as they relate to children and children's exposure, are then outlined. The third issue addressed concerns why children who are exposed to domestic violence can be considered victims of child maltreatment. These children, by nature of their experience in the home, are psychologically maltreated and are also at high risk for physical abuse and some risk for sexual abuse. Empirical questions concerning these definitions and taxonomies and their interrelations are discussed.

Getting critical with children: empowering approaches with a disempowered group

The study of children and childhood has historically been accorded a marginal place in the health, human, and social sciences. In part, this is due to prevailing Western ideology that constructs children as passive, presocial, innocent, and vulnerable. The dominant discourse is further characterized by the treatment of children as a homogeneous group, devoid of race, class, or gender. While many investigators have described strategies for the conduct of research that is situated in the interpretive paradigm, there has been no comparable articulation of ideas regarding the conduct of critically grounded research when our participants are children. The purpose of this article is to put forth a historical and contextual analysis of childhood, including a discussion of evolving perspectives about childhood. The manner by which changing social, political, and environmental landscapes have contributed to the marginalization and disenfranchisement of children is examined. Finally, strategies for conducting nursing research that is grounded in the critical paradigmatic perspective, with the simultaneous aims of action, change, and empowerment, are proposed.

Stories of pre-war, war and exile: Bosnian refugee children in Sweden

While standardized questionnaires produce counts of isolated events, a semi-structured interview derives a story, a complex narrative in time and place. Ninety Bosnian refugee children and adolescents (ages 1-20), resettled in Sweden, were assessed in a semi-structured clinical interview designed to identify and offer support to children at risk. A family-child account of traumatic exposure was analysed quantitatively and qualitatively. Type-stories or clusters of experience were identified for three distinct periods: prior to war, during war, and after war in exile. The extent of trauma-stress exposure during each of these periods proved unrelated. Pre-war experience presented as preponderantly good and safe. Differences in child exposure during war and exile could be understood in relation to identifiable socio-demographic factors; particularly ethnic background, social class, child age and family size. Further, the stories derived cast light on the equity of Swedish refugee reception, exposing both egalitarian and discriminatory tendencies.