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Hadfield K, Al-Hamad M, Dajani R, El Kharouf A, Michalek J, Qtaishat L, von Stumm S, Mareschal I. Effectiveness of a community-led shared book reading intervention in Syrian refugee children: a randomised controlled trial. Sci Rep 2024; 14:17822. [PMID: 39090188 PMCID: PMC11294350 DOI: 10.1038/s41598-024-68903-9] [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: 12/19/2023] [Accepted: 07/29/2024] [Indexed: 08/04/2024] Open
Abstract
Community-led, shared book reading programs may help improve refugee children's reading abilities and attitudes towards reading. We Love Reading (WLR)-a light-touch, community-led, shared book reading program-was evaluated in a pre-registered, wait-listed, randomised controlled trial (AEARCTR-0006523). 322 Syrian refugee mother-child dyads (children: 4-8-year-olds, 50.0% female) in Jordan were tested at two timepoints, 15 weeks apart. WLR did not significantly affect child literacy or child-reported child attitudes toward reading (ps > 0.05). Mothers did report improved child attitudes toward reading from WLR (p = 0.046, η2 = 0.013). The intervention did not lead to improvements in family relationships (ps > 0.05). WLR may have promise in improving attitudes toward reading in forcibly displaced children but did not affect literacy or child-reported attitudes toward reading; these results provide insight into what changes are needed for effective shared book reading interventions in this population.
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Affiliation(s)
- Kristin Hadfield
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | | | - Rana Dajani
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa, Jordan
| | - Amal El Kharouf
- Centre for Women's Studies, University of Jordan, Amman, Jordan
| | - Julia Michalek
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | | | | | - Isabelle Mareschal
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
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2
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Gao Q, Niu L, Wang W, Zhao S, Xiao J, Lin D. Developmental Trajectories of Mental Health in Chinese Early Adolescents: School Climate and Future Orientation as Predictors. Res Child Adolesc Psychopathol 2024; 52:1303-1317. [PMID: 38625459 DOI: 10.1007/s10802-024-01195-9] [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] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
There is growing support for the dual-continua model of mental health, which emphasizes psychopathology and well-being as related but distinct dimensions. Yet, little is known about how these dimensions co-develop from childhood to early adolescence and what factors predict their different trajectories. The current study aimed to identify distinct patterns of mental health in Chinese early adolescents, focusing on both psychopathological symptoms (i.e., depressive symptoms and self-harm behaviors) and subjective well-being (i.e., life satisfaction and affect balance). This study also examined the contributions of school climate and future orientation to these trajectories. A total of 1,057 students (Mage = 11.88, SDage = 1.67; 62.1% boys) completed four assessments over two years, with six-month intervals. Using parallel-process latent class growth modeling, we identified four groups: Flourishing (32.5%), Languishing (43.8%), Troubled with Stable Depressive Symptoms (16.1%), and Troubled with Increasing Self-Harm Risk (7.6%). Furthermore, school climate and future orientation contributed to adolescents' membership in these trajectories, either independently or jointly. Specifically, higher levels of future orientation combined with higher school climate were associated with a lower likelihood of belonging to the Troubled with Increasing Self-Harm Risk trajectory, compared to the Flourishing group. Our findings identified four distinct mental health trajectories consistent with the dual-continua model, and demonstrated that the development of psychopathology and well-being were not always inversely related (e.g., the Languishing group). Adolescents with unique developmental profiles may benefit from tailored intervention strategies that build on the personal and environmental assets of the adolescent.
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Affiliation(s)
- Qianqian Gao
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Li Niu
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wei Wang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shan Zhao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiale Xiao
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China.
- Faculty of Psychology, Beijing Normal University, Beijing, China.
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Lembke EJ, Linderkamp F, Casale G. Trauma-sensitive school concepts for students with a refugee background: a review of international studies. Front Psychol 2024; 15:1321373. [PMID: 38756485 PMCID: PMC11098281 DOI: 10.3389/fpsyg.2024.1321373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/11/2024] [Indexed: 05/18/2024] Open
Abstract
Children and adolescents with a refugee background are at high risk for traumatization. Once they arrive in safe countries, schools are the institutions where teachers are responsible for caring for them sensitively and competently. Furthermore, schools are organized in learning groups consisting of multiple peers of the same age, which provides excellent opportunities for social learning and experiences of social support. In this respect, schools are the appropriate places where preventive concepts can be applied to students with a refugee background. This systematic review summarizes studies that examine or evaluate existing international concepts of trauma-sensitive schools for supporting traumatized students with a refugee background. Based on N = 41 selected articles, 17 relevant concepts of trauma-sensitive schools were identified. In 35.3% of the concepts, traumatized students with a refugee background are explicitly included in the target group of the concept, while 47.1% of the concepts refer to groups of students with trauma as a result of various adverse childhood experiences, which also occur more frequently within the population of refugee children and adolescents 17.6% of the concepts contain specific adaptations for pupils with a refugee background. The majority of these concepts were developed in the United States. Additional concepts can be reported for Australia, the United Kingdom, Turkey, and Cambodia. Based on available empirical data, no significant effectiveness regarding the researched concepts' effects on academic and other school-related data can be determined. Although some studies indicate positive effects concerning school-related target variables, most of the studies have only limited significance due to inadequate research designs and methodological deficiencies. Therefore, there is a great need for further development, careful implementation, and evaluation of trauma-sensitive concepts in schools, especially for the growing group of refugee students.
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Affiliation(s)
- Eva J. Lembke
- School of Education, Institute of Educational Research, University of Wuppertal, Wuppertal, Germany
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Popham CM, McEwen FS, Karam E, Pluess M. The important role of mothers during displacement: Direct and indirect effects of the refugee context on Syrian refugee children's mental health. Child Dev 2024; 95:e206-e223. [PMID: 38108194 PMCID: PMC11023757 DOI: 10.1111/cdev.14055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Refugee children are at increased risk for mental health problems, including post-traumatic stress, depression, and externalizing problems. The refugee environment, maternal mental health, and parenting may reduce or exacerbate that risk. This study investigated their direct and indirect associations with child mental health cross-sectionally in a sample of Syrian refugee child-mother dyads in Lebanon in 2017-19. Mediating pathways were tested using structural equation modeling with 1446 dyads (child: Mage = 11.39, 52.1% females) and again 1 year later with 872 (child: Mage = 12.17, 53.1% females) of the original sample. Mediating pathways from the refugee environment through maternal mental health and parenting to child outcomes were detected, emphasizing the importance of a holistic approach to refugee mental health.
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Affiliation(s)
- Cassandra M. Popham
- Department of Biological and Experimental Psychology, Queen Mary University of London, UK
| | - Fiona S. McEwen
- Department of Biological and Experimental Psychology, Queen Mary University of London, UK
- Department of War Studies, King’s College London, London, UK
| | - Elie Karam
- Institute for Development, Research, Advocacy and Applied Care, Lebanon
- Saint George Hospital University Medical Center, Lebanon
- St Georges University of Beirut, Lebanon
| | - Michael Pluess
- Department of Biological and Experimental Psychology, Queen Mary University of London, UK
- School of Psychology, University of Surrey, Guildford, UK
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May AK, Smeeth D, McEwen F, Moghames P, Karam E, Rieder MJ, Elzagallaai AA, van Uum S, Pluess M. Hair hormone data from Syrian refugee children: Perspectives from a two-year longitudinal study. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 18:100231. [PMID: 38645423 PMCID: PMC11026725 DOI: 10.1016/j.cpnec.2024.100231] [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: 12/28/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
For numerous issues of convenience and acceptability, hair hormone data have been increasingly incorporated in the field of war trauma and forced displacement, allowing retrospective examination of several biological metrics thought to covary with refugees' mental health. As a relatively new research method, however, there remain several complexities and uncertainties surrounding the use of hair hormones, from initial hair sampling to final statistical analysis, many of which are underappreciated in the extant literature, and restrict the potential utility of hair hormones. To promote awareness, we provide a narrative overview of our experiences collecting and analyzing hair hormone data in a large cohort of Syrian refugee children (n = 1594), across two sampling waves spaced 12 months apart. We highlight both the challenges faced, and the promising results obtained thus far, and draw comparisons to other prominent studies in this field. Recommendations are provided to future researchers, with emphasis on longitudinal study designs, thorough collection and reporting of hair-related variables, and careful adherence to current laboratory guidelines and practices.
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Affiliation(s)
- Andrew K. May
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
| | - Demelza Smeeth
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Fiona McEwen
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of War Studies, King's College London, London, UK
| | | | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon
| | - Michael J. Rieder
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Abdelbaset A. Elzagallaai
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stan van Uum
- Division of Endocrinology and Metabolism, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Michael Pluess
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
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Fortuna LR, Porche MV. Upholding the Human Rights and Well-Being of Refugee Children Through Effective Clinical Care. Child Adolesc Psychiatr Clin N Am 2024; 33:111-124. [PMID: 38395499 PMCID: PMC10894321 DOI: 10.1016/j.chc.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Refugee children are often exposed to adversities and traumatic experiences that can harm the mental health and well-being of refugee children. These include human trafficking and exploitation and dangers in detention centers and refugee camps. All these adverse events can be traumatic and contribute to poor mental health, including posttraumatic stress, anxiety, depression, and substance use disorders. Therefore, the assessment of refugee children and adolescents should include screening and identification for these experiences, provision of evidence-based trauma treatment, and social supports to promote their well-being and thriving.
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Affiliation(s)
- Lisa R Fortuna
- University of California Riverside, School of Medicine Education Building 2, 5th Floor, Psychiatry and Neurosciences, 900 University Avenue, Riverside, CA 92521, USA.
| | - Michelle V Porche
- University of California, Psychiatry and Behavioral Sciences, 1001 Potrero Avenue, Building 5, 7M10, San Francisco, CA 94110, USA
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Masten AS. Emergence and evolution of developmental resilience science over half a century. Dev Psychopathol 2024:1-9. [PMID: 38456302 DOI: 10.1017/s0954579424000154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
This reflection on the history and future of developmental resilience science (DRS) highlights its co-emergence with developmental psychopathology (DP), as well as the roles of this journal and its founding editor, Dante Cicchetti, in the evolution of these intertwined domains of scholarship. A remarkable constellation of scholars at the University of Minnesota shaped the course of both conceptual frameworks and their dissemination. I describe fundamental assumptions common to DP and DRS frameworks that reflect their common roots and the pervasive influence of systems theory on developmental science. I describe four waves of DRS and key principles of DRS at the present time. In conclusion, I consider the possibility that a fifth wave of DRS is emerging with a focus on understanding patterns of multisystem, multilevel processes of resilience and their implications for interventions in the context of interacting, interdependent, and complex adaptive systems. I close this commentary with questions for future research and a hopeful outlook on the future of human resilience.
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Affiliation(s)
- Ann S Masten
- University of Minnesota Twin Cities, Minneapolis, MN, USA
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McEwen FS, El Khatib H, Hadfield K, Pluess K, Chehade N, Bosqui T, Skavenski S, Murray L, Weierstall-Pust R, Karam E, Pluess M. Feasibility and acceptability of phone-delivered psychological therapy for refugee children and adolescents in a humanitarian setting. Confl Health 2024; 18:7. [PMID: 38218936 PMCID: PMC10787498 DOI: 10.1186/s13031-023-00565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 12/28/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Refugee children are at high risk of mental health problems but face barriers to accessing mental health services, a problem exacerbated by a shortage of mental health professionals. Having trained lay counsellors deliver therapy via telephone could overcome these barriers. This is the first study to explore feasibility and acceptability of telephone-delivered therapy with refugee children in a humanitarian setting. METHODS An evidence-based intervention, Common Elements Treatment Approach, was adapted for telephone-delivery (t-CETA) and delivered by lay counsellors to Syrian refugee children in informal tented settlements in the Beqaa region of Lebanon. Following delivery of t-CETA, semi-structured interviews were conducted with counsellors (N = 3) and with children who received t-CETA (N = 11, 45% female, age 8-17 years) and their caregivers (N = 11, 100% female, age 29-56 years) (N = 25 interviews). Thematic content analysis was conducted separately for interviews with counsellors and interviews with families and results were synthesized. RESULTS Three themes emerged from interviews with counsellors and four themes from interviews with families, with substantial overlap between them. Synthesized themes were: counselling over the phone both solves and creates practical and logistical challenges; t-CETA is adapted to potential cultural blocks; the relationship between the counsellor and the child and caregiver is extremely important; the family's attitude to mental health influences their understanding of and engagement with counselling; and t-CETA works and is needed. Counselling over the phone overcame logistical barriers, such as poor transportation, and cultural barriers, such as stigma associated with attending mental health services. It provided a more flexible and accessible service and resulted in reductions in symptoms for many children. Challenges included access to phones and poor network coverage, finding an appropriate space, and communication challenges over the phone. CONCLUSIONS Despite some challenges, telephone-delivered therapy for children shows promising evidence of feasibility and acceptability in a humanitarian context and has the potential to increase access to mental health services by hard-to-reach populations. Approaches to addressing challenges of telephone-delivered therapy are discussed. Trial Registration ClinicalTrials.gov ID: NCT03887312; registered 22nd March 2019.
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Affiliation(s)
- Fiona S McEwen
- Biological and Experimental Psychology, School of Biological and Behavioural Science, G.E. Fogg Building, Queen Mary University of London, Mile End Road, London, UK
- Department of War Studies, King's College London, Strand, London, UK
| | - Hania El Khatib
- Biological and Experimental Psychology, School of Biological and Behavioural Science, G.E. Fogg Building, Queen Mary University of London, Mile End Road, London, UK
| | - Kristin Hadfield
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Karen Pluess
- Biological and Experimental Psychology, School of Biological and Behavioural Science, G.E. Fogg Building, Queen Mary University of London, Mile End Road, London, UK
| | | | - Tania Bosqui
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, American University of Beirut, Beirut, Lebanon
| | | | - Laura Murray
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Elie Karam
- Institute for Development, Research, Advocacy and Applied Care, Achrafieh, St. George Hospital Street, Beirut, Lebanon
- Saint Georges Hospital University Medical Center, Achrafieh, Beirut, Lebanon
- Saint Georges University of Beirut, Beirut, Lebanon
| | - Michael Pluess
- Biological and Experimental Psychology, School of Biological and Behavioural Science, G.E. Fogg Building, Queen Mary University of London, Mile End Road, London, UK.
- School of Psychology, University of Surrey, Guildford, UK.
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Khraisha Q, Sawalha L, Hadfield K, Al-Soleiti M, Dajani R, Panter-Brick C. Coparenting, mental health, and the pursuit of dignity: A systems-level analysis of refugee father-mother narratives. Soc Sci Med 2024; 340:116452. [PMID: 38171170 DOI: 10.1016/j.socscimed.2023.116452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024]
Abstract
Research on coparenting is virtually absent from the refugee literature, despite its importance for family systems, children's bio-behavioural and emotional development, and intergenerational responses to social change. In 2022, we conducted 30 semi-structured interviews with Syrian refugees in Jordan and used thematic analysis to examine how fathers and mothers (n = 15 dyads) enacted parenting together. We identified four approaches characterising how couples navigated coparenting interactions, family cohesion, and intergenerational change. These were negotiation, mirroring, anchoring, and transformation. Specifically, Syrian couples negotiated how to balance responsibilities, sought emotions and behaviours that reflected calm and respect, prioritised family togetherness over education or resettlement opportunities, and, strikingly, adopted gentler parenting approaches to transform intergenerational experiences. Underpinning these four themes were efforts to uphold family dignity. Syrians described themselves as ordinary parents, eschewing the label of refugee parents and building a normal life for their families after war and displacement. Our thematic analysis offers methodological and conceptual advances in exemplifying how to capture a dyadic understanding of coparenting and why refugees strive to parent in ways that sustain mental health and dignity. This systems-level analysis of coparenting in dignity is specifically relevant to strengthening the processes of family-level communication and to designing integrated programs that support caregiving, wellness, and family unity. Our findings lay the groundwork for developing a relational, agentic model of family caregiving systems in the context of precarity and forced displacement.
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Affiliation(s)
- Qusai Khraisha
- Trinity Centre for Global Health, Trinity College Dublin, Ireland; School of Psychology, Trinity College Dublin, Ireland
| | | | - Kristin Hadfield
- Trinity Centre for Global Health, Trinity College Dublin, Ireland; School of Psychology, Trinity College Dublin, Ireland
| | - Majd Al-Soleiti
- Tahgyeer Foundation, Amman, Jordan; Department of Psychiatry, Mayo Clinic, USA
| | - Rana Dajani
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Jordan
| | - Catherine Panter-Brick
- Department of Anthropology, Yale University, USA; Jackson School of Global Affairs, Yale University, USA; Conflict, Resilience, and Health Program, Yale University, USA.
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Rizzi D, Ciuffo G, Landoni M, Mangiagalli M, Ionio C. Psychological and environmental factors influencing resilience among Ukrainian refugees and internally displaced persons: a systematic review of coping strategies and risk and protective factors. Front Psychol 2023; 14:1266125. [PMID: 37876848 PMCID: PMC10590896 DOI: 10.3389/fpsyg.2023.1266125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/19/2023] [Indexed: 10/26/2023] Open
Abstract
Background There is much discussion in the literature about the link between traumatic events related to war and mental illness. However, in comparison, mental health has been more researched than protective factors such as coping methods, which are the primary factors to build resilience in these circumstances. This review examines the psychological and environmental elements that influence the resilience of Ukrainian refugees and IDPs by analyzing coping strategies and risk and protective factors. Methods A literature search was conducted on PsycINFO, Pubmed, Scopus, and Science Direct, with 259 articles screened and 13 determined as eligible for inclusion. Inclusion criteria were: (1) studies on adult Ukrainian refugees and/or IDPs; (2) original, peer-reviewed studies; and (3) studies written in English or Italian language. Single-case reports and qualitative studies were excluded, as well as those studies written in any other language, and any studies for which the full-text version could not be obtained (i.e., conference abstracts). Two reviewers independently reviewed titles and abstracts, reviewed relevant articles' full text, and extracted the data. Results A diverse range of individual and socio-environmental risk and protective factors were identified, influencing the resilience of Ukrainian refugees and IDPs, as well as five main categories of coping strategies: emotion-focused strategies, problem-focused strategies, avoidance, faith-based strategies, and the ones based on sense of belonging. Discussion War trauma and associated stressors can lead to distressing physical and psychological reactions, which persist even after leaving the war zone. Many individual and socio-environmental risk factors, such as mental disorders, financial security, having relatives wounded or displaced, and an unfamiliar environment could influence the risk and severity of psychological difficulties, emphasizing the importance of coping strategies, social connections, faith, and cultural resilience. Conclusion This systematic review underscores the complex range of coping strategies and factors influencing the resilience of Ukrainian refugees and IDPs. Social connections and inclusive community interventions play vital roles in improving their psychological well-being, while longitudinal studies and culturally sensitive support are needed to address their unique challenges and strengths. Implementing collaborative care models can provide comprehensive support by integrating mental health services with primary healthcare and community-based organizations.
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Affiliation(s)
- Damiano Rizzi
- Fondazione Soleterre Strategie di Pace ONLUS, Milan, Italy
- Unità di Medicina d’Urgenza, Dipartimento di Medicina Interna, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Unità di Ricerca sul Trauma, Dipartimento di Psicologia, Università Cattolica, Milan, Italy
| | - Giulia Ciuffo
- Unità di Ricerca sul Trauma, Dipartimento di Psicologia, Università Cattolica, Milan, Italy
- CRIdee, Dipartimento di Psicologia, Università Cattolica, Milan, Italy
| | - Marta Landoni
- CRIdee, Dipartimento di Psicologia, Università Cattolica, Milan, Italy
| | - Matteo Mangiagalli
- Fondazione Soleterre Strategie di Pace ONLUS, Milan, Italy
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, Pavia, Italy
| | - Chiara Ionio
- Unità di Ricerca sul Trauma, Dipartimento di Psicologia, Università Cattolica, Milan, Italy
- CRIdee, Dipartimento di Psicologia, Università Cattolica, Milan, Italy
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Wang Y. Influence of Early Family Nurturing Environment on Children's Psychological and Emotional Social Development. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:2138-2147. [PMID: 37899924 PMCID: PMC10612553 DOI: 10.18502/ijph.v52i10.13852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/14/2023] [Indexed: 10/31/2023]
Abstract
Background A good family environment and rearing mode play important roles in children's physical and psychological growth. This study aims to clarify the specific influence of early family nurturing environment on children's emotional and social development through longitudinal observation to provide theoretical reference for promoting the healthy development of children's bodies and minds. Methods Overall, 1320 parents of children aged 2 to 6 yr old in Xinyang City, Henan Province in 2021, were selected by stratified sampling. The children's physical and mental development, family rearing environment and emotional and social development were investigated by questionnaire. Results 58.03% family rearing environment is good, 27.95% normal, and 14.02% bad. There were significant differences in positive rates of adaptive ability, social behavior, language, developmental quotient score and emotional sociality among children in different families (all P<0.05). Language/cognition was significantly positively correlated with adaptive ability, social behavior, language and developmental quotient (all P<0.05), and social adjustment/self-care was significantly positively correlated with adaptive ability, social behavior, language and developmental quotient (all P<0.05). Emotional warmth/environmental atmosphere was negatively correlated with implicit behavior and disorder and positively correlated with ability (all P<0.05). Language/cognition was positively correlated with explicit behavior and ability (all P<0.05). Social adjustment/self-care was negatively correlated with explicit behavior and positively correlated with ability (all P<0.05); Neglect/punishment was significantly negatively correlated with explicit behavior, implicit behavior and disorder and significantly positively correlated with ability (all P<0.05). Conclusion The early family environment affects children's physical, mental, emotional and social development.
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Affiliation(s)
- Yujie Wang
- International Education College, Kaifeng University, Kaifeng, 475000, China
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Lawrence JA, Dodds AE, Kaplan I, Tucci MM. Recognizing Relational Interactions with Social Institutions in Refugee Children's Experiences of Intertwining Vulnerability and Agency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6815. [PMID: 37835085 PMCID: PMC10572281 DOI: 10.3390/ijerph20196815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/13/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023]
Abstract
In this paper, we examine relational interactions between refugee children and social institutions, building the case for the recognition of the co-occurrence and intertwining of vulnerability and agency in children's experiences in diverse refugee situations. This developmental relational approach offers refinement of a general relational worldview by specifying how vulnerable and agentic experiences are co-constructed by children and adult individuals and institutions. We analyze the conceptual roots of vulnerable and agentic experiences, and use the concept of co-construction to specify the processes and outcomes of interactive relational experiences. Evidence from example studies of the intertwining of vulnerability and agency in specific refugee situations demonstrates how refugee children contribute to power-oriented experiences. Due recognition of the relational co-construction of intertwining vulnerable and agentic experiences provides a basis for refining generalized relational observations, and a fine-grained basis for developing policies and procedures to dispel ambivalence to refugee children and to change inequitable policies and practices.
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Affiliation(s)
- Jeanette A. Lawrence
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne 3010, Australia; (A.E.D.); (I.K.)
- Victorian Foundation for Survivors of Torture, Brunswick 3056, Australia;
| | - Agnes E. Dodds
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne 3010, Australia; (A.E.D.); (I.K.)
- Victorian Foundation for Survivors of Torture, Brunswick 3056, Australia;
| | - Ida Kaplan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne 3010, Australia; (A.E.D.); (I.K.)
- Victorian Foundation for Survivors of Torture, Brunswick 3056, Australia;
| | - Maria M. Tucci
- Victorian Foundation for Survivors of Torture, Brunswick 3056, Australia;
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Ratnamohan L, Silove D, Mares S, Krishna Y, Hadzi-Pavlovic D, Steel Z. Breaching the family walls: Modelling the impact of prolonged visa insecurity on asylum-seeking children. Aust N Z J Psychiatry 2023; 57:1130-1139. [PMID: 36632824 DOI: 10.1177/00048674221148399] [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] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Children in asylum-seeking families are increasingly subject to deterrent host nation policies that undermine security in the post-migration context, however, little is known on the mental health consequences of such policy. This study examined the impact of prolonged visa insecurity on child mental health, by comparing two cohorts of refugee children entering Australia between 2010 and 2013, distinguished by visa security. METHODS The insecure visa sample comprised children from Tamil asylum-seeking families, while the secure visa sample was drawn from refugee families participating in the multi-ethnic 'Building a New Life in Australia' cohort study. Children in each sample were assessed for current mental health problems and trauma exposure. Mothers were assessed for trauma exposure, post-migration family stressors and post-traumatic stress disorder (PTSD). The effects of prolonged visa insecurity on child mental health via family-and child-level variables were modelled using multi-level path analysis. RESULTS Data comprised 361 children, aged 10-18, and 242 mothers across three levels of visa insecurity: permanent protection (n = 293), temporary protection (n = 40) and bridging visa (n = 28). Modelling showed that (1) visa insecurity was associated with poorer child mental health, (2) the association was mediated sequentially by post-migration family stressors and maternal PTSD and (3) the association was moderated by maternal PTSD. CONCLUSION Our findings suggest that when government policy persistently undermines post-migration security, the capacity of families to protect children from accrued stressors is lowered, leaving a significantly higher proportion of children developing along trajectories of risk rather than resilience.
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Affiliation(s)
- Lux Ratnamohan
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Rivendell Child, Adolescent and Family Mental Health Service, Thomas Walker Hospital, Concord West, NSW, Australia
| | - Derrick Silove
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Sarah Mares
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Yalini Krishna
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Zachary Steel
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Rivendell Child, Adolescent and Family Mental Health Service, Thomas Walker Hospital, Concord West, NSW, Australia
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14
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Garbade M, Eglinsky J, Kindler H, Rosner R, Sachser C, Pfeiffer E. Factors affecting the acculturation strategies of unaccompanied refugee minors in Germany. Front Psychol 2023; 14:1149437. [PMID: 37404580 PMCID: PMC10315911 DOI: 10.3389/fpsyg.2023.1149437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/22/2023] [Indexed: 07/06/2023] Open
Abstract
Background Different acculturation strategies might be related to different mental health outcomes and social participation of unaccompanied refugee minors (URMs), but little is known about which factors influence this acculturation process. Therefore, the aim of this investigation was to examine the impact of individual, stress-related, and contextual factors on the acculturation process of URMs in Germany. Methods A sample of N = 132 URMs living in child and youth welfare service facilities in Germany completed questionnaires about their acculturation orientation, traumatic experiences, daily stressors, asylum stress, and perceived social support between June 2020 and October 2021. This investigation is part of the multi-center randomized control trial BETTER CARE. Data were analyzed descriptively and via multiple hierarchical regression. Results Integration (43.5%) and Assimilation (37.1%) were the most common acculturation strategies used by URMs. Multiple hierarchical regression models showed that daily stressors (e.g., the lack of money) were associated with a stronger orientation toward the home country, whereas traumatic events were associated with a weaker orientation toward their home country. No significant predictors were found for the orientation toward the host country. Discussion Overall, URMs in Germany showed favorable acculturation strategies. Nevertheless, daily stressors and traumatic experiences might influence this process. The implications for practitioners and policymakers are discussed with a view to further improving the acculturation process of URMs in Germany.Clinical Trial Registration: German Clinical Trials Register, DRKS00017453 https://drks.de/search/de/trial/DRKS00017453. Registered on December 11, 2019.
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Affiliation(s)
- Maike Garbade
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jenny Eglinsky
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | | | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Elisa Pfeiffer
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
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15
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Feen-Calligan H, Grasser LR, Nasser S, Sniderman D, Javanbakht A. Photovoice Techniques and Art Therapy Approaches with Refugee and Immigrant Adolescents. ARTS IN PSYCHOTHERAPY 2023; 83. [PMID: 37006325 PMCID: PMC10062119 DOI: 10.1016/j.aip.2023.102005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
This paper describes a program informed by art therapy and Photovoice approaches and techniques aimed at helping new immigrant and refugee teens to navigate personal and cultural identities by reflecting on their experiences as new residents in the US. Photovoice is a photography and social action method that encourages participants to photograph aspects of their daily lives, reflect on their meaning and significance and galvanize necessary changes. The program began in February 2020 at the Arab-American National Museum (AANM), but was adapted for an online format and re-framed towards a reflection on the COVID-19 pandemic. Broad questions teens explored included: What is good? What is challenging? What is sustaining during challenging times? What needs to change? and What about your culture and background are you proud of and wish to share with other US residents? Highlights of the sessions demonstrate how art therapy interventions paralleled photography-assigned themes of self, home, and community and encouraged group interaction and mutual support. A virtual museum exhibition culminated the program and reached community leaders. Self-reports from select participants highlight changes in posttraumatic stress, anxiety, and somatic symptoms over the course of programming.
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Affiliation(s)
- Holly Feen-Calligan
- College of Education, Wayne State University, Detroit, MI 48202, USA
- Corresponding author. (H. Feen-Calligan)
| | | | - Sara Nasser
- College of Education, Wayne State University, Detroit, MI 48202, USA
| | - David Sniderman
- College of Education, Wayne State University, Detroit, MI 48202, USA
| | - Arash Javanbakht
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
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16
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Smeeth D, McEwen FS, Popham CM, Karam EG, Fayyad J, Saab D, Rieder MJ, Elzagallaai AA, van Uum S, Pluess M. War exposure, post-traumatic stress symptoms and hair cortisol concentrations in Syrian refugee children. Mol Psychiatry 2023; 28:647-656. [PMID: 36385169 PMCID: PMC9908541 DOI: 10.1038/s41380-022-01859-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/23/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022]
Abstract
Altered secretion of cortisol, the primary effector of the hypothalamus-pituitary-adrenal axis, has been proposed as a means by which traumatic experiences compromise later mental health. However, despite the popularity of cortisol as a potential biomarker for stress and adversity, findings are inconsistent, and little is known about the impact of war-related trauma on stress physiology of children and adolescents. Here we aimed to evaluate the relationships between war exposure, current living conditions, hair cortisol concentrations (HCC) and post-traumatic stress disorder (PTSD) symptoms in a large cohort of Syrian refugee children and adolescents (6-18 years) and their caregiver. This longitudinal observational study assessed Syrian refugee children and adolescents in two waves, 1 year apart, within informal tented settlements in Lebanon. The relationships between war exposure, time since leaving Syria, PTSD symptoms and HCC were investigated using linear mixed-model regression utilising both waves of data collected (Y1: N = 1574, Y2: N = 923). Hair cortisol concentration was positively, but weakly associated with the number of war-related events experienced. This was limited to those who were at least 12 years old at the time of war exposure. Conversely, HCC decreased with time since leaving Syria. HCC was also associated with PTSD symptoms but not with the quality of their current living conditions. This study revealed that changes to hypothalamic-pituitary-adrenal axis activity may accompany both earlier war exposure and current PTSD symptoms in children and adolescents. Additionally, early adolescence may be a particularly sensitive time in terms of trauma-related changes to the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- Demelza Smeeth
- grid.4868.20000 0001 2171 1133Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Fiona S. McEwen
- grid.4868.20000 0001 2171 1133Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Cassandra M. Popham
- grid.4868.20000 0001 2171 1133Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Elie G. Karam
- grid.429040.bDepartment of Psychiatry and Clinical Psychology, Balamand University, St George Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - John Fayyad
- grid.429040.bDepartment of Psychiatry and Clinical Psychology, Balamand University, St George Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Dahlia Saab
- grid.429040.bDepartment of Psychiatry and Clinical Psychology, Balamand University, St George Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Michael J. Rieder
- grid.39381.300000 0004 1936 8884Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON Canada
| | - Abdelbaset A. Elzagallaai
- grid.39381.300000 0004 1936 8884Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON Canada
| | - Stan van Uum
- grid.39381.300000 0004 1936 8884Division of Endocrinology and Metabolism, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON Canada
| | - Michael Pluess
- Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK.
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17
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Anjum G, Aziz M, Hamid HK. Life and mental health in limbo of the Ukraine war: How can helpers assist civilians, asylum seekers and refugees affected by the war? Front Psychol 2023; 14:1129299. [PMID: 36874809 PMCID: PMC9983366 DOI: 10.3389/fpsyg.2023.1129299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
The terror spread by the war disrupts lives and severs families, leaving individuals and communities devastated. People are left to fend for themselves on multiple levels, especially psychologically. It is well documented that war adversely affects non-combatant civilians, both physically and psychologically. However, how the war puts civilians' lives in a limbo is an under-researched area. This paper focuses on three aspects: (1) how the mental health and well-being of Ukrainian civilians, asylum seekers, and refugees are affected by the war caused limbo; (2) what factors affect this process of being stuck in the limbo of war; and (3) how psychologists and helpers in the war-ridden and host countries can provide meaningful support. Based on the authors' own practical work with Ukrainian civilians, refugees, and professional helpers during the war, this paper provides an overview of multi-level factors that impact human psyches in a war, and possible ways to help those who are living in the war limbo. In this research and experiential learning-based review, we offer some helpful strategies, action plans, and resources for the helpers including psychologists, counselors, volunteers, and relief workers. We emphasize that the effects of war are neither linear nor equal for all civilians and refugees. Some will recover and return to a routine life while others will experience panic attacks, trauma, depression, and even PTSD, which can also surface much later and can prolong over the years. Hence, we provide experience-based ways of dealing with short-term and prolonged trauma of living with war and post-traumatic stress disorder (PTSD). Mental health professionals and other helpers in Ukraine and in host countries can use these helping strategies and resources to provide effective support for Ukrainians and for war refugees in general.
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Affiliation(s)
- Gulnaz Anjum
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Mudassar Aziz
- Department of Psychology, Kwantlen Polytechnic University, Surrey, BC, Canada
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18
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Mental health in refugee children. Curr Opin Psychol 2022; 48:101460. [PMID: 36130437 DOI: 10.1016/j.copsyc.2022.101460] [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: 08/01/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 01/28/2023]
Abstract
Almost half of the world's forcibly displaced population are children, most commonly originating from Syria, Iraq, and Afghanistan. Health disparities are well documented, especially for mental health, but not consistent across groups, time or context. Despite high exposure to trauma and stress, refugee children also show remarkable resilience. An ecological model of refugee health including both risk and resilience factors is therefore recommended. The model also includes the dynamic inter-relationship of past traumatic experiences, ongoing daily stressors and the disruptions of basic systems affecting both the individual and families as a whole, offering a framework to better understand the health disparities and appropriate interventions for refugee children.
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19
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The Nexus Between Immigration Status, Policy, and Proceedings, and Mental Health. Curr Opin Psychol 2022; 47:101411. [DOI: 10.1016/j.copsyc.2022.101411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022]
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20
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Moore HE, Hill B, Tanser F, Siriwardena AN, Gussy M, Cutts M, Spaight R. Characterizing Unusual Spatial Clusters of Male Mental Health Emergencies Occurring During the First National COVID-19 "Lockdown" in the East Midlands Region, UK: A Geospatial Analysis of Ambulance 999 Data. Am J Mens Health 2022; 16:15579883221097539. [PMID: 35579400 PMCID: PMC9118447 DOI: 10.1177/15579883221097539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 12/05/2022] Open
Abstract
The widespread psychological effects of contagion mitigation measures associated with the novel coronavirus disease 2019 (COVID-19) are well known. Phases of "lockdown" have increased levels of anxiety and depression globally. Most research uses methods such as self-reporting that highlight the greater impact of the pandemic on the mental health of females. Emergency medical data from ambulance services may be a better reflection of male mental health. We use ambulance data to identify unusual clusters of high rates of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national "lockdown" and to explore factors that may explain clusters. Analysis of more than 5,000 cases of male mental health emergencies revealed 19 unusual spatial clusters. Binary logistic regression analysis (χ2 = 787.22, df = 20, p ≤ .001) identified 16 factors that explained clusters, including proximity to "healthy" features of the physical landscape, urban and rural dynamics, and socioeconomic condition. Our findings suggest that the factors underlying vulnerability of males to severe mental health conditions during "lockdown" vary within and between rural and urban spaces, and that the wider "hinterland" surrounding clusters influences the social and physical access of males to services that facilitate mental health support. Limitations on social engagement to mitigate effects of the pandemic are likely to continue. Our approach could inform delivery of emergency services and the development of community-level services to support vulnerable males during periods of social isolation.
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Affiliation(s)
| | - Bartholomew Hill
- Water WISER CDT, University of Loughborough, Loughborough, Leicestershire, UK
| | - Frank Tanser
- Lincoln Institute for Rural Health, University of Lincoln, Lincoln, UK
| | | | - Mark Gussy
- Lincoln Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Morgan Cutts
- Department of Geography, University of Lincoln, Lincoln, UK
| | - Robert Spaight
- East Midlands Ambulance Service NHS Trust, Nottingham, UK
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21
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Emerson SD, Gagné Petteni M, Guhn M, Oberle E, Georgiades K, Milbrath C, Janus M, Schonert-Reichl KA, Gadermann AM. Social context factors and refugee children's emotional health. Soc Psychiatry Psychiatr Epidemiol 2022; 57:829-841. [PMID: 34562109 DOI: 10.1007/s00127-021-02173-y] [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: 03/12/2021] [Accepted: 09/06/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Refugee children face numerous challenges associated with pre-migration trauma and post-migration adaptation. Much research pertaining to refugee children's well-being focuses on psychiatric symptoms. Relatively few studies have examined how social context factors-such as perceptions of peer belonging, and support from adults at home and at school-contribute to the emotional health of refugee children. Informed by social-ecological theories emphasizing dynamic interactions between the contexts in which children develop, we examined associations between social context factors and emotional health in refugee children. METHODS Data were drawn from a population-based data linkage in British Columbia, Canada. The analytic sample included 682 grade 4 students (Mage 9.2 years; 46.3% female) with a refugee background who responded to the Middle Years Development Instrument (MDI) during the 2010/2011-2016/2017 school years. The MDI is a self-report survey of children's social and emotional competencies and social context factors completed at school. Regression analyses were used to examine associations of social context factors (school climate, supportive adults at school and at home, and peer belonging) with indicators of emotional health (life satisfaction, self-concept, optimism, and sadness). Refugee generation status (first/second) was considered through stratification and testing of interactions with social context factors. RESULTS Perceived supportive school climate, support from adults in school and at home, and peer belonging were each independently associated with better emotional health. Results were similar for first- and second-generation children. CONCLUSION Taken together, results suggest a unique role of the school context to refugee children's emotional health. School-based programming that promotes positive school climate can be considered as an important approach to support newcomer refugee children and their families.
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Affiliation(s)
- Scott D Emerson
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| | - Monique Gagné Petteni
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Eva Oberle
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Constance Milbrath
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Magdalena Janus
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Kimberly A Schonert-Reichl
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Department of Psychology, University of Illinois at Chicago, Chicago, USA
| | - Anne M Gadermann
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada
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22
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Abstract
In this paper, I set out the challenges of care for refugees and suggest approaches to assessment and intervention. I discuss clinical interventions that can address the immediate concern of the clinician in a bio-psycho-social framework, and the value of considering eco-social and structural influences that can hinder recovery and perpetuate inequalities. Refugees face multiple adversities before, during and after escaping from life-threatening situations, political violence, torture and persecution. They present with complex health needs and encounter hostility from host countries and public services, which see their needs as an additional demand on the public purse. Regrettably, existing care practice and training of professionals do not often include skills for working across cultures, including cultural formulations and fair assessment, cultural adaptation of interventions, cultural competence and cultural consultation methods, including clinical ethnography and exploration of cultural identity and explanatory models. There are little data on effective and kind models of interpretation and translation. Care systems are rarely designed to fully address the needs of refugees. Health practitioners are not trained to address structural and institutional racism and discrimination, which leads to exclusion of the most marginalised, with little attention to social justice and fair processes as part of appropriate healthcare.
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Affiliation(s)
- Kamaldeep Bhui
- Department of Psychiatry and Nuffield Department of Primary Care Health Sciences, University of Oxford, UK; East London NHS Foundation Trust, UK; Oxford Health NHS Foundation Trust, UK; and World Psychiatric Association Collaborating Centre in Research, Training, Policy and Practice, UK
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23
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Michalek J, Lisi M, Binetti N, Ozkaya S, Hadfield K, Dajani R, Mareschal I. War-related trauma linked to increased sustained attention to threat in children. Child Dev 2022; 93:900-909. [PMID: 35147214 PMCID: PMC9542223 DOI: 10.1111/cdev.13739] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Experiences of war and displacement can have profound effects on children's affective development and mental health, although the mechanism(s) underlying these effects remain unknown. This study investigated the link between early adversity and attention to affective stimuli using a free-viewing eye-tracking paradigm with Syrian refugee (n = 31, Mage = 9.55, 12 female) and Jordanian non-refugee (n = 55, Mage = 9.98, 30 female) children living in Jordan (March 2020). Questionnaires assessed PTSD, anxiety/depression, insecurity, distress, and trauma. Refugee children showed greater initial avoidance of angry and happy faces compared to non-refugee children, and higher trauma exposure was linked to increased sustained attention to angry stimuli. These findings suggest that war-related trauma may have differential effects on the early and later stages of affective processing in refugee children.
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Affiliation(s)
- Julia Michalek
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Matteo Lisi
- Department of Psychology, Royal Holloway University of London, London, UK
| | - Nicola Binetti
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK.,International School for Advanced Studies (SISSA), Trieste, Italy
| | - Sumeyye Ozkaya
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Kristin Hadfield
- School of Psychology, Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Rana Dajani
- Department of Biology and Biotechnology, Hashemite University, Zarqa, Jordan
| | - Isabelle Mareschal
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
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Refugee Children's Social-Emotional Capacities: Links to Mental Health upon Resettlement and Buffering Effects on Pre-Migratory Adversity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212180. [PMID: 34831935 PMCID: PMC8618894 DOI: 10.3390/ijerph182212180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022]
Abstract
Refugee children who experience severe pre-migratory adversity often show varying levels of mental health upon resettlement. Thus, it is critical to identify the factors that explain which refugee children experience more vs. less healthy outcomes. The present study assessed child social-emotional capacities (i.e., emotion regulation, sympathy, optimism, and trust) as potential moderators of associations between child, parental, and familial pre-migratory adversities and child mental health (i.e., internalizing and externalizing symptoms) upon resettlement. Participants were N = 123 five- to 12-year-old Syrian refugee children and their mothers living in Canada. Children and mothers reported their pre-migratory adverse life experiences, and mothers reported their children's current social-emotional capacities, internalizing symptoms, and externalizing symptoms. Greater familial (i.e., the sum of children's and their mother's) pre-migratory adversity was associated with higher child internalizing and externalizing symptoms upon resettlement. Higher emotion regulation and optimism were associated with lower internalizing and externalizing symptoms, and higher sympathy was associated with lower externalizing symptoms. In contrast, higher trust was associated with higher internalizing symptoms. Finally, higher child optimism buffered against the positive association between familial pre-migratory adversity and child internalizing symptoms. In sum, select social-emotional capacities may serve as potential protective factors that support mental health and buffer against the deleterious effects of pre-migratory adversity in refugee children.
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Dangmann C, Solberg Ø, Myhrene Steffenak AK, Høye S, Andersen PN. Syrian Refugee Youth Resettled in Norway: Mechanisms of Resilience Influencing Health-Related Quality of Life and Mental Distress. Front Public Health 2021; 9:711451. [PMID: 34631646 PMCID: PMC8494783 DOI: 10.3389/fpubh.2021.711451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The importance of resilience factors in the positive adaptation of refugee youth is widely recognised. However, their actual mechanism of impact remains under-researched. The aim of this study was therefore to explore protective and promotive resilience mechanisms to inform future interventions and policy. Promotive resilience is seen as a direct main effect and protective resilience as a moderating effect. Methods: This was a cross-sectional study of Syrian youth recently resettled in Norway, aged 13–24 years. Regression and moderation analyses were used to explore different interactions, including moderated mediation using the PROCESS macro for SPSS. Result: A direct main effect of promotive resilience was found for health-related quality of life (HRQoL) and general mental distress, but not for post-traumatic stress disorder (PTSD). No moderating effects of protective resilience were found. Post-migration stressors mediated the effects of potentially traumatic events (PTE) from war and flight, and this indirect effect was present at all levels of resilience. Conclusion: Despite high risk exposure and mental distress, resilience was also high. Broad resilience interventions targeting multiple factors would likely benefit the group, but these should include both individual assets and building supportive environments. Additionally, reducing current stress and providing treatment for those in need could enable recovery and increase the efficacy of resilience factors already present.
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Affiliation(s)
- Cecilie Dangmann
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Øivind Solberg
- Department of Health Science, Swedish Red Cross University College, Stockholm, Sweden
| | | | - Sevald Høye
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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Jaffee SR. Editorial: 'In our time': Has the pandemic changed the way we write and read mental health and neurodevelopmental disorder research reviews? J Child Psychol Psychiatry 2021; 62:481-483. [PMID: 33905121 DOI: 10.1111/jcpp.13424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The past year was marked by upheaval, as countries across the globe shut down in the face of the COVID-19 pandemic. Although the topics for this year's Annual Research Review were decided long before most of had heard of the coronavirus, many readers may find themselves reading the papers in this issue through a pandemic lens. For some authors, the COVID-19 pandemic and the social unrest that characterized parts of the world where these authors live are likely to have shaped the way they ultimately framed the topics of their reviews. This issue serves as a reminder that it is critical to read science in social and historical context. Our preoccupations as psychologists and psychiatrists reflect our cultural values and societal experiences at a particular time and place.
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Pérez IE, Wu R, Murray CB, Bravo D. An interdisciplinary framework examining culture and adaptation in migrant children and adolescents. New Dir Child Adolesc Dev 2021; 2021:13-39. [DOI: 10.1002/cad.20405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Isabela E. Pérez
- Department of Psychology University of California Riverside Riverside California USA
| | - Rachel Wu
- Department of Psychology University of California Riverside Riverside California USA
| | - Carolyn B. Murray
- Department of Psychology University of California Riverside Riverside California USA
| | - Diamond Bravo
- Department of Psychology University of California Riverside Riverside California USA
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Bamford J, Fletcher M, Leavey G. Mental Health Outcomes of Unaccompanied Refugee Minors: a Rapid Review of Recent Research. Curr Psychiatry Rep 2021; 23:46. [PMID: 34196826 PMCID: PMC8249279 DOI: 10.1007/s11920-021-01262-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE To examine mental health outcomes of unaccompanied refugee minors during global policy shift. Additionally, to consider mental health service delivery and placement type for this group. METHODS A rapid systematic search of research published since 2018 which related to mental health outcomes of unaccompanied refugee minors. Data extracted, risk of bias assessed and outcomes reviewed qualitatively. RESEARCH FINDINGS We found 181 papers, of which 14 met inclusion criteria. This review found consistently high levels of PTSD and PTSS among URMs in various contexts. Exposure to trauma, being unaccompanied (compared to accompanied), being female and being older are associated with poor outcomes. Depression and anxiety were consistently high among URMs and associated with discrimination, limited language attainment and daily hassles. High rates of mental illness and symptoms among unaccompanied refugee minors were consistent across national and settlement contexts but the quality of the evidence is variable with significant heterogeneity of assessment. We relate persistence of poor mental health outcomes with problems accessing mental health services and discuss the role of key post-migration factors influencing outcomes-in particular placement type and the use of detention centres.
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Affiliation(s)
- Jordan Bamford
- grid.4777.30000 0004 0374 7521Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Mark Fletcher
- grid.4777.30000 0004 0374 7521Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health & Wellbeing, Ulster University, Coleraine, Northern Ireland, UK.
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