Self- and parent assessment of mental health: disagreement on externalizing and internalizing behaviour in young refugees from the Middle East

[Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial]

Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial Abstract. Unaccompanied minor refugees (UMR) are a group particularly vulnerable to mental illness. They pose a great challenge not only for child and youth psychiatric and psychotherapeutic care, but also for youth-welfare institutions. The study examines the effectiveness of Stabilization Training for Adolescent Refugees with Trauma Induced Disorders in inpatient youth-welfare facilities. Methods: We conducted a randomized controlled trial with pre-post design in a naturalistic setting, randomly assigning 9 housing groups for UMRs to the intervention or waiting control condition. The mental stress of 46 UMRs was assessed by both self-report and educational staff-report. Two educational staff members conducted the Stabilization Training for Adolescent Refugees with Trauma Induced Disorders as an intervention in each of the respective residential groups. Results: Participation in training led to a reduction in subjective general psychological stress. At the end of the training, psychological stress in self-judgment was significantly lower in the intervention group than in the waiting control condition. The effectiveness of the training is apparently not reflected by educational staff assessments. Conclusions: Stabilization training is a suitable instrument for the preclinical care of UMR and thus an essential basis for further psychotherapy.

Trauma and resilient functioning among Syrian refugee children

Following the civil war in Syria, there has been a growing interest in the impact of war, violent conflict, and refuge on the development and mental health of refugee children in general and Syrian refugee children in particular. The objective of this paper is threefold: (a) to critically review the existing literature on the psychological functioning of Syrian refugee children, with a particular focus on those residing in the urban areas or camps in Turkey; (b) to identify the main theoretical and methodological problems of this emerging literature; and (c) to suggest guidelines for how to improve research and practice in this field. The reviewed literature predominantly focuses on psychological trauma, trauma-related symptomatology or other maladaptive functioning in children, and psychosocial interventions conducted toward alleviating these issues. This paper will summarize the research findings in the above-mentioned topics to discern what can be known from the existing literature on Syrian refugee children.

Agreement Between Parent Proxy Reports and Self-Reports of Adolescent Emotional Distress

Parents' recognition of adolescents' emotional distress is a significant determinant of early detection and treatment of mental disorders. However, there is dearth of research exploring parent-adolescent agreement regarding adolescents' emotional distress. This cross-sectional, school-based study compared parents' proxy reports and self-reports of adolescent's emotional distress among 289 parent-adolescent dyads in Korea. Findings revealed low agreement between adolescents' and parents' reports of depression, anxiety, and anger, with an average polychoric r of .25 to .27. The agreement was particularly low for high school students, boys, and father-adolescent dyads. Additionally, parents tended to underestimate adolescents' emotional distress symptoms; a significant percentage of adolescents experiencing symptoms were rated in the normal range by parents, particularly high school students experiencing anger. Interventions are needed to help adolescents learn to manage and express their negative emotions. Moreover, parent education programs that improve parents' recognition of emotional distress and appropriate help-seeking behaviors are needed.

Assessing trauma and mental health in refugee children and youth: a systematic review of validated screening and measurement tools

Background

: It is estimated that children below 18 years constitute 50% of the refugee population worldwide, which is the highest figure in a decade. Due to conflicts like the Syrian crises, children are continuously exposed to traumatic events. Trauma exposure can cause mental health problems that may in turn increase the risk of morbidity and mortality. Tools such as questionnaires and interview guides are being used extensively, despite the fact that only a few have been tested and their validity confirmed in refugee children and youth. : Our aim was to provide a systematic review of the validated screening and measurement tools available for assessment of trauma and mental health among refugee children and youth. : We systematically searched the databases PubMed, PsycINFO and PILOTS. The search yielded 913 articles and 97 were retained for further investigation. In accordance with the PRISMA guidelines two authors performed the eligibility assessment. The full text of 23 articles was assessed and 9 met the eligibility criteria. Results : Only nine studies had validated trauma and mental health tools in refugee children and youth populations. A serious lack of validated tools for refugee children below the age of 6 was identified. : There is a lack of validated trauma and mental health tools, especially for refugees below the age of 6. Detection and treatment of mental health issues among refugee children and youth should be a priority both within the scientific community and in practice in order to reduce morbidity and mortality.

The interaction of Matrix Reasoning and Social Motivation as predictors of Separation anxiety in boys with Autism Spectrum Disorder

BACKGROUND

It has been suggested that higher cognitive functioning based in the pre-frontal cortex is implicated in the ability of people with Autism Spectrum Disorder (ASD) to understand and communicate in social situations. Low motivation to engage in social interaction may also be influential in this process. Although both of these factors have been argued to influence the levels of comorbid anxiety in young people with ASD, no detailed examination of those relationships has been reported to date.

METHODS

A sample of 90 boys with ASD (aged 6 to 12 yr) and 29 of their non-ASD peers, matched for age and IQ, completed tests of cognitive function and anxiety.

RESULTS

Only one form of anxiety-fear of being separated from their parents- was significantly associated with cognitive function, at the Full Scale IQ and Matrix Reasoning levels, plus motivation to engage in social interactions, and only for the ASD boys.

CONCLUSION

These data represent a complex interaction between the neurobiological aspects of ASD, fluid reasoning, social motivation, and Separation Anxiety in boys with ASD. As such, they bring a new perspective to understanding and treating anxious behaviour in these boys.

The cost and impact of compulsivity: A research perspective

Compulsivity is the defining feature of various psychiatric disorders including Obsessive Compulsive Related Disorders (OCRDs), and other compulsive, impulsive, and addictive disorders. These disorders are disabling, chronic conditions with an early onset and high rates of comorbidity, misdiagnoses, and delay in treatment onset. Disorders of compulsivity are responsible for considerable socioeconomic burden to society. We review the costs and impacts of compulsivity. In order to facilitate earlier diagnosis and targeted treatments, we examine the overlapping mechanisms that underlie compulsivity. We reconceptualize psychiatric disorders based on core features of compulsivity, highlight challenges in harmonizing research in children and adults, describe newer research methodologies, and point to future directions that can impact the costs and impact of disorders of compulsivity.

Variation in the Profile of Anxiety Disorders in Boys with an ASD According to Method and Source of Assessment

To determine any variation that might occur due to the type of assessment and source used to assess them, the prevalence of 7 anxiety disorders were investigated in a sample of 140 boys with an Autism spectrum disorder (ASD) and 50 non-ASD (NASD) boys via the Child and Adolescent Symptom Inventory and the KIDSCID Clinical Interview. Boys with an ASD were significantly more anxious than their NASD peers. Data collected from the boys with an ASD themselves showed differences in the severity and diagnostic criterion of anxiety disorders to data collected from the boys' parents. There were age-related variations to the pattern of anxiety disorder differences across reports from the boys with an ASD and reports from their parents.

Disclosure and silencing: A systematic review of the literature on patterns of trauma communication in refugee families

This systematic review aimed to explore the effects of different degrees of parental disclosure of traumatic material from the past on the psychological well-being of children in refugee families. A majority of studies emphasize the importance of the timing of disclosure and the manner in which it takes place, rather than the effects of open communication or silencing strategies per se. A pattern emerged in which the level of parental disclosure that promotes psychological adjustment in refugee children depends on whether the children themselves have been directly exposed to traumatic experiences, and whether the children are prepubescent or older. The process of trauma disclosure is highly culturally embedded. Future research needs to address the culturally shaped variations in modulated disclosure and further explore how modulated disclosure can be facilitated in family therapy with traumatized refugee families.

Self-reported mental health in 12-year-old second-generation immigrant children in Sweden

BACKGROUND

Today 29.3% of all newborns in Sweden are second-generation immigrants. Studies on mental health among these children are few, inconclusive and vary widely with regard to the informant used and the age of the immigrant. The majority of previous studies focus on study groups that cover a wide age span but since mental health varies considerably during the preadolescent and adolescent years, more age-specific studies are needed. Additional focus on the health and well-being of these children is necessary if a well-functioning society is to develop.

AIM

To investigate whether and how second-generation immigrant children in Sweden differ from non-immigrant children in their presentation of self-reported mental health at the age of 12.

METHODS

Second-generation immigrant children (n = 142) from a birth cohort in southern Sweden, subjects of the SESBiC-study (the South East Sweden Birth Cohort-study) were compared with non-immigrant children (n = 1036) from the same cohort in their presentation of self-reported mental health at the age of 12 using the Strengths and Difficulties Questionnaire. Gender, family structure and parents' educational level were controlled for.

RESULTS

Second-generation immigrant children did not differ from the non-immigrant children in their own presentation of mental health at the age of 12 in any of the categories of immigrant groups.

CONCLUSION

It is a promising sign for future integration that second-generation immigrant children's self-reported mental health at the age of 12 was quite similar to that of non-immigrant children.

Trauma, exile and mental health in young refugees

OBJECTIVE

To review evidence of trauma and exile-related mental health in young refugees from the Middle East.

METHOD

A review of four empirical studies: i) a qualitative study of 11 children from torture surviving families, ii) a cohort study of 311 3-15-year-old asylum-seeking children, iii) a qualitative study of 14 members of torture surviving families and iv) a follow-up study of 131 11-23-year-old refugees.

RESULTS

The reactions of the children were not necessarily post-traumatic stress disorder specific. Seventy-seven per cent suffered from anxiety, sleep disturbance and/or depressed mood at arrival. Sleep disturbance (prevalence 34%) was primarily predicted by a family history of violence. At follow-up, 25.9% suffered from clinically relevant psychological symptoms. Traumatic experiences before arrival and stressful events in exile predicted internalizing behaviour, witnessing violence and frequent school changes in exile predicted externalizing behaviour. School participation, Danish friends, language proficiency and mother's education predicted less long-term psychological problems.

CONCLUSION

Psychological problems are frequent in refugee children, but the extents are reduced over time in exile. Traumatic experience before arrival is most important for the short-term reaction of the children while aspects of life in exile are important for the children's ability to recover from early traumatization.

Psychological evaluation of refugee children: contrasting results from play diagnosis and parental interviews

Many refugee families from Bosnia and Herzegovina arrived in Sweden during the Balkan conflict in the 1990s. We studied 14 of these families to compare psychological evaluation of the children using two different methods. We first carried out a semi-structured interview of a parent or parents in each family. The symptoms of each of the children, who ranged in age from 5 to 12 years, were evaluated based on these interview results. Then a second method, the Erica play-diagnosis method, was used to study the inner thoughts and feelings of the children. Results from the Erica play-diagnosis method were compared with results from Erica play- diagnosis from a normal group. According to results from the parental interviews all but one child in this study had a low level of psychological symptoms. In contrast, results from Erica play-diagnosis of these children showed that there were higher frequencies of not-normal play in these children compared with those in the normal group, which is an indication of deficiencies in the psychological well-being of these children. The results emphasise the importance of getting diagnostic information from the child in order to understand each child's psychological condition.

Cross-informant symptoms from CBCL, TRF, and YSR: trait and method variance in a normative sample of Russian youths

A large community-based sample of Russian youths (n = 841, age M = 13.17 years, SD = 2.51) was assessed with the Child Behavior Checklist (mothers and fathers separately), Teacher's Report Form, and Youth Self-Report. The multiple indicator-version of the correlated trait-correlated method minus one, or CT-C(M - 1), model was applied to analyze (a) the convergent and divergent validity of these instruments in Russia, (b) the degree of trait-specificity of rater biases, and (c) potential predictors of rater-specific effects. As expected, based on the published results from different countries and in different languages, the convergent validity of the instruments was rather high between mother and father reports, but rather low for parent, teacher, and self-reports. For self- and teacher reports, rater-specific effects were related to age and gender of the children for some traits. These results, once again, attest to the importance of incorporating information from multiple observers when psychopathological traits are evaluated in children and adolescents.

Trauma and resilience in young refugees: A 9-year follow-up study

The aim of the present study was to assess and understand the long-term trajectory of psychological problems among young Middle Eastern refugees in Denmark. Participants were 131 young refugees from the Middle East (76 girls, 55 boys; mean age = 15.3 years) from 67 families. They were assessed first on arrival in Denmark in 1992–1993 and again 8–9 years later. The high prevalence of psychological problems at arrival was considerably reduced by the time of follow-up, but it was still somewhat higher than what has been found in most community studies using the same assessment tools. Groups of children differed in showing low levels of symptoms at arrival that were stable (spared) or increased (reacting) and high levels at arrival that persisted (traumatized) or decreased (adapted). The number of types of traumatic experiences before arrival distinguished the spared and the traumatized young refugees and the number of types of stressful events after arrival the adapted and the traumatized, also after corrections for age, sex, specific traumatic events, parents' education and health, and the social situation of the young refugees. The study emphasizes the importance of environmental factors for healthy long-term adaptation after traumatic experiences related to war and other organized violence.

Better mental health in children of Vietnamese refugees compared with their Norwegian peers--a matter of cultural difference?

BACKGROUND

There are conflicting results on whether immigrant children are at a heightened risk of mental health problems compared with native youth in the resettlement country. THE OBJECTIVE OF THE STUDY: To compare the mental health of 94 Norwegian-born children from a community cohort of Vietnamese refugees, aged 4 - 18 years, with that of a Norwegian community sample.

METHODS

The SDQ was completed by two types of informants; the children's self-reports, and the parents' reports, for comparison with Norwegian data from the Health Profiles for Children and Youth in the Akershus study.

RESULTS

The self-perceived mental health of second-generation Vietnamese in Norway was better than that of their Norwegian compatriots, as assessed by the SDQ. In the Norwegian-Vietnamese group, both children and parents reported a higher level of functioning.

CONCLUSION

This surprising finding may result from the lower prevalence of mental distress in Norwegian-Vietnamese children compared with their Norwegian peers, or from biased reports and cultural differences in reporting emotional and behavioural problems. These findings may represent the positive results of the children's bi-cultural competencies.