Die mehrgenerationale Weitergabe von Traumatisierungen – empirische und familiendynamische Perspektiven

Addressing the Mental Health Challenges of Refugees-A Regional Network-Based Approach in Middle Hesse Germany

Refugees constitute a vulnerable group with an increased risk of developing trauma-related disorders. From a clinician's integrative perspective, navigating the detrimental impact of the social, economic, structural, and political factors on the mental health of refugees is a daily experience. Therefore, a collective effort must be made to reduce health inequities. The authors developed a treatment concept which provides broader care structures within a scientific practitioner's approach. The resulting "Trauma Network" addresses the structural challenges for refugees in Middle Hesse. Accompanying research provided a sound basis for further discussions with policy-makers to improve the situation for refugees in the short- and long-term.

Different Patterns of Mental Health Problems in Unaccompanied Refugee Minors (URM): A Sequential Mixed Method Study

Unaccompanied refugee minors (URM) represent one of the most vulnerable refugee groups due to their young age, developmental status, and insufficient coping strategies. Clinical observations indicate that the frequency of mental health problems varies between different URM subgroups. In the present research project, clinical interviews as a source of qualitative data were combined with quantitative psychometric information in a mixed-method approach in order to study the patterns of mental health problems in 561 URM from four different language groups (Arabic, Farsi, Somali, and Tigrinya) immediately after arrival in the host country (Germany). Qualitative analysis obtained as differentiating categories "language, countries of origin, age, and gender"; quantitatively, the Refugee Health Screener (RHS-15) was applied. According to the positive screening results, the highest number of mental complaints was returned by children and adolescents speaking Farsi (65.9%) and Somali (65.8%). They were followed by URM speaking Arabic (49.4%) and Tigrinya (43.3%). The results were influenced not only by origin, but also by age (with higher burden among older Farsi-speaking URM) and gender (with higher burden among male URM). Although the prevalences in URM subgroups differ, the observed high rates of positive screening results in our sample of URM from Germany substantiate the need for early detection of mental complaints and appropriate mental health care for at least every second URM.

Prevalence of and risk factors for mental disorders in refugees

Given the increasing numbers of refugees worldwide, the prevalence of their mental disorders is relevant for public health. Prevalence studies show that, in the first years of resettlement, only post-traumatic stress disorder (PTSD) rates are clearly higher in refugees than in host countries' populations. Five years after resettlement rates of depressive and anxiety disorders are also increased. Exposure to traumatic events before or during migration may explain high rates of PTSD. Evidence suggests that poor social integration and difficulties in accessing care contribute to higher rates of mental disorders in the long-term. Policy and research implications are discussed.

Mental Health in Offspring of Traumatized Refugees with and without Post-traumatic Stress Disorder

Intergenerational transmission of psychological trauma and the impact of parental post-traumatic stress disorder (PTSD) on offspring are controversially discussed. We studied 50 offspring (36 women and 14 men, mean age 42.1 years) of refugees who were severely traumatized as children at the end of World War II. From these, 25 of the refugees currently suffered from chronic PTSD, and 25 had no PTSD. Parental PTSD status did not significantly influence mental health [as per the Symptom Checklist (SCL)-90-R] or quality of life (assessed by the 36-item Short-form Health Survey) in their children. In the entire sample, frequency of talking with the mother about the flight correlated with phobic anxiety (r = 0.67, p = 0.03). Interestingly, the stated burden of having a parent with a history of flight significantly (p < 0.05) correlated with almost all subscales of the SCL-90-R. These results in a non-clinical sample do not support a specific role of parental PTSD in intergenerational trauma transmission. Our other remarkable, but preliminary, results need to be studied in larger samples using more subtle interaction or schema analyses. Copyright © 2015 John Wiley & Sons, Ltd.

Wirksamkeitsstudien zu Frühen Hilfen in Deutschland

Frühe Hilfen richten sich primär und sekundär präventiv an Eltern mit kleinen Kindern (pränatal bis drei Jahre) und sollen die Beziehungs- und Erziehungskompetenz verbessern, um Kindern gute Entwicklungen zu ermöglichen sowie Kindesmisshandlung und Vernachlässigung zu verhindern. Im Rahmen eines narrativen Review wurden sechs Datenbanken für den Zeitraum zwischen 2003 und 2013 zu Studien zur Programmwirksamkeit Früher Hilfen in Deutschland durchsucht. Die Einschlusskriterien erfüllten 8 Studien, deren Forschungsdesigns, Studiendurchführung und Programmeffekte zusammengefasst wurden. Die Studienqualität wird als heterogen eingeschätzt; besonderer Verbesserungsbedarf wird hinsichtlich der Adhärenzprüfung, der Randomisierung der Teilnehmerinnen und der Kontrolle von Allegiance-Effekten diskutiert.