The number of war-related traumatic events is associated with increased behavioural but not emotional problems among Syrian refugee children years after resettlement

Peer relationships, adolescent anxiety, and life satisfaction: a moderated mediation model in Turkish and syrian samples

Prior studies comparing Syrian refugee adolescents to their native peers in the same region have found higher anxiety and lower life satisfaction. Therefore, identifying regulatory variables is crucial for implementing support programs. This study examined the mediating effect of peer relationships and the moderating effect of being a refugee or native adolescent on the relationship between adolescent anxiety and life satisfaction across different samples. Participants and setting: The study included 2,336 adolescents aged 11-19 (M = 14.79, SD = 1.04). Participants completed the Screen for Child Anxiety Related Disorders, Satisfaction with Life Scale, and Strengths and Difficulties Questionnaire. The mediation and moderation effects were analyzed with the path analysis codes written on Mplus 8.3. SPSS 26 was used for descriptive statistics and group comparisons. The findings showed that peer relationships mediate adolescent anxiety and life satisfaction, and this relationship is moderated according to whether the participants are native adolescents or refugee adolescents. This study highlights the significant associations between peer relationships, adolescent anxiety, and life satisfaction and the moderating role of the participant identity. The findings may inform psychological interventions to improve Syrian refugee adolescents' mental health and well-being. These findings may also have implications for policies and programs aimed at supporting the integration of Syrian refugee adolescents in host communities.

A systematic review of the factors influencing the risky behaviors of syrian forced migrant children and adolescents in Turkey

Risky behaviors are defined as emotional and behavioral problems that harm mental and physical health. The present study aimed to systematically review and synthesize research investigating the risky behaviors of Syrian children living in Turkey. The study was conducted through a systematic review of articles published in the Scopus and Web of Science database between 2013 and the present day, and met the STROBE reporting criteria. The inclusion criteria for studies in the systematic review were established, and studies that focused on Syrian-origin forced migrant child-adolescents aged 7-18 years and investigated risky behaviors without a clinical diagnosis and treatment purpose were included. Four studies with a sample of 790 children were examined. According to the findings of this study, there is a measurement issue for risky behaviors. In this study, there are numerous factors influencing risky behaviors, including those related to traumatic life events due to war, psychopathology, acculturation-related factors, and sociodemographic factors. The most significant finding highlighted in the study is the need for methodological improvements and context-specific studies to be repeated in future research, to ensure statistical generalizability and clinical implications in research on this subject.

The important role of mothers during displacement: Direct and indirect effects of the refugee context on Syrian refugee children's mental health

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.

Psychosocial wellbeing and risky health behaviors among Syrian adolescent refugees in South Beirut: a study using the HEEADSSS interviewing framework

Purpose

Adolescent refugees are at risk of mental health disorders and underdiagnosed risky behaviors. Limited research exists in the Middle East and North Africa. This study aims to assess psychosocial wellbeing and risk-taking behaviors among adolescent refugees displaced to South Beirut following a standardized framework.

Methods

A cross-sectional study using face-to-face confidential HEEADSSS (Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Safety and Suicide/Depression) interviews was conducted among 52 Syrian adolescent refugees, between the ages of 14 and 21, in a health center in South Beirut.

Results

The mean age of the interviewees was 17.04 ± 1.77 years, with a male predominance 34 (65.4%). Five (9.6%) were married, 38 (73.1%) were not attending school 27 (52.9%) lived in a place with a crowding index ≥3.5 and 21 (40.4%) were working. Risky health concerns or behaviors detected included no activities or exercise 38 (73.1%), eating one to two meals per day 39 (75%) and smoking 22 (42.3%). Eleven (21.2%) have been ever offered drugs and 22 (42.3%) believed they should carry a weapon for protection. Twenty one out of 32 (65.7%) had major depressive disorders and 33 (63.5%) screened positive for behavioral problems. Exposure to home verbal or physical violence, male gender, smoking, and employment were associated with high scoring in behavioral problems. Smoking and ever been touched in an unwanted way were found to be associated with depression.

Conclusion and practical implications

Implementing the HEEADSSS interviewing assessment within medical encounters with refugee adolescents is one efficient way to detect risky health behaviors and mental health problems. Interventions need to be implemented as early as possible in the refugees' journey to help them cope and gain resilience. Training health care providers to conduct the questionnaire and delivering brief counseling when required is recommended. Establishing a network of referrals to provide multidisciplinary care to adolescents can be helpful. Obtaining a fund to distribute safety helmets for adolescent motorbike drivers can be a way to reduce injuries. More research among adolescent refugees in multiple settings, including teenagers in the host country, is needed to serve this population better.

Annual Research Review: A multilevel bioecological analysis of factors influencing the mental health and psychosocial well-being of refugee children

BACKGROUND

This paper revisits the themes of an influential 1993 review regarding the factors shaping the mental health and psychosocial well-being of refugees to take stock of developments in the evidence base and conceptualisation of issues for refugee children over the last 25 years.

METHODS

The study deployed a systematic search strategy. This initially identified 784 papers, which was reduced to 65 studies following application of inclusion and exclusion criteria. We used a later iteration of Bronfenbrenner's bioecological model of human development - the PPCT model - to consolidate evidence.

RESULTS

We identify a range of risk and protective factors operating at individual, familial, community and institutional and policy levels that influence outcomes for refugee children. The dynamics shaping the interaction of these influences are linked to the life course principles of socio-historical time and developmental age, proximal processes and child agency.

CONCLUSIONS

Actions at individual, familial, community, school, institutional and policy levels all have potential traction on mental health and psychosocial well-being of refugee children. However, evidence suggests that greatest impact will be secured by multilevel interventions addressing synergies between ecological systems, approaches engaging proximal processes (including parenting programmes) and interventions facilitating the agency of the developing refugee child.

Academic Achievement and Psychosocial Adjustment in Child Refugees: A Systematic Review

Child refugees are at high risk for problems with academic achievement and psychosocial well-being. We aimed to review the literature concerning these outcomes in primary school-aged child refugees. This study was a systematic review and included studies that reported on outcomes of interest in child refugees between 5 and 12 years of age. Our search generated 3,172 articles; we selected 313 for review and included 45. Child refugees are diverse in their educational performance, and early deficits often resolve with time spent in the host country. These children are at an increased risk of emotional and behavioral difficulties, and multiple factors are associated with these outcomes. Although educational difficulties of primary school-aged child refugees in high-income countries tend to resolve, the risks for psychosocial problems persist. This review provides a deepened understanding of the diverse educational and psychosocial experiences of these children and highlights the need for developing health and educational programs to support this population.

A systematic review of socio-ecological factors contributing to risk and protection of the mental health of refugee children and adolescents

In the past decade, millions of children and adolescents have been forced to flee from protracted or newly erupted violent conflicts. Forcibly displaced children are particularly vulnerable for developing mental health problems. However, a timely and systematic review of the current evidence is lacking. We conducted a systematic review of factors contributing to the mental health of refugee children across different socio-ecological levels (individual, family, community, sociocultural). We systematically searched the databases Medline, PsycINFO, Web of Science, and Cochrane for English studies published in peer-reviewed journals between August 2010 and May 2020. Of the 2413 identified studies, 63 were included in the analyses. Only 24 studies were considered to be of high quality. Pre-migration individual (risk: exposure to war-related trauma, female gender) and post-migration family factors (risk: parental mental health problems and impaired parenting, protective: family cohesion) currently have the best evidence base. Post-migration community (protective: school connectedness, support by peers) and sociocultural factors (risk: discrimination and acculturative stress, protective: integrative acculturation) have gained some support in high-income settings. Prevention and intervention approaches should integrate factors across different socio-ecological levels. More longitudinal studies and research in low- and middle-income countries are needed to advance our knowledge on causal mechanisms behind factors contributing to refugee youth's mental health.