Chinese Medicine | |
Development of mental health problems - a follow-up study of unaccompanied refugee minors | |
Krister W Fjermestad2  Envor M Bjørgo Skårdalsmo1  Tine K Jensen1  | |
[1] Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugveien 1-3, 0484 Oslo, Norway;Frambu center for rare disorders, Sandbakkveien 18, 1404 Siggerud, Norway | |
关键词: Longitudinal; Trauma; Mental health; Refugee children; Unaccompanied; | |
Others : 1142326 DOI : 10.1186/1753-2000-8-29 |
|
received in 2014-06-12, accepted in 2014-10-28, 发布年份 2014 | |
【 摘 要 】
Background
Studies have shown that unaccompanied refugee children have elevated symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and externalizing problems. Few studies have examined change in this group’s mental health symptoms after resettlement in a new country, particularly for those who arrive to a host country when being under the age of 15.
Method
The sample included 75 unaccompanied refugee children (mean age 16.5 years, SD =1.6; 83% boys) who settled in Norway. We examined change in the number of stressful life events, symptoms of PTSD (Child PTSD Symptom Scale; CPSS), and symptoms of anxiety, depression and externalizing problems (Hopkins Symptom Checklist; HSCL-37A) from 6 months after arrival (T1) to 1.9 years (SD =0.6) later (T2) using paired samples t-tests. Linear regression models were used to examine whether length of stay, level of education or change in the number of experienced stressful life events predicted symptom change.
Results
There was a small and non-significant change in the mean scores of both symptom scales between T1 and T2, although there was considerable variation among the participants. The number of children who remained above the clinical cut-off value from T1 to T2 was as follows: 28 of 47 (59.6%) on the CPSS and eight of 16 (50.0%) on the HSCL-37A. There was a significant increase in the number of reported stressful life events from T1 to T2. An increase in reported stressful life events predicted an increase in PTSS (β =1.481, 95% CI .552 to 2.411). Length of stay, increase in stressful life events and level of education did not predict changes in the HSCL-37A.
Conclusions
There was no average change in the level of PTSS, depression, anxiety, or externalizing problems in this group of unaccompanied refugee children from shortly after arrival to nearly two years later. The large variation in change scores across informants indicates a need for monitoring the development of mental health problems and securing that the youth’s primary psychosocial needs are met. The high rate of children above clinical cut-off on the symptoms scales and with suicidal ideation indicates that many may be in need of treatment.
【 授权许可】
2014 Jensen et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150328030701791.pdf | 456KB | download | |
Figure 2. | 53KB | Image | download |
Figure 1. | 51KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
【 参考文献 】
- [1]Tol WA, Song S, Jordans MJ: Annual research review: resilience and mental health in children and adolescents living in areas of armed conflict–a systematic review of findings in low- and middle-income countries. J Child Psychol Psychiatry 2013, 54(4):445-460.
- [2]Vervliet M, Meyer Demott MA, Jakobsen M, Broekaert E, Heir T, Derluyn I: The mental health of unaccompanied refugee minors on arrival in the host country. Scand J Psychol 2014, 55(1):33-37.
- [3]Reed RV, Fazel M, Jones L, Panter-Brick C, Stein A: Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet 2012, 379(9812):250-265.
- [4]Fazel M, Reed RV, Panter-Brick C, Stein A: Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet 2012, 379(9812):266-282.
- [5]Bean TM, Eurelings-Bontekoe E, Spinhoven P: Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: one year follow-up. Soc Sci Med 2007, 64(6):1204-1215.
- [6]Felsman KJ, Leong FTL, Johnson MC, Felsman IC: Estimates of psychological distress among Vietnamese refugees: adolescents, unaccompanied minors and young adults. Soc Sci Med 1990, 31(11):1251-1256.
- [7]Jensen TK, Fjermestad KW, Granly L, Wilhelmsen NH: Stressful life experiences and mental health problems among unaccompanied asylum-seeking children. Clin Child Psychol Psychiatry 2013. [Epub ahead of print]
- [8]Lustig SL, Kia-Keating M, Knight WG, Geltman P, Ellis H, Kinzie JD, Keane T, Saxe GN: Review of child and adolescent refugee mental health. J Am Acad Child Adolesc Psychiatry 2004, 43(1):24-36.
- [9]Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P: Comparing psychological distress, traumatic stress reactions, and experiences of unaccompanied refugee minors with experiences of adolescents accompanied by parents. J Nerv Ment Dis 2007, 195(4):288-297.
- [10]Derluyn I, Mels C, Broekaert E: Mental health problems in separated refugee adolescents. J Adolesc Health 2009, 44(3):291-297.
- [11]Hodes M, Jagdev D, Chandra N, Cunniff A: Risk and resilience for psychological distress amongst unaccompanied asylum seeking adolescents. J Child Psychol Psychiatry 2008, 49(7):723-732.
- [12]Berry JW: Conceptual approaches to acculturation. In Acculturation: Advances in Theory, Measurement, and Applied Research . Edited by Chun KM, Organista PB, Marín G. Washington, DC: American Psychological Association; 2003:17-37.
- [13]Oppedal B: Development and acculturation. In The Cambridge Handbook of Acculturation Psychology . Edited by Sam DL, Berry JW. New York, NY: Cambridge University Press; 2006:97-112.
- [14]Seglem KB, Oppedal B, Raeder S: Predictors of depressive symptoms among resettled unaccompanied refugee minors. Scand J Psychol 2011, 52(5):457-464.
- [15]Thommessen S, Laghi F, Cerrone C, Baiocco R, Todd BK: Internalizing and externalizing symptoms among unaccompanied refugee and Italian adolescents. Child Youth Serv Rev 2013, 35(1):7-10.
- [16]Vervliet M, Lammertyn J, Broekaert E, Derluyn I: Longitudinal follow-up of the mental health of unaccompanied refugee minors. Eur Child Adolesc Psychiatry 2014, 23(5):337-346.
- [17]Pynoos RS, Steinberg AM, Wraith R: A developmental model of childhood traumatic stress. In Developmental psychopathology. Volume 2. Edited by Cicchetti D, Cohen DJ. Oxford, England: John Wiley & Sons; 1995::72-95. [Risk, disorder, and adaptation]
- [18]Coll CG, Magnuson K: The psychological experience of immigration: A developmental perspective. In Immigration and the Family: Research and Policy on US Immigrants. Edited by Booth A, Crouter AC, Landale N. Hilsdale, NJ: Lawrence Erlbaum Associates; 1997.
- [19]Chase E: Security and subjective wellbeing: the experiences of unaccompanied young people seeking asylum in the UK. Sociol Health Illn 2013, 35(6):858-872.
- [20]Eide K, Hjern A: Unaccompanied refugee children – vulnerability and agency. Acta Paediatr 2013, 102(7):666-668.
- [21]Bronstein I, Montgomery P, Dobrowolski S: PTSD in asylum-seeking male adolescents from Afghanistan. J Trauma Stress 2012, 25(5):551-557.
- [22]Huemer J, Karnik NS, Voelkl-Kernstock S, Granditsch E, Dervic K, Friedrich MH, Steiner H: Mental health issues in unaccompanied refugee minors. Child Adolesc Psychiatr Mental Health 2009, 3:13. BioMed Central Full Text
- [23]Bronstein I, Montgomery P, Ott E: Emotional and behavioural problems amongst Afghan unaccompanied asylum-seeking children: results from a large-scale cross-sectional study. Eur Child Adolesc Psychiatry 2013, 22(5):285-294.
- [24]Derluyn I, Broekaert E: Different perspectives on emotional and behavioural problems in unaccompanied refugee children and adolescents. Ethn Health 2007, 12(2):141-162.
- [25]Oppedal B, Idsoe T: Conduct problems and depression among unaccompanied refugees: the association with pre-migration trauma and acculturation. An Psicol 2012, 28(3):683-694.
- [26]Geltman PL, Grant-Knight W, Ellis H, Landgraf JM: The “lost boys” of Sudan: Use of health services and functional health outcomes of unaccompanied refugee minors resettled in the U.S. J Immigr Minor Health 2008, 10(5):389-396.
- [27]Alisic E, Zalta AK, Van Wesel F, Larsen SE, Hafstad GS, Hassanpour K, Smid GE: Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Brit J Psychiat 2014, 204(5):335-340.
- [28]Reijneveld SA, De Boer JB, Bean T, Korfker DG: Unaccompanied adolescents seeking asylum: poorer mental health under a restrictive reception. J Nerv Ment Dis 2005, 193(11):759-761.
- [29]Tolin DF, Foa EB: Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 2006, 132(6):959-992.
- [30]Bean TM, Eurelings-Bontekoe E, Derluyn I, Spinhoven P: Hopkins Symptom Checklist-37A for Adolescents (HSCL-37A) User’s Manual. http://www.amadiagnostics.centrum45.nl/english/home.htm webcite
- [31]Bean TM, Eurelings-Bontekoe E, Derluyn I, Spinhoven P: Stressful life events (SLE): User’s Manual. Centrum '45, Oegstgeest. 2004.
- [32]Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P: Validation of the multiple language versions of the Hopkins symptom checklist - 37 for refugee adolescents. Adolescence 2007, 42(165):51-71.
- [33]Foa EB, Johnson KM, Feeny NC, Treadwell KR: The child PTSD symptom scale: a preliminary examination of its psychometric properties. J Clin Child Psychol 2001, 30(3):376-384.
- [34]Hukkelberg S, Ormhaug SM, Holt T, Wentzel-Larsen T, Jensen TK: Diagnostic utility of CPSS vs. CAPS-CA for assessing posttraumatic stress symptoms in children and adolescents. J Anxiety Disord 2014, 28(1):51-56.
- [35]Cohen J: A power primer. Psychol Bull 1992, 112(1):155-159.
- [36]Derluyn I, Broekaert E: Unaccompanied refugee children and adolescents: the glaring contrast between a legal and a psychological perspective. Int J Law Psychiat 2008, 31(4):319-330.
- [37]Montgomery E: Trauma and resilience in young refugees: a 9-year follow-up study. Dev Psychopathol 2010, 22(2):477-489.
- [38]Fivush R, Shukat JR: Content, consistency, and coherence of early autobiographical recall. In Memory and Testimony in the Child Witness Applied Psychology: Individual, Social, and Community Issues. 1st edition. Edited by Zaragoza MS, Graham JR. Thousand Oaks, CA: Sage Publications, Inc; 1995:5-23.
- [39]Spinhoven P, Bean T, Eurelings-Bontekoe L: Inconsistencies in the self-report of traumatic experiences by unaccompanied refugee minors. J Trauma Stress 2006, 19(5):663-673.
- [40]Smid GE, Lensvelt-Mulders GJLM, Knipscheer JW, Gersons BPR, Kleber RJ: Late-onset PTSD in unaccompanied refugee minors: exploring the predictive utility of depression and anxiety symptoms. J Clin Child Adolesc Psychol 2011, 40(5):742-755.
- [41]Silove D: Do conflict-affected societies need psychiatrists? Br J Psychiatry 2012, 201(4):255-257.
- [42]Van Ommeren M: Validity issues in transcultural epidemiology. Br J Psychiatry 2003, 182(5):376-378.