Development of mental health problems - a follow-up study of unaccompanied refugee minors

Abstract

BackgroundStudies 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.MethodThe 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.ResultsThere 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.ConclusionsThere 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.

Descriptive Characterization of Psycho-Trauma, Psychological Distress, and Post-traumatic Stress Disorder among Children and Adolescent Internally Displaced Persons in Kaduna, Nigeria

“…The prevalence of either probable or definitive PTSD found in this study is very low when compared with a pool prevalence of 47% from a meta-analysis of studies of mental health in children and adolescents living in areas of armed conflict (18). The overall lower prevalence of psychological distress and PTSD may partly be explained by the 2 years difference between the conflict and the study, but evidence from a 2-year follow-up study suggested that psychological distress/PTSD among children and adolescent exposed to trauma do not change significantly over time especially if they are without care giver or protection (19). Unaccompanied children and adolescent exposed to psycho-trauma have been shown to have higher psycho-traumatic experiences and subsequent psychological distress and morbidity than those accompanied by their parents or guardian (20).…”

Refugees in Europe: national overviews from key countries with a special focus on child and adolescent mental health

“…Unaccompanied refugee minors consistently reported significantly higher levels of internalizing problems, traumatic stress, and stressful life events [41]. In a study by Jakobsen et al [42], 41.9% of the participants among unaccompanied minors fulfilled diagnostic criteria for a current psychiatric disorder.…”

Traumafokussierte kognitive Verhaltenstherapie: Einblick in die manualisierte Arbeit mit einem unbegleiteten minderjährigen Flüchtling

“…Auch erhöhte depressive (20%) und Angstsymptome (30%) wurden berichtet [Jensen et al, 2015]. Längsschnittstudien weisen auf eine Persistenz der Symptome von UMF hin, wobei Stressoren im Alltag mit der Zeit im Exilland eher zuzunehmen scheinen [Jensen et al, 2014]. Aussagekräftige Zahlen aus Deutschland fehlen bislang, es ist aber davon auszugehen, dass sich die europäischen Studienergebnisse weitgehend übertragen lassen.…”