Polytraumatization in young male refugees from the Middle East and its association with internalizing and externalizing symptoms

Abstract

Background Young Middle Eastern male refugees are currently among the most vulnerable groups in Europe. Most of them have experienced potentially traumatic events (PTEs) such as rape, torture, or violent assaults. Compared to their peers, young refugees suffer more from internalizing and externalizing symptoms, especially when unaccompanied. Little is known about the cumulative impact of experiencing different types of PTEs on mental health outcomes (polytraumatization) of young male refugees from the Middle East. We investigated (1) whether there is a dose–response relationship between multiple PTE types experienced and mental health outcomes, (2) whether individual types of PTEs are particularly important, and (3) to what extent these are differentially associated with mental health outcomes among unaccompanied or accompanied peers. Methods In total, 151 young Middle Eastern male refugees in Germany (Mage = 16.81 years, SDage = 2.01) answered questionnaires on PTEs, mental health, and post-migration stress. Results Hierarchical regression analyses revealed, while controlling for age, duration of stay, unaccompanied status, and post-migration stress, (1) a dose–effect between PTE types on both internalizing and externalizing symptoms. Moreover, (2) regarding internalizing symptoms, violent family separation and experiencing life-threatening medical problems were particularly crucial. The latter was driven by unaccompanied refugees, who also reported higher levels of substance use. Conclusions The results extend findings from the literature and suggest that not only may greater polytraumatization be related to greater depression among refugees, but also to a range of other mental health outcomes from the internalizing and externalizing symptom domains. Furthermore, the results highlight the mental health risks that unaccompanied and accompanied refugee adolescents face after exposure to PTEs, and provide information for practitioners as well as researchers about event types that may be particularly relevant.

Navigating cultural transitions during resettlement: the case of unaccompanied refugee minors

“…Moreover, studies on URMs have demonstrated how they immigrants work hard to be involved in their host countries by creating supportive networks and developing cultural competence. Increased host-cultural competence in combination with support from one's family abroad and the possibility to maintain one's culture of origin are associated with fewer mental health problems and post-migration stress among these youth (Oppedal and Idsoe, 2015;EL-Awad et al, 2021). By contrast, acculturation-specific hassles, such as discrimination, feeling unsafe, and uncertainty about the future, are associated with mental health problems among URMs (Keles et al, 2016;Jensen et al, 2019).…”

“…The youth' aspiration toward gaining cultural competence and engaging in activities that facilitated opportunities for work and a better future is in line with research literature. Both youth and adult immigrants, also URMs, have expressed the importance of engaging to understand and gain knowledge about their host country's culture (Luster et al, 2010;Oppedal and Idsoe, 2015;Fedi et al, 2019;EL-Awad et al, 2021;Woodgate and Busolo, 2021). Andreouli (2013) reported that cultural competence and adjusting their behavior, among other things, increased immigrants' chances to participate in the society, thus facilitating opportunities for work and a better future.…”

“…That the youth had to struggle -and sometimes choose -between these two cultures is not in accordance with the concept of integration. Furthermore, the youth experiencing these conflicting demands is concerning considering that research has indicated that host-culture competence together with maintenance of one's culture of origin and support from family abroad are associated with fewer mental health problems and less post-migration stress (Oppedal and Idsoe, 2015;EL-Awad et al, 2021). Discussions about resettlement and integration are most often held from the host country's perspective.…”

“…Children and youth traveling alone are often considered particularly vulnerable refugees, both during flight and after arrival in their country of resettlement. For URMs, crosscultural transitions can be extra challenging and, in some studies, they are associated with mental health problems (Jore et al, 2020;EL-Awad et al, 2021). Due to the lack of parental protection they are at a higher risk of experiencing stressful life events without the support from a caregiver to deal with these strains (Bean et al, 2007;Derluyn et al, 2010;Jensen et al, 2019;Pfeiffer et al, 2022).…”

Asylum seeking and refugee adolescents’ mental health service use and help-seeking patterns: a mixed-methods study

“…Procedure and participants. Cross-sectional baseline data from a longitudinal dataset collected by the YOURHEALTH consortium were utilized in this study [36][37][38] . Data collection took place between February 2019 and November 2020 in schools and refugee accommodations, located across three federal states in Northern and Southern Germany.…”