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Associations between family-level adversity and society-level trauma with emotional and behavioural problems amongst children of West Papuan refugees

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Abstract

Few studies have examined associations between family-level parental factors, society-level violence, and the emotional and behavioral status of children of refugee populations. Our study used cross-sectional epidemiological data to test a theoretical model of these key associations amongst a community sample of children (n = 162) of West Papuan refugees living in remote town in Papua New Guinea (PNG), a setting of endemic violence and poverty. Culturally adapted instruments were used to assess three types of intra-familial factors (adverse parenting, physical and/or sexual abuse and emotional abuse) and three types of society-level violence and stressors (exposure to systematic violence, peer violence, living difficulties). Emotional and behavioural problems were assessed using the Youth Self-Report Checklist. Path analysis was used to test theoretical associations. Key findings include direct associations between both family-level physical and/or sexual abuse (β = .43; p < .001) and adverse parenting (β = .40; p < .001) with emotional and behavioural problems amongst children. In the broader social domain, peer violence (β = .29; p < .001) had a direct association with children’s emotional and behavioural problems. Several indirect paths demonstrated a chain of relationships involving family- and society-level factors and emotional and behavioural problems in children. Only longitudinal data can provide further support for veridical causal pathways linking family and social factors with adverse emotional and behavioural outcomes in offspring of refugees, thereby supporting mechanisms leading to a transgenerational transmission of adverse mental health outcomes in refugee populations. Such data would give further support for a multisectoral approach to dealing with at risk families in refugee populations, in which attention should focus on supporting parents, and promoting the protection of children from abuse in the family and in the wider society.

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References

  1. Achenbach TM, Dumenci L (2001) Advances in empirically based assessment: revised cross-informant syndromes and new DSM-oriented scales for the CBCL, YSR, and TRF: comment on Lengua, Sadowksi, Friedrich, and Fischer (2001). J Consult Clin Psychol 69:699–702

    Article  CAS  Google Scholar 

  2. Alisic E, Zalta AK, van Wesel F, Larsen SE, Hafstad GS, Hassanpour K, Smid GE (2014) Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Br J Psychiatry 204:335–340

    Article  Google Scholar 

  3. Betancourt TS (2011) Attending to the mental health of war-affected children: the need for longitudinal and developmental research perspectives. J Am Acad Child Adolesc Psychiatry 50:323–325

    Article  Google Scholar 

  4. Betancourt TS (2005) Stressors, supports and the social ecology of displacement: psychosocial dimensions of an emergency education program for chechen adolescents displaced in Ingushetia, Russia. Cult Med Psychiatry 29:309–340

    Article  Google Scholar 

  5. Betancourt TS, Brennan RT, Rubin-Smith J, Fitzmaurice GM, Gilman SE (2010) Sierra Leone's Former Child Soldiers: a longitudinal study of risk, protective factors, and mental health. J Am Acad Child Adolesc Psychiatry 49:606–615

    PubMed  PubMed Central  Google Scholar 

  6. Betancourt TS, McBain R, Newnham EA, Brennan RT (2014) Context matters: community characteristics and mental health among war-affected youth in Sierra Leone. J Child Psychol Psychiatry 55:217–226

    Article  Google Scholar 

  7. Betancourt TS, Newnham EA, Layne CM, Kim S, Steinberg AM, Ellis H, Birman D (2012) Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States. J Trauma Stress 25:682–690

    Article  Google Scholar 

  8. Betancourt TS, Speelman L, Onyango G, Bolton P (2009) A qualitative study of mental health problems among children displaced by war in Northern Uganda. Transcultural Psychiatry 46:238–256

    Article  Google Scholar 

  9. Betancourt TS, Williams T (2008) Building an evidence base on mental health interventions for children affected by armed conflict. Intervention 6:39–56

    Article  Google Scholar 

  10. Boonchooduang N, Louthrenoo O, Likhitweerawong N, Charnsil C, Narkpongphun A (2019) Emotional and behavioral problems among sexual minority youth in Thailand. Asian J Psychiatr 45:83–87

    Article  Google Scholar 

  11. Bryant RA, Edwards B, Creamer M, O'Donnell M, Forbes D, Felmingham KL, Silove D, Steel Z, Nickerson A, McFarlane AC, Van Hooff M, Hadzi-Pavlovic D (2018) The effect of post-traumatic stress disorder on refugees' parenting and their children's mental health: a cohort study. Lancet Public Health 3:e249–e258

    Article  Google Scholar 

  12. Catani C, Schauer E, Elbert T, Missmahl I, Bette JP, Neuner F (2009) War trauma, child labor, and family violence: life adversities and PTSD in a sample of school children in Kabul. J Trauma Stress 22:163–171

    Article  Google Scholar 

  13. Chandler J (2019) Refugees on their own land: the West Papuans in limbo in Papua New Guinea. In: The Pacific Project: West Papua. Guardian, United Kingdom

  14. Clukay CJ, Dajani R, Hadfield K, Quinlan J, Panter-Brick C, Mulligan CJ (2019) Association of MAOA genetic variants and resilience with psychosocial stress: a longitudinal study of Syrian refugees. PLoS ONE 14:e0219385

    Article  CAS  Google Scholar 

  15. De Haene L, Grietens H, Verschueren K (2010) Adult attachment in the context of refugee traumatisation: the impact of organized violence and forced separation on parental states of mind regarding attachment. Attach Hum Dev 12:249–264

    Article  Google Scholar 

  16. Ebesutani C, Bernstein A, Martinez JI, Chorpita BF, Weisz JR (2011) The youth self report: applicability and validity across younger and older youths. J Clin Child Adolesc Psychol 40:338–346

    Article  Google Scholar 

  17. Fazel M (2018) Refugees and the post-migration environment. BMC Med 16:164

    Article  Google Scholar 

  18. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 14:245–258

    Article  CAS  Google Scholar 

  19. Hair JBW, Babin BJ, Anderson RE (2010) Multivariate data analysis, 7th edn. Prentice Hall, Englewood Cliffs

    Google Scholar 

  20. Halevi G, Djalovski A, Vengrober A, Feldman R (2016) Risk and resilience trajectories in war-exposed children across the first decade of life. J Child Psychol Psychiatry 57:1183–1193

    Article  Google Scholar 

  21. Hauff E, Vaglum P (1995) Organised violence and the stress of exile. Predictors of mental health in a community cohort of Vietnamese refugees three years after resettlement. Br J Psychiatry 166:360–367

    Article  CAS  Google Scholar 

  22. Hjern A, Angel B, Jeppson O (1998) Political violence, family stress and mental health of refugee children in exile. Scand J Public Health 26:18–25

    Article  CAS  Google Scholar 

  23. Hox JJ, Bechger TM (1998) An introduction to structural equation modeling. Fam Sci Rev 11:354–373

    Google Scholar 

  24. Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equation Model 6:1–55

    Article  Google Scholar 

  25. IBMCorp (Released 2019) IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp

  26. Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Aguilar-Gaxiola S, Alhamzawi AO, Alonso J, Angermeyer M, Benjet C, Bromet E, Chatterji S, de Girolamo G, Demyttenaere K, Fayyad J, Florescu S, Gal G, Gureje O, Haro JM, Hu CY, Karam EG, Kawakami N, Lee S, Lepine JP, Ormel J, Posada-Villa J, Sagar R, Tsang A, Ustun TB, Vassilev S, Viana MC, Williams DR (2010) Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry 197:378–385

    Article  Google Scholar 

  27. Kline RB (1998) Principles and practice of structural equation modeling.

  28. Marcoulides GA, Schumacker RE (1996) Advanced structural equation modeling: issues and techniques. Lawrence Erlbaum Associates, Mahwah

    Google Scholar 

  29. McLaughlin KA, Greif Green J, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC (2012) Childhood adversities and first onset of psychiatric disorders in a national sample of US adolescents. Arch Gen Psychiatry 69:1151–1160

    Article  Google Scholar 

  30. Mollica RF, Poole C, Son L, Murray CC, Tor S (1997) Effects of war trauma on Cambodian refugee adolescents' functional health and mental health status. J Am Acad Child Adolesc Psychiatry 36:1098–1106

    Article  CAS  Google Scholar 

  31. Muthén LK, Muthén BO (1998–2012) Mplus User’s Guide, 7th edn, Muthén & Muthén, Los Angeles

  32. Oram S, Stockl H, Busza J, Howard LM, Zimmerman C (2012) Prevalence and risk of violence and the physical, mental, and sexual health problems associated with human trafficking: systematic review. PLoS Med 9:e1001224

    Article  Google Scholar 

  33. Panter-Brick C, Goodman A, Tol W, Eggerman M (2011) Mental health and childhood adversities: a longitudinal study in Kabul, Afghanistan. J Am Acad Child Adolesc Psychiatry 50:349–363

    Article  Google Scholar 

  34. Parker G, Roussos J, Hadzi-Pavlovic D, Mitchell P, Wilhelm K, Austin MP (1997) The development of a refined measure of dysfunctional parenting and assessment of its relevance in patients with affective disorders. Psychol Med 27:1193–1203

    Article  CAS  Google Scholar 

  35. Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. J Am Med Assoc 294:602–612

    Article  CAS  Google Scholar 

  36. Reed RV, Fazel M, Jones L, Panter-Brick C, Stein A (2012) Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet 379:250–265

    Article  Google Scholar 

  37. Rees S, Thorpe R, Tol W, Fonseca M, Silove D (2015) Testing a cycle of family violence model in conflict-affected, low-income countries: a qualitative study from Timor-Leste. Soc Sci Med 130:284–291

    Article  Google Scholar 

  38. Semrau M, van Ommeren M, Blagescu M, Griekspoor A, Howard LM, Jordans M, Lempp H, Marini A, Pedersen J, Pilotte I, Slade M, Thornicroft G (2012) The development and psychometric properties of the Humanitarian Emergency Settings Perceived Needs (HESPER) Scale. Am J Public Health 102:e55–63

    Article  Google Scholar 

  39. Sharma M, Fine SL, Brennan RT, Betancourt TS (2017) Coping and mental health outcomes among Sierra Leonean war-affected youth: results from a longitudinal study. Dev Psychopathol 29:11–23

    Article  Google Scholar 

  40. Silove D, Rees S, Mohsin M, Tam N, Kareth M, Tay AK (2018) Differentiating ICD-11 complex post-traumatic stress disorder from other common mental disorders based on levels of exposure to childhood adversities, the traumas of persecution and postmigration living difficulties among refugees from West Papua. BJPsych Open 4:361–367

    Article  Google Scholar 

  41. Sim A, Bowes L, Gardner F (2018) Modeling the effects of war exposure and daily stressors on maternal mental health, parenting, and child psychosocial adjustment: a cross-sectional study with Syrian refugees in Lebanon. Glob Ment Health (Camb) 5:e40–e40

    Article  Google Scholar 

  42. UNHCR (2020) UNHCR Projected Global Resettlement Needs. In: Resettlement tATCo (ed), Geneva

  43. Vostanis P (2016) New approaches to interventions for refugee children. World Psychiatry 15:75–77

    Article  Google Scholar 

  44. Zijlstra AE, Menninga MC, van Os ECC, Kalverboer ME (2020) They ask for protection: An exploratory study into experiences with violence among unaccompanied refugee children in Dutch reception facilities. Child Abuse Negl 103:104442

    Article  CAS  Google Scholar 

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Funding

This study was funded by National Health and Medical Research Council (RG133490-A, RG170682-A).

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Authors and Affiliations

  1. School of Psychiatry, Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia

    Alvin Kuowei Tay, Susan Rees, Moses Kareth, Mohammed Mohsin, Natalino Tam & Derrick Silove

  2. Mental Health Unit, Liverpool Hospital, New South Wales Health, Sydney, NSW, Australia

    Susan Rees & Mohammed Mohsin

  3. Centre for Global Health and Social Change, Perdana University, Kuala Lumpur, Malaysia

    Alvin Kuowei Tay

Authors
  1. Alvin Kuowei Tay
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  2. Susan Rees
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Correspondence to Alvin Kuowei Tay.

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Tay, A.K., Rees, S., Kareth, M. et al. Associations between family-level adversity and society-level trauma with emotional and behavioural problems amongst children of West Papuan refugees. Eur Child Adolesc Psychiatry 30, 909–920 (2021). https://doi.org/10.1007/s00787-020-01569-6

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  • DOI: https://doi.org/10.1007/s00787-020-01569-6

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