Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors
- 183 Downloads
Unaccompanied refugee minors are a particularly vulnerable group. The aim of this study is to increase our knowledge about possible pathways to well-being and integration for unaccompanied refugee minors as they strive to establish new lives in a host county. The present study followed a group of youth who fled to Norway without their caregivers at three time points; 6 months (n = 95; M age = 13.8, 80% boys), 2 years (n = 78; M age = 16.5, 83% boys), and 5 years (n = 47; M age 20.0, 83% boys) after arrival. Linear mixed effects models were used to assess whether age, gender, and trauma exposure prior to arrival were associated with levels and changes in symptoms of posttraumatic stress (PTS), depression, anxiety, and externalizing symptoms over time. Regression analyses were conducted to examine whether daily hassles, perceived social support, and new trauma experiences predict PTS, internalization, externalization, and somatization. The mean levels of depression had decreased significantly at 5 years, but mean levels of anxiety, PTS, and externalizing symptoms did not. Females and severely trauma exposed had higher levels of symptoms. Higher age was associated with less change in symptoms of depression and posttraumatic stress over time. Five years after arrival, many still experienced clinical levels of mental health problems, and level of daily hassles was an important predictor. Support may be needed not only at arrival to handle mental health problems in general and posttraumatic stress in particular, but also after resettlement. Help to manage daily hassles may be especially important to ensure well-being and integration.
KeywordsAsylum seekers Daily hassles Social support Mental health trajectories Trauma Somatic complaints
We would like to thank all the young refugees for participating in this study, and Tore Wentzel-Larsen for his statistical advice and comments. This work was supported by grants from The Norwegian Directorate of Health, and the Norwegian Extra Foundation for Health and Rehabilitation through The Norwegian Council for Mental Health.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study has been approved by The National Committee for Medical and Health Research Ethics and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study have been omitted.
- 1.UNHCR (2016) Global trends in forced displacement in 2016. UNHCR, GenevaGoogle Scholar
- 3.Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P (2007) Comparing psychological distress, traumatic stress reactions, and experiences of unaccompanied refugee minors with experiences of adolescents accompanied by parents. J Nervous Ment Dis 195(4):288–297. https://doi.org/10.1097/01.nmd.0000243751.49499.93 Google Scholar
- 10.Hodes M, Vasquez MM, Anagnostopoulos D, Triantafyllou K, Abdelhady D, Weiss K, Koposov R, Cuhadaroglu F, Hebebrand J, Skokauskas NJEC, Psychiatry A (2018) Refugees in Europe: national overviews from key countries with a special focus on child and adolescent mental health. Eur Child Adolesc Psychiatry 27(4):389–399. https://doi.org/10.1007/s00787-017-1094-8 Google Scholar
- 22.Kien C, Sommer I, Faustmann A, Gibson L, Schneider M, Krczal E, Jank R, Klerings I, Szelag M, Kerschner B, Brattström P, Gartlehner GJEC, Psychiatry A (2018) Prevalence of mental disorders in young refugees and asylum seekers in European Countries: a systematic review. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-018-1215-z Google Scholar
- 23.Geltman PL, Grant-Knight W, Ellis H, Landgraf JM (2008) The “lost boys” of Sudan: use of health services and functional health outcomes of unaccompanied refugee minors resettled in the US. J Immigr Minor Health 10(5):389–396Google Scholar
- 29.Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68(5):748–766Google Scholar
- 36.Nickerson A, Liddell B, Asnaani A, Carlsson J, Fazel M, Knaevelsrud C, Morina N, Neuner F, Newnham E, Rasmussen A (2018) Trauma and mental health in forcibly displaced populations: an International Society for Traumatic Stress Studies Briefing Paper. ISTSS, ChicagoGoogle Scholar
- 37.Bean TM, Eurelings-Bontekoe E, Derluyn I, Spinhoven P (2004) Hopkins Symptom Checklist-37A for Adolescents (HSCL-37A) User’s ManualGoogle Scholar
- 38.Bean T, Derluyn I, Eurelings-Bontekoe E, Broekaert E, Spinhoven P (2007) Validation of the multiple language versions of the Hopkins symptom checklist—37 for refugee adolescents. Adolescence 42(165):51–71Google Scholar
- 43.Bean TM, Eurelings-Bontekoe E, Derluyn I, Spinhoven P (2004) Stressful life events (SLE): User’s Manual. Centrum ‘45. https://www.psychotraumadiagnostics.centrum45.nl/en/other/children-and-adoloscents
- 46.Behrendt S (2014) lm.beta. R-package v1.5-1. https://cran.r-project.org/package=lm.beta. Accessed 15 Jan 2019
- 47.Hiller RM, Meiser-Stedman R, Fearon P, Lobo S, McKinnon A, Fraser A, Halligan SL (2016) Research review: changes in the prevalence and symptom severity of child post-traumatic stress disorder in the year following trauma—a meta-analytic study. J Child Psychol Psychiatry 57(8):884–898. https://doi.org/10.1111/jcpp.12566 Google Scholar
- 48.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(11):1151–1160. https://doi.org/10.1001/archgenpsychiatry.2011.2277 Google Scholar
- 51.Almeida DM, Piazza JR, Stawski RS, Klein LC (2011) Chapter 12—the speedometer of life: stress, health and aging. In: Schaie KW, Willis SL (eds) Handbook of the psychology of aging, 7th edn. Academic Press, San Diego, pp 191–206. https://doi.org/10.1016/B978-0-12-380882-0.00012-7 Google Scholar
- 53.La Greca AM, Silverman WK, Lai B, Jaccard J (2010) Hurricane-related exposure experiences and stressors, other life events, and social support: concurrent and prospective impact on children’s persistent posttraumatic stress symptoms. J Consult Clin Psychol 78(6):794–805. https://doi.org/10.1037/a0020775 Google Scholar