The dynamic nature of refugee children's resilience: a cohort study of Syrian refugees in Lebanon.

Autor: Popham CM; Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK., McEwen FS; Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK., Karam E; Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon.; Saint George Hospital University Medical Center, Beirut, Lebanon.; Faculty of Medicine, Balamand University, El-Koura, Lebanon., Fayyad J; Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon.; Saint George Hospital University Medical Center, Beirut, Lebanon.; Faculty of Medicine, Balamand University, El-Koura, Lebanon., Karam G; Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon.; Saint George Hospital University Medical Center, Beirut, Lebanon.; Faculty of Medicine, Balamand University, El-Koura, Lebanon., Saab D; Institute for Development, Research, Advocacy and Applied Care, Beirut, Lebanon., Moghames P; Medecins du Monde, Beirut, Lebanon., Pluess M; Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK.
Jazyk: angličtina
Zdroj: Epidemiology and psychiatric sciences [Epidemiol Psychiatr Sci] 2022 Jun 15; Vol. 31, pp. e41. Date of Electronic Publication: 2022 Jun 15.
DOI: 10.1017/S2045796022000191
Abstrakt: Aims: Children's responses to war and displacement are varied; many struggle, while others appear resilient. However, research into these outcomes disproportionately focuses on cross-sectional data in high-income countries. We aimed to (1) investigate change in resilience across two timepoints in a highly vulnerable sample of Syrian refugee children in Lebanon, and (2) explore predictors of their mental health problems across time.
Methods: In total, 982 Syrian child-caregiver dyads living in refugee settlements in Lebanon completed questionnaires via interview at baseline and follow-up one year later. We categorised children into groups based on their risk for mental health problems across both timepoints (stable high risk/SHR, deteriorating, improving, stable low risk) according to locally validated cut-offs on measures of post-traumatic stress disorder (PTSD), depression and behavioural problems. Analyses of covariance identified how the groups differed on a range of individual and socio-environmental predictors, followed up by cross-lagged panel models (CLPMs) to investigate the directionality of the relationships between significantly related predictors and symptoms.
Results: The sample showed a meaningful amount of change in mental health symptoms from baseline to follow-up. Over half (56.3%) of children met SHR criteria and 10.3% deteriorated over time, but almost one-quarter (24.2%) showed meaningful improvement, and 9.2% were consistently at low risk for mental health problems at both timepoints. Several predictors differentiated the groups, particularly social measures. According to CLPMs, maternal acceptance ( β = -0.07) predicted child mental health symptoms over time. Self-esteem ( β = -0.08), maternal psychological control ( β = 0.10), child maltreatment ( β = 0.09) and caregiver depression ( β = 0.08) predicted child symptoms and vice versa ( β se = -0.11, β b = 0.07, β mpc = 0.08, β cm = 0.1, β cd = 0.11). Finally, child symptoms predicted loneliness ( β = 0.12), bullying ( β = 0.07), perceived social support ( β = -0.12), parent-child conflict ( β = 0.13), caregiver PTSD ( β = 0.07), caregiver anxiety ( β = 0.08) and the perceived refugee environment ( β = -0.09).
Conclusions: Our results show risk and resilience are dynamic, and the family environment plays a key role in children's response to war and displacement. Conversely, children also have a significant impact on the family environment and caregiver's own mental health. Interventions to promote resilience in refugee children should therefore consider family-wide mechanisms.
Databáze: MEDLINE