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1.
BMC Public Health ; 24(1): 1921, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39026230

RESUMO

BACKGROUND: During recent years, Europe has faced the arrival of migrants whereof a considerable group of youth present mental health problems, such as symptoms of post-traumatic stress disorder (PTSD). Schools offer a safe environment for mental health interventions to these groups, yet there is limited research on the impact of school-based interventions addressing mental health problems in newcomer youths, especially in the Swedish context. This cluster randomized controlled trial (RCT) aimed to explore the effectiveness of the Teaching Recovery Techniques (TRT) intervention among newcomer students with PTSD symptoms in Swedish secondary schools. METHODS: Nine schools were randomly assigned to TRT or a wait list control group prior to the baseline assessment. Follow-up data were collected immediately following the intervention and three months post-intervention. In total, 531 students were approached, of which 61 gave consent and were eligible to be included in the study: 55 in TRT and 6 in the control condition. Given the low number of participants in the control condition, we merely analyzed students who had received TRT. RESULTS: We report on feasibility of recruitment, data collection, intervention delivery and intervention effectiveness. In terms of intervention effectiveness, within subjects ANOVAs revealed significant reductions in PTSD symptoms and general mental health problems from baseline to the three months-follow-up (p < 0.001). CONCLUSIONS: Our results indicate that TRT is a promising school-based intervention for newcomer students with PTSD symptoms. For a successful implementation of TRT in the school context, schools need to be engaged and the implementation should be managed by a local coordinator. TRIAL REGISTRATION: ISRCTN, ISRCTN48178969, Retrospectively registered 20/12/2019.


Assuntos
Estudos de Viabilidade , Transtornos de Estresse Pós-Traumáticos , Estudantes , Humanos , Suécia , Masculino , Feminino , Adolescente , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Instituições Acadêmicas , Avaliação de Programas e Projetos de Saúde
2.
Disasters ; 48(3): e12624, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38441334

RESUMO

Since the end of the Second World War in 1945, the erection of camps within and across state borders has become the most common response to the influx of displaced persons. Based on empirical evidence from northern Uganda, this paper aims to provide answers to two main questions: (i) how does the camp influence and frame the upbringing of children?; and (ii) how do caregivers shape and adjust upbringing within this setting and when they return to their 'former homes' ? Interviews and focus-group discussions were conducted with 48 caregivers living in Kitgum District, northern Uganda. Deductive thematic analysis was employed to structure participants' accounts of past and present interconnections between upbringing and (previous) encampment. By paying close attention to their (counter-)narratives, people's agency and coping are emphasised through the simultaneous forging of new interconnections (that is, discontinuities) and holding on to old interconnections (that is, continuities) between upbringing, the camp, and the post-war village.


Assuntos
Cuidadores , Grupos Focais , Humanos , Uganda , Cuidadores/psicologia , Feminino , Masculino , Criança , Adulto , Refugiados/psicologia , Pré-Escolar , Adaptação Psicológica , Pessoa de Meia-Idade , Adolescente , Campos de Refugiados , Pesquisa Qualitativa , Adulto Jovem
3.
Scand J Public Health ; : 14034948231191850, 2023 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-37589293

RESUMO

AIMS: socNAMs provides a comprehensive and comparative dataset for researchers to identify how students' recent migration and their school setting relates to their social wellbeing, particularly regarding their feelings of loneliness. Results: This study design article delineates a quantitative cross-sectional research study (socNAMs) which successfully developed three questionnaires that were administered with unique and hard to reach populations, newly-arrived adolescent migrants (NAMs) and school staff offering reception education in Flanders, Belgium. METHODS: At the individual level, socNAMs collected information on: (1) socio-demographic variables of NAMs; (2) migration and family context; (3) social relationships; (4) school experiences; (5) self-perceived wellbeing (physical and social); and (6) experiences with discrimination. The questionnaire developed for NAMs is available in 16 languages. To gain a further understanding of the impact of the school environment on NAMs, socNAMs collected contextual information primarily concerning school social capital by including data collected from teachers and reception-class coordinators. The final sample included 1379 NAMs, 50 teachers and 26 reception-class coordinators, from 35 schools offering reception education. CONCLUSIONS: In this article, we present the rationale for this study, the methodology of sampling and recruitment, the development and content of the questionnaires, some preliminary descriptive results and the strengths and limitations of the study. Future empirical studies will address the research aims outlined in this protocol paper. In addition, we highlight the opportunities that the dataset provides for advancing research regarding the social wellbeing of NAMs in varying school and national contexts.

4.
Ethn Health ; 28(2): 257-280, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35138212

RESUMO

OBJECTIVES: The COVID-19 pandemic has exacerbated health inequalities worldwide, having a disproportionately harsh impact on unprivileged populations such as migrants and refugees. These populations are often more exposed to the virus, but less protected, while at the same time being at higher risk of suffering from poor living and working conditions, limited access to healthcare, and discrimination by the host society, all of which is challenging to their mental health. Empirical evidence on how the COVID-19 pandemic is affecting migrants and refugees is required to design effective actions aimed at ensuring health equity. Therefore, this paper aims to analyse how the pandemic has impacted the psychological well-being of migrants and refugees living in Spain. DESIGN: This study was carried out within the framework of the ApartTogether study sponsored by the World Health Organization. Data collection was carried out during March-November 2020, through an online survey completed by 241 participants (age: M = 37 years; 129 women). RESULTS: The results indicate that 78.7% of participants had suffered a decrease in their psychological well-being since the onset of the COVID-19 pandemic, with number of difficulties and worries experienced being the best individual predictors of this outcome. Enjoying social connections and perceiving positive treatment from the host society were positively associated with psychological well-being at a relational and community level, respectively. CONCLUSION: Based on these findings, we outline priority areas of psychosocial interventions aimed at guaranteeing the mental health of migrants and refugees in the face of the pandemic in Spain.


Assuntos
COVID-19 , Refugiados , Migrantes , Humanos , Feminino , Adulto , COVID-19/epidemiologia , Espanha/epidemiologia , Pandemias , Bem-Estar Psicológico , Refugiados/psicologia
5.
BMC Public Health ; 22(1): 942, 2022 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-35538463

RESUMO

BACKGROUND: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020). METHODS: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2. RESULTS: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection. CONCLUSIONS: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.


Assuntos
COVID-19 , Angústia Psicológica , Refugiados , Migrantes , Europa (Continente)/epidemiologia , Humanos , Pandemias/prevenção & controle , Saúde Pública , SARS-CoV-2
6.
J Youth Adolesc ; 51(5): 848-870, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34686949

RESUMO

While scholarly literature indicates that both refugee and non-refugee migrant young people display increased levels of psychosocial vulnerability, studies comparing the mental health of the two groups remain scarce. This study aims to further the existing evidence by examining refugee and non-refugee migrants' mental health, in relation to their migration history and resettlement conditions. The mental health of 883 refugee and 483 non-refugee migrants (mean age 15.41, range 11-24, 45.9% girls, average length of stay in the host country 3.75 years) in five European countries was studied in their relation to family separation, daily material stress and perceived discrimination in resettlement. All participants reported high levels of post-traumatic stress symptoms. Family separation predicted post-trauma and internalizing behavioral difficulties only in refugees. Daily material stress related to lower levels of overall well-being in all participants, and higher levels of internalizing and externalizing behavioral difficulties in refugees. Perceived discrimination was associated with increased levels of mental health problems for refugees and non-refugee migrants. The relationship between perceived discrimination and post-traumatic stress symptoms in non-refugee migrants, together with the high levels of post-traumatic stress symptoms in this subsample, raises important questions on the nature of trauma exposure in non-refugee migrants, as well as the ways in which experiences of discrimination may interact with other traumatic stressors in predicting mental health.


Assuntos
Separação da Família , Refugiados , Migrantes , Adolescente , Criança , Feminino , Humanos , Masculino , Saúde Mental , Discriminação Percebida , Refugiados/psicologia
7.
Eur J Pediatr ; 177(12): 1767-1774, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30225635

RESUMO

Unaccompanied refugee adolescents who have fled war and persecution often have poor mental health. Yet, little is known about their own perspectives on what can relieve their mental health problems. The aim was to explore unaccompanied refugee adolescents' perspectives on healing and the mental healthcare offered to them when resettled. The study was based on methodical triangulation of participant observation in a Danish municipal institution for unaccompanied refugee minors, semi-structured individual interviews with experts, social workers and male refugee minors and a focus group interview with refugee minors. Results show that the refugee adolescents associated traditional conversational therapy with discussing negative and stigmatising aspects of their past and carrying risks of re-traumatisation. Instead, alternative activities were proposed, through which resources could be accumulated and they could be met without stereotype.Conclusion: To enhance the complex mental health needs of unaccompanied minors' mental healthcare, the perspective of the refugee adolescents should be taken into account. This calls for a holistic approach to mental healthcare in their daily lives, where they are met in a non-stigmatising manner in which their unique capabilities are the main focus. Moreover, a trusting relationship constitutes the fundament to support good mental health among refugee adolescents. What is Known: • Unaccompanied refugee adolescents are at risk of poor mental health outcomes, e.g., depression, anxiety, PTSD and psychosocial stress. • Stigma, lack of social support, stressful life events and lack of intercultural competency among mental health professionals are barriers to good mental health. What is New: • There is a need for informal and tailored health promotion initiatives in the refugee adolescents' everyday lives. • To treat the refugee adolescents as equal human beings through curiosity and receptiveness to their resources is important in order to build trust and address stigma.


Assuntos
Promoção da Saúde/métodos , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde Mental , Saúde Mental , Refugiados/psicologia , Adaptação Psicológica , Adolescente , Dinamarca , Humanos , Masculino , Menores de Idade , Apoio Social , Estresse Psicológico/psicologia
8.
Int J Psychol ; 52(4): 291-299, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26443278

RESUMO

Although social relationships and social support are salient factors for post-war adolescents' psychosocial coping and adjustment, there is only limited information regarding war-affected adolescents' views on social support and the relationships within which social support is provided. This study therefore explored both elements among a clinical sample of 20 adolescents living in post-war Northern Uganda. Following Braun and Clarke's thematic analysis, we found a prominent role of the biological mother and other primary biological family members in the upbringing of our participants. Spiritual and material support were perceived to be the most important type of support, respectively, while the adolescents were growing up and in their current lives. These findings provide support for the perception that caregiving systems are adaptable to particular sociocultural contexts. Further, the importance of particular functions of social support could signify a potentially selective buffering effect of these functions in adverse contexts. Because of the importance of the primary biological family and the salient role of parent-child relationships in the face of adversity, future research needs to focus on this particular kind of social relationship in contexts of prolonged collective violence.


Assuntos
Adaptação Psicológica/fisiologia , Apoio Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino , Uganda , Guerra
9.
Cult Med Psychiatry ; 40(4): 620-640, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27021343

RESUMO

In the aftermath of war and armed conflict, individuals and communities face the challenge of dealing with recollections of violence and atrocity. This article aims to contribute to a better understanding of processes of remembering and forgetting histories of violence in post-conflict communities and to reflect on related implications for trauma rehabilitation in post-conflict settings. Starting from the observation that memory operates at the core of PTSD symptomatology, we more closely explore how this notion of traumatic memory is conceptualized within PTSD-centered research and interventions. Subsequently, we aim to broaden this understanding of traumatic memory and post-trauma care by connecting to findings from social memory studies and transcultural trauma research. Drawing on an analysis of scholarly literature, this analysis develops into a perspective on memory that moves beyond a symptomatic framing toward an understanding of memory that emphasizes its relational, political, moral, and cultural nature. Post-conflict memory is presented as inextricably embedded in communal relations, involving ongoing trade-offs between individual and collective responses to trauma and a complex negotiation of speech and silence. In a concluding discussion, we develop implications of this broadened understanding for post-conflict trauma-focused rehabilitation.


Assuntos
Memória Episódica , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/reabilitação , Violência/psicologia , Guerra , Humanos
10.
Community Ment Health J ; 52(1): 118-25, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26602773

RESUMO

This study aimed to investigate difficulties experienced by the wives of Palestinian men arrested and held in Israeli prisons. 16 captives' wives were interviewed using a semi-structured interview to provide them with a greater opportunity to speak about their experiences. Three main research questions were discussed; community difficulties, social support, and coping strategies. A thematic analysis was used throughout the interviews. We concluded that in addition to the stress of being separated from their husbands, the frustrating visitation process to prison and the ongoing political conflict, the wives expressed a frustrating social network characterized by constant interferences in their personal lives and the choices they make. Most women expressed a lack in psychosocial support given through governmental and non-governmental organizations; in addition they expressed a need for that kind of support. Coping strategies ranged from religious, acceptance, distraction, to planning strategies.


Assuntos
Árabes , Prisioneiros , Cônjuges/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Pesquisa Qualitativa , Apoio Social
11.
Child Adolesc Ment Health ; 21(3): 154-160, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32680351

RESUMO

BACKGROUND: Since 1967, the Palestinian Occupied Territories are marked by a protracted political conflict. During this conflict, about one fifth of the Palestinian population has been detained; a considerable part of them having children outside prison. Although parental detention negatively impacts children's psychological well-being, little is known about this impact within contexts of protracted armed conflict. Therefore, this study aimed at gaining insight into the impact of parental detention onto adolescents' psychological well-being. METHOD: Of 314 (11- to 18-year old) Palestinian adolescents who took part, the fathers of 204 adolescents were detained in Israeli prisons. The adolescents completed two self-report questionnaires: the UCLA-PTSD-Reaction Index, investigating symptoms of posttraumatic stress, and the Strengths and Difficulties Questionnaire, looking at overall psychological problems. Several hierarchical regression analyses investigated mental health differences between both the groups, and possible associations between sociodemographic characteristics and the witnessing of the father's arrest, and the mental health outcomes. RESULTS: Parental detention largely impacted adolescents' mental health, with one fifth to two thirds of the adolescents reporting considerable mental health problems. Witnessing the arrest of the father even increased this risk considerably. Above, girls, younger adolescents, participants living in refugee camps, and those living with extended families also reported higher scores on both questionnaires. CONCLUSIONS: Detention of fathers in the context of protracted armed conflicts has a large impact on adolescents' mental health. Besides an overall plea to end armed conflicts as fast as possible, the study also delineates considerable implications for the support and care for these adolescents and their families.

12.
BMC Int Health Hum Rights ; 15: 28, 2015 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-26467430

RESUMO

BACKGROUND: Worldwide, thousands of children are acting in different roles in armed groups. Whereas human rights activism and humanitarian imperatives tend to emphasize the image of child soldiers as incapable victims of adults' abusive compulsion, this image does not fully correspond with prevailing pedagogical and jurisprudential discourses, nor does it represent all child soldiers' own perceptions of their role. Moreover, contemporary warfare is often marked by fuzzy distinctions between perpetrators and victims. This article deepens on the question how to conceptualize the victim-perpetrator imaginary about child soldiers, starting from three disciplines, children's rights law, psychosocial approaches and transitional justice, and then proceeding into an interdisciplinary approach. DISCUSSION: We argue that the victim-perpetrator dichotomy in relation to child soldiers needs to be revisited, and that this can only be done successfully through a truly interdisciplinary approach. Key to this interdisciplinary dialogue is the growing awareness within all three disciplines, but admittedly only marginally within children's rights law, that only by moving beyond the binary distinction between victim- and perpetrator-hood, the complexity of childhood soldiering can be grasped. In transitional justice, the concept of role reversal has been instructive, and in psychosocial studies, emphasis has been put on the 'agency' of (former) child soldiers, whereby child soldiers sometimes account on how joining the armed force or group was (partially) out of their own free will. Hence, child soldiers' perpetrator-hood is not only part of the way child soldiers are perceived in the communities they return to, but equally of the way they see themselves. These findings plea for more contextualized approaches, including a greater participation of child soldiers, the elaboration of accountability mechanisms beyond criminal responsibility, and an intimate connection between individual, social and societal healing by paying more attention to reconciliation. This article deepens on the question how to conceptualize the victim-perpetrator imaginary about child soldiers through an interdisciplinary dialogue between children's rights law, psychosocial approaches and transitional justice. With this interdisciplinary perspective, we intend to open up narrow disciplinary viewpoints, and contribute to more integrated approaches, beyond a binary distinction between victimhood and perpetrator-hood.


Assuntos
Proteção da Criança , Vítimas de Crime , Direitos Humanos , Comunicação Interdisciplinar , Militares , Fatores Etários , Criança , Humanos , Fatores de Risco , Comportamento Sexual
13.
BMC Psychiatry ; 14: 260, 2014 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-25199474

RESUMO

BACKGROUND: Previous studies have shown a relationship between stressful war experiences and mental health symptoms in children and adolescents. To date, no comprehensive studies on the role of childhood adversities have been conducted with war-exposed adolescents living in post-war, low-resource settings in Sub-Saharan Africa. METHODS: A cross-sectional study of 551 school-going adolescents aged 13-21 years old was undertaken four years post-war in northern Uganda. Participants completed self-administered questionnaires assessing demographics, stressful war experiences, childhood adversities, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. RESULTS: Our analyses revealed a main effect of gender on all mental health outcomes except avoidance symptoms, with girls reporting higher scores than boys. Stressful war experiences were associated with all mental health symptoms, after adjusting for potential confounders. Childhood adversity was independently associated with depression symptoms but not PTSD, anxiety, and PTSD cluster symptoms. However, in situations of high childhood adversity, our analyses showed that stressful war experiences were less associated with vulnerability to avoidance symptoms than in situations of low childhood adversity. CONCLUSIONS: Both stressful war experiences and childhood adversities are risk factors for mental health symptoms among war-affected adolescents. Adolescents with histories of high childhood adversities may be less likely to develop avoidance symptoms in situations of high stressful war experiences. Further exploration of the differential roles of childhood adversities and stressful war experiences is needed.


Assuntos
Ansiedade/diagnóstico , Depressão/diagnóstico , Acontecimentos que Mudam a Vida , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Guerra , Adolescente , Ansiedade/psicologia , Criança , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Uganda , Adulto Jovem
14.
BMC Womens Health ; 14: 106, 2014 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-25195041

RESUMO

BACKGROUND: The conflict-ridden context of eastern Congo has set the scene for grueling human rights violations, with sexual violence as one of the 'weapons of war'. Currently, sexual violence continues, with a considerable increase in civilian perpetrators. However, little is known regarding the particular impact of different experiences of sexual violence on adolescents' mental health. This study therefore investigates the impact of sexual violence on eastern Congolese adolescents' mental health and its differing associations with daily stressors, stigma, and the labeling of sexual violence (as 'rape' or 'non-consensual sexual experience'). METHODS: A cross-sectional, population-based survey design was implemented in 22 secondary schools, randomly selected from a stratified sample, in Bunia, eastern Congo, a region extensively affected by war. A total of 1,305 school-going adolescent girls aged 11 to 23 participated. Self-report measures of mental health symptoms, war-related traumatic events, experiences of sexual violence, daily stressors, and stigmatization were administered. Differences in sociodemographic characteristics, traumatic experiences and daily and social stressors between types of sexual violence (rape, non-consensual sexual violence, no sexual violence) were explored through statistical analysis. ANCOVA analyses investigated associations between those risk factors and adolescents' mental health. RESULTS: More than one third of eastern Congolese adolescent girls reported experiences of sexual violence. Elevated levels of daily stressors, experiences of stigmatization, and stressful war-related events were found amongst girl victims of sexual violence, with the highest levels for girls who labeled the sexual violence as rape. Daily stressors, stigmatization, and war-related events showed a large impact on the girls' mental health. Last, girls who labeled the sexual violence as non-consensual sexual experiences reported more post-traumatic hyper-arousal and intrusion symptoms compared to those labeling the sexual violence as rape. CONCLUSIONS: These findings point to the important association between how war-affected adolescent girls label sexual violence (rape or non-consensual sexual experiences) and their mental health. This study also documents the large impact of sexual violence on other stressors (daily stressors, stigmatization, and stressful war events) and the impact of these stressors on girl victims' mental health. It discusses important implications for addressing sexual violence and its consequences in war-affected contexts.


Assuntos
Vítimas de Crime/psicologia , Saúde Mental , Estupro/psicologia , Estigma Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Guerra , Adolescente , Criança , Congo , Vítimas de Crime/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Terminologia como Assunto , Adulto Jovem
15.
Ethn Health ; 19(1): 100-18, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23489117

RESUMO

OBJECTIVE: To explore processes of conceptualizing nodding syndrome (NS), an unknown illness which has been reported to affect thousands of children in post-conflict northern Uganda, in South Sudan and in Tanzania. DESIGN: This qualitative study comprised 40 in-depth interviews with affected families, health workers and politicians during five months of fieldwork in northern Uganda and a review of available reports, newspapers and academic literature on NS. In addition, observations have been made at treatment centers and during outreaches and meetings. Focus is put on how meanings of key terms related to NS are produced and negotiated. Attention is being paid to the circulation of different discourses and explanatory models. RESULTS: Discourses and explanatory models play an active role in the conceptualization of illness, as much by medical personnel as by affected families and the media. The prominent use of biomedical terms in the academic discourse on NS is striking; links are suggested with onchocerciasis and epilepsy. In contrast, the local discourse associates NS with social issues. The illness experiences are connected to the trauma of past conflict, to poverty and to (region-bound) frustration over neglect. The cultural significance of physical symptoms raises the question of the impact of culture on health. CONCLUSION: By only looking at the biomedical significance of this new syndrome, we will miss important aspects of how this illness is being experienced and understood. In our future dealings with NS, we will have to consider and re-conceive the relation between culture and neurobiology.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Família , Política de Saúde , Prioridades em Saúde , Síndrome do Cabeceio , Adolescente , Criança , Pré-Escolar , Humanos , Entrevistas como Assunto , Síndrome do Cabeceio/diagnóstico , Síndrome do Cabeceio/etiologia , Síndrome do Cabeceio/fisiopatologia , Síndrome do Cabeceio/psicologia , Política , Pesquisa Qualitativa , Uganda
16.
Eur Child Adolesc Psychiatry ; 23(5): 337-46, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23979476

RESUMO

Despite growing numbers of unaccompanied refugee minors (UMs) in Europe, and evidence that this group is at risk of developing mental health problems, there still remain important knowledge gaps regarding the development of UMs' mental health during their trajectories in the host country and, in particular, the possible influencing role of traumatic experiences and daily stressors therein. This study therefore followed 103 UMs from the moment they arrived in Belgium until 18 months later. Traumatic experiences (SLE), mental health symptoms (HSCL-37A, RATS) and daily stressors (DSSYR) were measured at arrival in Belgium, after 6 and 18 months. UMs reported generally high scores on anxiety, depression and post-traumatic stress disorder (PTSD). Linear mixed model analysis showed no significant differences in mental health scores over time, pointing towards the possible long-term persistence of mental health problems in this population. The number of traumatic experiences and the number of daily stressors leaded to a significant higher symptom level of depression (daily stressors), anxiety and PTSD (traumatic experiences and daily stressors). European migration policies need to reduce the impact of daily stressors on UMs' mental health by ameliorating the reception and care facilities for this group. Moreover, regular mental health screenings are needed, in combination with, if needed, adapted psychosocial and therapeutic care.


Assuntos
Acontecimentos que Mudam a Vida , Saúde Mental , Menores de Idade/psicologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adolescente , Ansiedade/diagnóstico , Ansiedade/psicologia , Bélgica/epidemiologia , Criança , Depressão/diagnóstico , Depressão/psicologia , Feminino , Seguimentos , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Autorrelato , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários
17.
Scand J Psychol ; 55(1): 33-7, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25130065

RESUMO

Despite increasing numbers of unaccompanied refugee minors (UM) in Europe and heightened concerns for this group, research on their mental health has seldom included the factor "time since arrival." As a result, our knowledge of the mental health statuses of UM at specific points in time and over periods in their resettlement trajectories in European host countries is limited. This study therefore examined the mental health of UM shortly after their arrival in Norway (n = 204) and Belgium (n = 103) through the use of self-report questionnaires (HSCL-37A, SLE, RATS, HTQ). High prevalence scores of anxiety, depression and posttraumatic stress disorder (PTSD) symptoms were found. In addition, particular associations were found with the number of traumatic events the UM reported. The results indicate that all UM have high support needs on arrival in the host country. Longitudinal studies following up patterns of continuity and change in their mental health during their trajectories in the host country are necessary.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Acontecimentos que Mudam a Vida , Menores de Idade/psicologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Ansiedade/psicologia , Bélgica , Depressão/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Noruega , Prevalência , Autorrelato , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários
18.
Transcult Psychiatry ; 61(1): 47-59, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37097911

RESUMO

Unaccompanied refugee minors (URMs) are a group in an especially vulnerable situation with heightened psychological suffering due to both stressful life events and current daily stressors. Research has shown that certain coping strategies such as avoidance can be adaptive in the face of ongoing stress. We conceptualize social support as an essential coping resource that these strategies tap into. Since the interrelations between these factors are often not clear in the literature, this study strives to identify and link URMs' coping strategies, the respective coping resources and the various stressors they target, shortly after arrival in a high-income country. Seventy-nine URMs from various backgrounds were recruited in two first-phase reception centers in Belgium. In addition to self-report questionnaires to assess stressful life events and current daily stressors, we conducted semi-structured interviews, with cultural mediators if required. Thematic analysis was applied to the participants' accounts and resulted in the identification of four coping strategies: avoidance and distraction, continuity and coherence, selective reliance, and positive appraisal and acceptance. The relation between these coping strategies, the various coping resources used, and the specific stressors at which they aim are discussed. We conclude that avoidant coping and contact with the ethnic community, particularly the peer group, are fundamental strategies for successful coping. Practitioners need to support URMs in their coping efforts by providing and facilitating appropriate coping resources.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Bélgica , Capacidades de Enfrentamento , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Menores de Idade/psicologia
19.
J Sch Psychol ; 102: 101260, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38143093

RESUMO

This study explored supportive relational processes for immigrant children's well-being between peers, teachers, and parents in the development of school-based creative interventions in European multi-ethnic societies. Within the present study, we integrated the perspectives of teachers and parents to broaden the dominant focus on the assessment of individual symptomatology within the existing body of studies of school-based interventions studies. As a part of a larger multi-method study on the implementation of a creative expression program for immigrant children ages 8-12 years in three schools in Belgium, we conducted focus group discussions to learn parents' and teachers' perspectives on the role of school-based creative interventions in children's coping with histories of migration and life in exile. Parents and teachers identified the need for the intervention to foster emotional expression impacting children's self-esteem and social connectedness with peers and to foster emotional connections between parents, teachers, and children. Parents also stressed the importance of the intervention within society as a forum to engage with social conditions, promote cultural belonging, and social integration. Results identified the importance of school-based interventions in terms of individual benefits as well as connectedness and coherence in entire communities, thereby strengthening the development of transcultural research evidence for school-based interventions in multi-ethnic societies.


Assuntos
Pessoal de Educação , Pais , Criança , Humanos , Pais/psicologia , Instituições Acadêmicas , Professores Escolares/psicologia , Bélgica
20.
Transcult Psychiatry ; 61(2): 260-272, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38304985

RESUMO

Art-based interventions, such as classroom drama workshops (CDWs), increasingly form part of a collection of mental health-promoting activities introduced in school settings. While research points to the potential benefits of CDWs for the mental well-being of refugee and migrant adolescents, the mechanisms to such improvement are less understood. In this article we respond to the need for qualitative evidence of how CDW interventions affect refugee and migrant adolescents' experience. The study draws on eight focus group discussions (FGDs) with 41 adolescents, four semi-structured interviews with teachers and a school coordinator, and written documents from two drama therapists. Our thematic analysis revealed that the CDWs were found to foster trust and improve social relations in the classroom-key facets of bonding social capital. Several processes were described as being linked to these changes. Participants spoke about how the CDWs were facilitated in an emancipatory and safe manner, creating social spaces where the adolescents could have fun together, share, and bear witness to each other's stories, as well as experiencing a sense of agency. In some cases, however, activities in the CDWs crossed the learners' psychological boundaries, which led to withdrawal and a loss of trust. We conclude that whilst CDWs have the potential to facilitate bonding social capital amongst refugee and migrant adolescents and their teachers, this potential hinges on how the CDWs are facilitated.


Assuntos
Refugiados , Capital Social , Migrantes , Humanos , Adolescente , Refugiados/psicologia , Saúde Mental , Dinamarca
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