Parasympathetic Nervous System Functioning Moderates the Associations between Callous-Unemotional Traits and Emotion Understanding Difficulties in Late Childhood.

BACKGROUND: Callous-unemotional (CU) traits are characterized by low empathy, guilt, and prosociality, putting children at risk for lifespan antisocial behavior. Elevated CU traits have been linked separately to difficulties with emotion understanding (i.e., identifying emotional states of others) and disrupted parasympathetic nervous system (PNS) functioning. However, no study has investigated how PNS functioning and emotion understanding are jointly related to CU traits. METHOD: We explored associations between CU traits, emotion understanding, and PNS functioning (indexed via respiratory sinus arrhythmia [RSA]) among children aged 7-10 years old (n = 55). We also tested whether deficits in emotion understanding differ across specific emotions (i.e., fear, pain, happiness, anger). Each child's RSA was continuously recorded while they watched a film that included emotionally evocative social interactions. To assess emotion understanding, children identified emotions replayed in 1s animations of scenes from the film. Parents reported on child CU traits, conduct problems, and demographic information. RESULTS: Higher CU traits were related to lower emotion understanding (ß = -0.43, p = 0.03). PNS activity during the film moderated this association (ß = -0.47, p < 0.001), such that CU traits were associated with lower emotion understanding among children with mean (B = -0.01, t = -2.46, p = 0.02) or high (i.e., 1 SD > M; B = -0.02, t = -3.00, p < 0.001) RSA levels during the film, but not among children with low RSA levels (i.e., 1 SD < M; B = 0.00, t = -0.53, p = 0.60). Moreover, we found that the observed moderated associations are driven by deficits in fear, specifically. CONCLUSIONS: The link between poorer emotion understanding, fear understanding in particular, and CU traits was attenuated for children who demonstrated patterns of PNS functioning consistent with attentional engagement while viewing the emotion stimuli.

Exploring hair steroid concentrations in asylum seekers, internally displaced refugees, and immigrants.

The study of physiology in response to war and forced displacement can yield insight into the origin of stress-related mental health disorders. Previous studies found alterations in hair cortisol concentrations (HCC) in refugees. However, the direction of this alteration in HCC, as well as the association between HCC and psychological stress, remain unclear. Mixed findings can potentially be explained by the lack of contextual factors that have been taken into account. In this explorative study, we investigated HCCs in three female refugee samples (N = 89) in different contexts. Samples were i) asylum seekers from Syria, who sought protection in Germany two years ago (n = 37), ii) internally displaced persons (IDPs), who fled a genocide and lived in conditions of onging insecurity in Iraq (n = 14), and iii) Kurdish immigrants and former asylum seekers, who resettled to Germany 18 years ago and were used as reference group (n = 38). HCC was assessed in the scalp-nearest 6 cm of hair (2*3 cm segments). Data on mental and physical health, exposure to traumatic events, and time between immigration and HCC assessments were collected. Syrian asylum seekers had lower HCC than immigrant controls (η2 = .06). PTSD symptoms and perceived stress were associated with elevated cortisol levels in IDPs (r = .66 and r = .56), while time since immigration was associated with cortisol levels only in immigrant controls (r = .38). We discuss our findings with regard to the importance of contextual factors, particularly time since displacement and on-going insecurity, when studying physiological reactions in refugees.Lay summaryFemale Syrian asylum seekers had lower levels of hair cortisol concentration than Kurdish immigrants in Germany. Hair cortisol concentration was associated with post-traumatic stress symptoms only in internally displaced women who were exposed to ongoing stress and insecurity in Iraq.

Refugee mother-child dyads' hair cortisol, post-traumatic stress, and affectionate parenting.

Refugees are a special population who experience adversity before, during and after forced displacement. Hence, many of them show post-traumatic stress symptoms (PTSS). PTSS can be transmitted from the mother to the child and are associated with alterations in cortisol responses. Positive parenting practices, such as maternal affection, counteracts psychopathology in early childhood. The aim of this explorative study was to investigate how children's cortisol is associated with mothers' cortisol after forced displacement, and whether or not an association depends on maternal affection. A total of 42 Arabic-speaking mother-child dyads, who came to Germany as refugees from Syria or Iraq within the past four years, participated in the present cross-sectional study. All children were below the age of 5 years. We assessed children's and mothers' hair cortisol concentration (HCC) and PTSS. Additionally, we observed and objectively rated maternal affection during mother-child interactions. The association between mothers' and children's HCC, as well as their associations with maternal affection, depended on the difference between children's and mothers' HCC. Furthermore, this HCC difference significantly predicted children's PTSS. Hence, in order to understand the mechanisms underlying children's PTSS, it is essential to consider maternal variables and differential effects within samples. We discussed possible explanations for those findings.

Mental Health Needs of Refugee Children in Specialized Early Education and Care Programs in Germany.

Refugee children are at risk to develop mental health problems, which have rarely been investigated in educational contexts. We conducted three studies in childcare programs for refugees in Germany. Children's behavior was assessed by educators on site (n = 84) and online (n = 50) using a two-stage-cluster sampling and on site (n = 107) using complete samples. In Study 1 and 2, children showed elevated attention problems ranging from medium to large effect sizes, r = 0.2 and r = 0.5, respectively, and aggressive behavior problems ranging from small to large effect sizes, r = 0.1 and r = 0.5, respectively, when compared to norm data. In Study 3, children showed elevated peer-problems, r = 0.5. Future research needs to investigate whether these problems are a consequence of adapting to a novel context or a precursor of a psychopathology caused by risk factors in the context of forced displacement.

Challenges and Solutions Perceived by Educators in an Early Childcare Program for Refugee Children.

Immigration to Germany peaked in 2016. More than 105,000 refugees below the age of 7 years arrived within 12 months. Since then, Germany and other host nations have been in need of strategies to cover the emerging demand for childcare services. The German federal state North-Rhine Westphalia has funded a specialized early childhood education and care (ECEC) program for recently arrived refugees. The present study investigated challenges and possible solutions in this specialized ECEC. In a pilot study, inductive content analysis of n1 = 28 semi-structured interviews with early childhood educators revealed 19 distinct challenges and four generic categories for solutions (provide clear and predictable structures, involve and support parents, ensure adequate structural features of the childcare group, convey trust and feelings of competence). For the main study, identified challenges were transcribed into items for a closed-format questionnaire, which was distributed to a second sample of educators (n2 = 96). Challenges perceived as most difficult concerned language barriers and communication with parents. An exploratory factor analysis of the challenges questionnaire yielded four underlying domains (interpersonal stress, feasibility and attendance, cultural and communication barriers, structural features of a childcare group). Our study provides a first basis to adapt childcare settings for refugees, and to guide staff training for this special group. We discuss evidence in regard to understanding how ECEC programs can successfully promote refugee children's psychosocial adaptation and educational outcomes.

Exploring Mental Health Status and Syndrome Patterns Among Young Refugee Children in Germany.

Refugee children share a large number of pre-, peri-, and post-migration risk factors, which make them vulnerable for developing mental health concerns. Within the last few years, a large number of families with young children have sought refuge in Germany. However, children's mental health status in Germany is mostly unclear. A central aim of developmental psychopathology is to understand how risk factors lead to the emergence of mental health concerns. One approach to investigating this association is the study of specificity, which describes the idea that specific risk factors are related to specific psychological outcomes. The aim of our study was to assess the mental health status of young refugee children in Germany, and to explore a potential refugee-specific mental health pattern. In two studies, we assessed mental health outcomes of 93 children from Syria or Iraq, aged 1.5-5 years, who recently arrived in Germany. The results were compared to U.S. norm data of typically developing children, and to norm data of a clinical sample in order to explore mental health patterns. In the first study (n = 35), we used standardized screening tools for parents (CBCL 1.5-5). In the second study (n = 58), mental health states of refugee children were assessed by caretakers (CTRF 1.5-5). In comparison to U.S. norm data of normally developing children, refugee parents reported more mental health concerns for their children, especially on syndrome scales of internalizing difficulties. A comparison to U.S. clinical reference data showed a specific mental health pattern, characterized by increased levels of anxiety/depression, attention problems, and withdrawal behavior. Caretakers, too, reported more mental health problems compared to typically developing children, albeit to a smaller extent. However, a comparison to clinically-referred children only led to partial confirmation of a specific mental health pattern. Our studies offer important insights into the mental health status and pattern of young refugee children, which is essential for preventing the onset of psychopathology and for offering tailored interventions.