The dynamic nature of refugee children's resilience: a cohort study of Syrian refugees in Lebanon.
Epidemiol Psychiatr Sci
; 31: e41, 2022 Jun 15.
Article
in En
| MEDLINE
| ID: mdl-35702899
ABSTRACT
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 (ß = -0.07) predicted child mental health symptoms over time. Self-esteem (ß = -0.08), maternal psychological control (ß = 0.10), child maltreatment (ß = 0.09) and caregiver depression (ß = 0.08) predicted child symptoms and vice versa (ßse = -0.11, ßb = 0.07, ßmpc = 0.08, ßcm = 0.1, ßcd = 0.11). Finally, child symptoms predicted loneliness (ß = 0.12), bullying (ß = 0.07), perceived social support (ß = -0.12), parent-child conflict (ß = 0.13), caregiver PTSD (ß = 0.07), caregiver anxiety (ß = 0.08) and the perceived refugee environment (ß = -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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Refugees
/
Stress Disorders, Post-Traumatic
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
Epidemiol Psychiatr Sci
Year:
2022
Document type:
Article
Affiliation country:
United kingdom