Predictors of psychological risk and resilience among Syrian refugee children

Abstract

Objectives: War-exposed refugee children are at elevated risk for mental health problems, but a notable proportion appear resilient. We aimed to investigate the proportion of Syrian refugee children who can be considered resilient, and applied a novel approach to identify factors predicting individual differences in mental health outcomes following war exposure. Methods: The sample included 1,528 war-exposed Syrian refugee children and their primary caregiver living in refugee settlements in Lebanon. Children were classed as having low symptoms (LS) if they scored below clinically validated cut-offs for post-traumatic stress disorder (PTSD), depression and externalising behaviour problems. Children scoring above any cut-off were classified as having high symptoms (HS). Each LS child was matched with one HS who reported similar war exposure, to test what differentiates children with similar exposures but different outcomes. Results: 19.3% of the children met our resilience criteria and were considered LS. At the individual level, protective traits (e.g. self-esteem; OR = 1.51, 95% CI [1.25, 1.81]) predicted LS classification, while environmental sensitivity (OR = 0.69, 95% CI [0.59, 0.82]), poorer general health (OR = 0.71, 95% CI [0.58, 0.87]) and specific coping strategies (e.g. avoidance; OR = 0.90, 95% CI [0.85, 0.96]) predicted HS classification. Social/ environmental predictors included perceived social support (OR = 1.23, 95% CI [1.02, 1.49]), loneliness and social isolation (OR = 0.85, 95% CI [0.80, 0.90]), child maltreatment (OR = 0.96, 95% CI [0.94, 0.97]), and caregiver mental and general health (e.g. caregiver depression; OR = 0.94, 95% CI [0.92, 0.97]). Conclusions: Future research should take multiple dimensions of functioning into account when defining risk for mental health problems and consider the identified predictors as potential targets for interventions.

Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety–A secondary analysis of the Better Care study

“…Contrary to prior studies ( Sirin et al, 2013 ; Oppedal and Idsoe, 2015 ; Sierau et al, 2018 ; Popham et al, 2023 ), satisfaction with social support did not predict mental health problems in the current study. This might be due to methodological reasons (e.g., satisfaction with social support measured only by a single item) or due to the fact that we did not examine whether there is support from at least one adult mentor.…”

“…However, there is a substantial number of UYRs in the present study (41.2%) with no identifiable mental health problems despite adverse experiences before, during and after flight. This is in line with more recent research and practice highlighting the resilience of young refugees and a growing number of studies attempting to identify factors contributing to healthy trajectories ( Montgomery, 2010 ; Vindevogel and Verelst, 2020 ; Popham et al, 2023 ).…”

“… Oppedal and Idsoe (2015) found direct effects of social support on depression, but not PTSD symptoms in a group of resettled UYRs. Social support also predicted mental health problems in a recent study of Syrian refugee children from Popham et al (2023) .…”

“…However, many UYRs show a remarkable resilience and high levels of functioning in their every-day lives, despite the experience of potentially traumatic events ( Keles et al, 2018a ; Popham et al, 2023 ). Hence, a growing number of researchers in the field attempt to identify factors that predict mental health outcomes of young refugees.…”

Psychometric properties of an Arabic translation of the 10-item Connor-Davidson resilience scale (CD-RISC-10), the 8- and 10-item post-traumatic growth inventory-short form (PTGI-SF) scales

“…The Palestinian socio-political concept of ‘Sumud’ is a perfect example illustrating the new conceptual framework of the social ecology of resilience [ 62 ], and refers to ways of surviving in the specific Arab Palestinian context of chronic adversity, ongoing occupation, limited infrastructure and lack of resources. Lebanese youth facing a series of crises and disastrous living conditions [ 63 ] and war-exposed Syrians [ 64 ] represent two other examples of resilience largely involving physical/social ecologies and particular cultures/environments that are far different from those observed in the Western world. However, there is scant data on resilience within conflict zones and in underdeveloped countries, and a very limited amount of research on resilience within an Arabic or Muslim cultural context [ 62 ].…”