title: A 2-year follow-up of orphans' competence, socioemotional problems and post-traumatic stress symptoms in traditional foster care and orphanages in Iraqi Kurdistan.
abstract: BACKGROUND
  This paper aims to compare orphans' development in two different care systems.
  
  
  METHODS
  Based on age, sex, psychological trauma scores, competence and psychological problem scores, two comparable samples were found representing orphans in the traditional foster care (n = 94) and the orphanages (n = 48) in a middle-large city in Iraqi Kurdistan. At an index interview, Child Behaviour Checklist (CBCL), Harvard-Uppsala Trauma Questionnaire for Children and Post-traumatic Stress Symptoms for Children (PTSS-C) were administered to the caregivers. After 1 year the CBCL, and after 2 years both the CBCL and the PTSS-C, were-re-administered, consecutively.
  
  
  RESULTS
  Although both samples revealed significant decrease in the means of total competence and problem scores over time, the improvement in activity scale, externalizing problem scores and post-traumatic stress disorder-related symptoms proved to be more significant in the foster care than in the orphanages. While the activity scale improved in the foster care, the school competence deteriorated in both samples, particularly among the girls in the orphanages. The improvement of boys' activity scores in the foster care, and deterioration of girls' school competence in the orphanages were the most significant gender differences between samples over time.
  
  
  CONCLUSIONS
  Even if the two orphan care systems showed more similarities than differences, the foster care revealed better outcomes over time. The results are discussed in relation to gender, age, socio-economic situation, cultural values and the characteristics of each care system.
authors.affiliation: Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden. abdulbaghi.ahmad@bupinist.uu.se
authors.forename: A
authors.initials: A
authors.lastname: Ahmad
authors.forename: J
authors.initials: J
authors.lastname: Qahar
authors.forename: A
authors.initials: A
authors.lastname: Siddiq
authors.forename: A
authors.initials: A
authors.lastname: Majeed
authors.forename: J
authors.initials: J
authors.lastname: Rasheed
authors.forename: F
authors.initials: F
authors.lastname: Jabar
authors.forename: A-L
authors.initials: AL
authors.lastname: von Knorring
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000534:rehabilitation; D002669:Child Welfare; D002658:Developmental Disabilities / Q000453:epidemiology / Q000208:ethnology / Q000534:rehabilitation*; D004522:Educational Status; D005260:Female; D005581:Foster Home Care; D006801:Humans; D007493:Iraq / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D019964:Mood Disorders / Q000453:epidemiology / Q000208:ethnology / Q000534:rehabilitation; D019372:Orphanages; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000208:ethnology / Q000534:rehabilitation