title: Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States.
abstract: There is an increasing need to deliver effective mental health services to refugee children and adolescents across the United States; however, the evidence base needed to guide the design and delivery of services is nascent. We investigated the trauma history profiles, psychopathology, and associated behavioral and functional indicators among war-affected refugee children presenting for psychological treatment. From the National Child Traumatic Stress Network's Core Data Set, 60 war-affected refugee children were identified (51.7% males, mean age = 13.1 years, SD = 4.13). Clinical assessments indicated high rates of probable posttraumatic stress disorder (30.4%), generalized anxiety (26.8%), somatization (26.8%), traumatic grief (21.4%), and general behavioral problems (21.4%). Exposure to war or political violence frequently co-occurred with forced displacement; traumatic loss; bereavement or separation; exposure to community violence; and exposure to domestic violence. Academic problems and behavioral difficulties were prevalent (53.6% and 44.6%, respectively); however, criminal activity, alcohol/drug use, and self-harm were rare (all < 5.45%). These findings highlight the complex trauma profiles, comorbid conditions, and functional problems that are important to consider in providing mental health interventions for refugee children and adolescents. Given the difficulties associated with access to mental health services for refugees, both preventive and community-based interventions within family, school, and peer systems hold particular promise.
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts 02115, USA. Theresa_Betancourt@harvard.edu
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Newnham
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Layne
authors.forename: Soeun
authors.initials: S
authors.lastname: Kim
authors.forename: Alan M
authors.initials: AM
authors.lastname: Steinberg
authors.forename: Heidi
authors.initials: H
authors.lastname: Ellis
authors.forename: Dina
authors.initials: D
authors.lastname: Birman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D008605:Mental Health Services; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014481:United States; D014857:Warfare