A socio-ecological analysis of risk, protective and promotive factors for the mental health of Burundian refugee childre
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ORIGINAL CONTRIBUTION
A socio‑ecological analysis of risk, protective and promotive factors for the mental health of Burundian refugee children living in refugee camps Florian Scharpf1 · Getrude Mkinga3 · Faustine Bwire Masath1,2 · Tobias Hecker1,4 Received: 18 June 2020 / Accepted: 13 September 2020 © The Author(s) 2020
Abstract Children and adolescents’ mental health risk and resilience arise from a complex interplay of factors on several socioecological levels. However, little is known about the factors that shape the mental health of refugee youth living in refugee camps close to ongoing conflict. We conducted a cross-sectional study with a representative sample of 217 Burundian refugee children aged 7–15 and their mothers residing in refugee camps in Tanzania to investigate associations between risk, protective and promotive factors from various ecological levels (individual, microsystem, exosystem), and children’s post-traumatic stress disorder (PTSD) symptoms, internalizing and externalizing problems, and prosocial behavior. Data were collected using structured clinical interviews and analyzed using multiple regression models. Exposure to violence across all contexts and engagement coping were risk factors for PTSD symptoms and internalizing problems, while only violence by mothers seemed to increase children’s vulnerability for externalizing problems. A differential impact of violence exposures on prosocial behavior was observed. Higher-quality friendships appeared to protect youth from PTSD symptoms and externalizing problems, while they also promoted children’s prosocial behavior, just as mothers’ social support networks. Prevention and intervention approaches should integrate risk, protective and promotive factors for refugee youth’s mental health across multiple ecological contexts and take into account context-specific and adaptive responses to war and displacement. Keywords Refugee children · Ecological · Risk factors · Mental health · Resilience · Post-traumatic stress
Introduction Refugee children and adolescents are at an increased risk of developing mental health problems due to their exposure to violence before their flight, potentially traumatizing experiences during their journey and daily stressors after their arrival in the host country [1, 2]. Accordingly, high prevalence rates of trauma-related psychopathology, such * Florian Scharpf florian.scharpf@uni‑bielefeld.de 1
Department of Psychology, Bielefeld University, P. O. Box 100131, 33501 Bielefeld, Germany
2
Vivo International, Konstanz, Germany
3
Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, Dar es Salaam, Tanzania
4
Department of Psychology, University of Zurich, Zurich, Switzerland
as post-traumatic stress disorder (PTSD), internalizing problems (e.g., depression and anxiety), and externalizing problems (e.g., aggressive and antisocial behavior), have been found among refugee youth [3, 4]. A better understanding of the factors which increase and alle
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