Abstract
Children and adolescents’ mental health risk and resilience arise from a complex interplay of factors on several socio-ecological 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.
Highlights
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]
Applying a socio-ecological framework, this study aimed to investigate risk, protective, and promotive factors for the mental health of Burundian refugee children and adolescents currently living in refugee camps
This study investigated risk, protective, and promotive factors across multiple socio-ecological levels for negative (PTSD symptoms, internalizing and externalizing problems) and positive mental health outcomes in Burundian refugee youth living in camps close to ongoing conflict
Summary
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]. Healthy child development has been widely depicted using ecological systems theory [5], which describes development as interactions between children and their social environment across five nested contexts: ontogenetic level (individual attributes), microsystem (family and peers), mesosystem (interactions between microsystems), exosystem (wider community context) and macrosystem (society and culture). Such a socioecological framework has been recently applied to conceptualize the factors that contribute to the mental health and well-being of refugee and other conflict-affected children [2, 6, 7]. The model’s broad view takes into account the shattering direct
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