Abstract

BackgroundConflict in Iraq has displaced millions of refugee youth. Warzone exposure and forced migration have unique acute and chronic impacts on youth, yet effects of exposure may not be universal across diverse refugee groups. Understanding how youth from various refugee groups are differentially affected by stress and trauma is critical to allocate resources and implement screening measures with the goal of providing early intervention.MethodTo identify the effects of warzone exposure and forced migration, a convenience sample of 48 Iraqi refugee youth ages 6–17 was assessed within the first month of arrival to the United States. Youth provided self-reported severity of posttraumatic stress and anxiety symptoms; symptom severity was then compared with an existing sample of 135 Syrian refugee youth to explore whether refugee youth of different nationalities experience the same effects of warzone exposure and forced migration. These data are the baseline for a longitudinal developmental study of refugee health, which also includes parental data.ResultsSeverity of separation anxiety and negative alterations in cognition and mood were the greatest symptomatic concerns in Iraqi refugee youth. Thirty-eight percent of responding Iraqi youth showed possible indication of an anxiety disorder. Severity of posttraumatic stress symptoms was lower in Iraqi youth compared to Syrian youth. For both Iraqi and Syrian refugee youth, separation anxiety was the most significant concern, with more than 80% of both samples showing a possible indication of clinically significant separation anxiety.ConclusionThe present observational study indicated that Iraqi refugee youth experience a range of anxiety and posttraumatic stress symptoms following warzone exposure and forced migration; posttraumatic stress symptoms were less severe in Iraqi versus Syrian youth. Comparing refugee youth of different nationalities is of particular importance, as our results demonstrate that findings from one refugee population cannot easily be generalized to another. Clinical and research efforts should prioritize interventions to address separation anxiety in refugee youth, which was of concern in both samples.

Highlights

  • The ongoing conflict in Iraq (2003–present) has resulted in the displacement of more than 3 million people (UNHCR, 2018)

  • Traumarelated psychopathology is less clearly defined in Iraqi refugee youth, and the present study fills this gap by assessing severity of trauma-related psychopathology in Iraqi refugee youth resettled in the United States

  • The primary aims of this study were to (1) assess severity posttraumatic stress and anxiety symptoms, as well as possible indication of PTSD and anxiety disorders, in Iraqi refugee youth resettling in Southeastern Michigan, and (2) compare levels of distress in the present Iraqi refugee youth with a sample of Syrian refugee youth resettled in the same region at the same time period

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Summary

Introduction

The ongoing conflict in Iraq (2003–present) has resulted in the displacement of more than 3 million people (UNHCR, 2018) These individuals have been forced to flee their countries because of persecution, war, or violence – defining refugee status (UNHCR, 1984). There are different levels of stress among Muslim and non-Muslim Iraqi adult refugees (Arfken et al, 2018), and female gender and religion of Islam (compared to Buddhism and Christianity) are predictors of high anxiety in a cohort of torture survivors arriving in the United States (Song et al, 2015; Abu Suhaiban et al, 2019). Warzone exposure and forced migration have unique acute and chronic impacts on youth, yet effects of exposure may not be universal across diverse refugee groups. Understanding how youth from various refugee groups are differentially affected by stress and trauma is critical to allocate resources and implement screening measures with the goal of providing early intervention

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