Refugee children are generally considered to be at high risk for mental health problems because of the extreme stressors they experience in the pre- and post-migration periods. This paper summarizes current knowledge on the manifestations of emotional disorder among refugee children and on the associated risk and protective factors. Special attention is given to the interaction of culture with the specific family, social and cultural context of refugee children. Intervention and preven tion services, as well as the implementation of community programs, are discussed.
Get full access to this article
View all access options for this article.
References
1.
Adam, H. & Riedesser, P. (1993, September). Psychosocial problems of refugee children: Experiences of the Department of Child and Adolescent Psychiatry, University Clinic of Hamburg. Paper presented at the Congress on Children—War and Persecution, Hamburg, Germany.
2.
Alcock, A.T. (1941). War strain on children. British Medical Journal, 1, 124.
3.
Allodi, F. (1980). The psychiatric effects of political persecution and torture in children and families of victims. Canada's Mental Health, 28, 3-10.
4.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. (Fourth Ed.). Washington, D.C.: American Psychiatric Association .
5.
Arroyo, W. & Eth, S. (1985). Children traumatized by Central American warfare . In S. Eth & R.S. Pynoos (Eds.), Post-traumatic stress disorder in children (pp. 183-195). Washington, D.C.: American Psychiatric Press.
6.
Axelrod, S., Felia, L.O. & Rav, H.J. (1980). Hospitalized offspring of Holocaust survivors . Bulletin of the Menninger Clinic, 44,1-19.
7.
Baker, A.M. (1990). The psychological impact of the intifada on Palestinian children in the occupied West Bank and Gaza: An exploratory study. American Journal of Orthopsychiatry, 60(4), 496-505.
8.
Bar-On, D. (1993, September). Children as unintentional transmitters of undiscussable traumatic life events. Paper presented at the Congress on Children—War and Persecution, Hamburg, Germany.
9.
Barudy, J. (1989). A programme of mental health for political refugees: Dealing with the invisible pain of political exile. Social Science and Medicine, 28(7), 715-727.
10.
Becker, D., Lira, E., Castillo, M.I., Gomez, E. & Kovalskys, J. (1990). Therapy with victims of political repression in Chile: The challenge of social reparation. Journal of Social Issues, 46(3), 133-149.
11.
Berry, J.W., Trimble, J.E. & Olmedo, E.L. (1986). Assessment of acculturation. In W.J. Lonner & J.W. Berry (Eds.), Field methods in crosscultural research. Beverly Hills, CA: Sage.
12.
Bottinelli, M.C., Maldonado, I., Troya, E., Herrera, P. & Rodriguez, C. (1990). Psychological impacts of exile: Salvadoran and Guatemalan families in Mexico. Washington, D.C.: Center for Immigration Policy and Refugee Assistance, Georgetown University.
13.
Brown, W.G., Tirril, H.O. & Bifulco, A. (1986). Long-term effects of early loss of parent. In C.E. Izard & P.B. Read (Eds.), Depression in young people. New York, NY: Guilford Press.
14.
Bürgin, D. (1993, September). Psychic traumatisation in children and adolescents. A clinical and theoretical survey. Paper presented at the Congress on Children—War and Persecution, Hamburg, Germany.
15.
Burke, A.W. (1982). Determinants of delinquency in female West Indian migrants. International Journal of Social Psychiatry, 28, 28-34.
16.
Camilleri, C. (1973). Jeunesse, famille et développement. Paris: Editions CNRS.
17.
Carlin, E.J. (1979). The catastrophically uprooted child: Southeast Asian refugee children. In J.D. Nospiltz (Ed.), Basic handbook of child psychiatry (pp. 290-300). New York, NY: Basic Books.
18.
Centlivres, P. (1988). L'innocence en question: les enfants afghans dans la guerre et l'exil. Nouvelle Revue d'Ethnopsychiatrie, 12,127-142.
19.
Charron, D.W. & Ness, R.C. (1981). Emotional distress among Vietnamese adolescents: A statewide survey. Journal of Refugee Resettlement, 1(3), 7-15.
20.
Clarke, G., Sack, W.H. & Goff, B. (1993a). Three forms of stress in Cambodian adolescent refugees. Journal of Abnormal Child Psychology, 21(1), 65-77.
21.
Clarke, G.N., SACK, W.H., BEN, R., LANHAM, K. & HIM, C. (1993b). English language skills in a group of previously traumatized Khmer adolescent refugees. Journal of Nervous and Mental Disease, 181(7), 454-456.
22.
Cohn, J.K., Holzer, I.M., Koch, L. & Severin, B. (1980). Children and torture: An investigation of Chilean immigrant children in Denmark. Danish Medical Bulletin, 27(5), 238-239.
23.
D'Kissy, M., Dolce, R., Filion, G. & Vendette, M. (1990). La mosaïque éclatée: Perceptions et stratégies de jeunes Québécois(es) français(es), Asiatiques du Sud-Est et Italien(ne)s de secondaire I dans un quartier à majorité multiethnique (sous la direction de A. Laperrière). Montréal: Université du Québec à Montréal.
24.
Do-Lam, C.-L. (1988). Adolescents vietnamiens en exil en France dix ans après. Anthropologia medica, 4, 28-31.
25.
Douville, O. (1985). Étude diagnostique des processus d'acculturation chez les adolescents magrebins en France. Cahiers d'anthropologie et de biométrie humaine, 1, 75-90.
26.
Dreman, S. & Cohen, E. (1990). Children of victims of terrorism revisited: Integrating individual and family treatment approaches. American Journal of Orthopsychiatry, 60, 204-209.
27.
Duncan, J. & Kang, S. (1985). Using Buddhist ritual activities as foundation for a mental health program for Cambodian children in foster care. Unpublished manuscript. Mountlake Terrace, WA: Lutheran Social Services.
28.
Eisenbruch, M. (1988). The mental health of refugee children and their cultural development. International Migration Review, 22(2), 282-300.
29.
Eisenbruch, M. (1990). The Cultural bereavement interview: A new clinical research approach for refugees. Psychiatric Clinics of North America, 13, 715-735.
30.
Eisenbruch, M. (1991). From post-traumatic stress disorder to cultural bereavement: Diagnosis of Southeast Asian refugees. Social Science and Medicine, 33,673-680.
31.
Erikson, E.H. (1972). Adolescence et crise: La quête de l'identité. Paris: Flammarion.
32.
Espino, C.M. (1991). Trauma and adaptation: The case of Central American children. In F.L. Ahearn & J.L. Athey (Eds.), Refugee children: Theory, research and services (pp. 106-124). Baltimore, MD: Johns Hopkins University Press.
33.
Eth, S. & Pynoos, R.S. (1985). Interaction of trauma and grief in childhood. In S. Eth & R.S. Pynoos (Eds.), Post-traumatic stress disorder in children (pp. 168-186). Washington, D.C.: American Psychiatric Press.
34.
Farias Campero, P.J. & Miranda Redondo, R. (Eds.). (1994). Experiencas del refugio Centro Americano: Perspectivas de salud mental y psicosocial. San Cristobal de Las Casas, Chiapas: Federación Mundial de Salud Mental, Centro de Investigaciones en Salud de Comitàn, Colegio de la Frontera Sur.
35.
Farias, P.J. (1991). Emotional distress and its socio-political correlates in Salvadoran refugees: Analysis of a clinical sample. Culture, Medicine and Psychiatry, 15, 167-192.
36.
Freud, A. & Burlingham, D. (1944). Children in war. New York, NY: International Universities Press.
37.
Ganesan, S., Fine, S. & Yilin, T. (1989). Psychiatric symptoms in refugee families from Southeast Asia: Therapeutic challenges. American Journal of Psychotherapy, 43(2),218-228.
38.
Garmezy, N. & Rutter, M. (Eds.). (1983). Stress, coping and development . New York, NY: McGraw-Hill.
39.
Garmezy, N. & Rutter, M. (1985). Acute reactions to stress. In M. Rutter & L. Herson (Eds.), Child and adolescent psychiatry. Oxford: Blackwell Scientific Publications.
40.
Gibson, K. (1989). Children in political violence. Social Science and Medicine, 28(7), 659-667.
41.
Gilad, L. (1990). Refugees in Newfoundland: Families after flight . Journal of Comparative Family Studies, 21, 379-396.
42.
Herzog, J.M. (1993, September). The nature of the treatment of children in our times. Paper presented at the Congress on Children—War and Persecution, Hamburg, Germany.
43.
Hicks, R., Lalonde, R.N. & Pepler, D. (1993). Psychosocial considerations in the mental health of immigrant and refugee children. Canadian Journal of Community Mental Health, 12(2), 71-87.
44.
Hjern, A., Angel, B. & Hojer, B. (1991). Persecution and behaviors: A report of refugee children from Chile. Child Abuse and Neglect, 15, 239-248.
45.
Hughes, D. & Dumont, K. (1993). Using focus groups to facilitate culturally anchored research. American Journal of Community Psychology, 21(6), 775-806.
46.
Irwin, A.D. & Madden, C. (1985). A psychoeducational assessment procedure for Southeast Asia refugee students. In T.C. Owen (Ed.), Southeast Asian mental health: Treatment, prevention, services, training and research (pp. 260-272). Washington, D.C.: U.S. Department of Health and Human Services Utilization.
47.
Jenkins, J.H. (1991). The state construction of affect: Political ethos and mental health among Salvadoran refugees. Culture, Medicine and Psychiatry, 15,139-165.
48.
Jensen, P.S. & Shaw, J. (1993). Children as victims of war: Current knowledge and future research needs. Journal of the American Academy of Child and Adolescent Psychiatry, 32(4), 697-708.
49.
Jupp, J.J. & Luckey, J. (1990). Educational experience in Australia of Indochinese adolescent refugees. International Journal of Mental Health , 18(4), 78-91.
50.
Kestenberg, J.S. (1993a, September). Children of Nazi perpetrators. Paper presented at the Congress on Children—War and Persecution , Hamburg, Germany.
51.
Kestenberg, J.S. (1993b, September). The diversity of child survivors of the Holocaust. Paper presented at the Congress on Children—War and Persecution, Hamburg, Germany.
52.
Kinzie, D.J., Sack, H.W., Angell, H.R., Manson, S. & Roth, B. (1986). The psychiatric effects of massive trauma on Cambodian children: 1. The children. Journal of the American Academy of Child and Adolescent Psychiatry, 25(3), 370-376.
53.
Kinzie, D.J. & Sacks, W. (1991). Severely traumatized Cambodian children. In F.L. Ahearn & J.L. Athey (Eds.), Refugee children: Theory, research and services (pp. 92-105). Baltimore, MD: Johns Hopkins University Press.
54.
Kinzie, J.D., Sack, W., Angell, R., Clarke, G. & Ben, R. (1989). A three-year follow-up of Cambodian young people traumatized as children. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 501-504.
55.
Kleinman, A. & Good, B. (Eds.). (1985). Culture and depression. Berkeley, CA: University of California Press.
56.
Krener, P. & Sabin, C. (1985). Indochinese immigrant children: Problems in psychiatric diagnosis. Journal of the American Academy of Child and Adolescent Psychiatry, 24(4), 453-458.
57.
Krupinski, J. & Burrows, G. (Eds.). (1986). The Price of freedom: Young Indochinese refugees in Australia. Sydney: Pergamon Press.
58.
Lee, E. ( 1988). Cultural factors in working with Southeast Asian refugee adolescents. Journal of Adolescence, 11, 167-179.
59.
Lefley, H.P., Scott, C.S., Llabre, M. & Hicks, D. (1993). Cultural beliefs about rape and victims' response in three ethnic groups. American Journal of Orthopsychiatry , 63(4), 623-632.
60.
Leiper De Monchy, M. (1991). Recovery and rebuilding: The challenge for refugee children and service providers. In F.L. Ahearn Jr. & J.L. Athey (Eds.), Refugee children: Theory, research, and services (pp. 163-180). Baltimore, MD: Johns Hopkins University Press.
61.
Leslie, L.A. (1993). Families fleeing war: The case of Central Americans . In B. H. Settles, D.E. Hanks III & M.B. Sussman (Eds.), Families on the move: Migration, immigration, emigration, and mobility (pp.193-205). NewYork, NY: Haworth Press.
62.
Linowitz, J. & Boothby, N. (1988). Cross-cultural placements. In E.M. Ressler, N. Boothby & D.J. Steinbock (Eds.), Unaccompanied children: Care and protection in wars, natural disasters, and refugee movements (pp.181-207). New York, NY: Oxford University Press.
63.
Lira, E. & Weinstein, E. (1984). Psicoterapia y represión politica. Mexico: Siglo Veintiuno.
64.
Looney, J., Rahe, R., Harding, R., Ward, H. & Liu, W. (1979). Consulting to children in crisis. Child Psychiatry and Human Development, 10(1), 5-14.
65.
Lopez, A. & Saenz, I. (1992). Nuestro origen, nuestro exilio: de niño a niño . Mexico: Comité del Distrito Federal de Ayuda a Refugiados Guatemaltecos.
66.
Lykes, M.B. & Farina, J.J. (1992). Niños y violencia politica. Dossiers bibliograficos en salud mental y derechos humanos. Buenos Aires: Editado por el Centro de Documentación.
67.
Lyons, H.A. (1979). Civil violence: The psychological aspects. Journal of Psychosomatic Research, 23, 373-393.
68.
Malakoff, M.E. (1994). Refugee children and violence. In C. Chiland & J. G. Young (Eds.), Children and violence (pp. 145-162). Northvale, London: Jason Aronson .
69.
Maton, K.I. (1993). A bridge between cultures: Linked ethnographic empirical methodology for culture-anchored research. American Journal of Community Psychology, 21(6), 747-776.
70.
Meijer, A. (1985). Child psychiatric sequels of maternal war stress . Acta Psychiatrica Scandinavica, 72, 505-511.
71.
Melville, M.B. & Lykes, M.B. (1992). Guatemalan Indian children and the sociocultural effects of government-sponsored terrorism. Social Science and Medicine, 34, 533-548.
72.
Mollica, R.F. ( 1988). The trauma story: The psychiatric care of refugee survivors of violence and torture. In F.M. Ochberg (Ed.), Post-traumatic therapy and victims of violence (pp. 295-314). New York, NY: Brunner/ Mazel.
73.
Mollica, R.F., Caspi-Yavin, Y., Bollini, P., TRUONG, T., TOR, S. & LAVELLE, J. ( 1992). The Harvard Trauma Questionnaire: Validating a cross-cultural instrument for measuring torture, trauma, and post-traumatic stress disorder in Indochinese refugees . Journal of Nervous and Mental Disease, 180, 111-116.
74.
Ornitz, E.M. & Pynoos, R.S. (1989). Startle modulation in children with post-traumatic stress disorder. American Journal of Psychiatry,146, 866-870.
75.
Pask, D.E. & Jayne, A. (1984). Resettlement of minor refugees: Some interdisciplinary issues. Canadian Journal of Family Law, 3, 275-292.
76.
Punamaki, R.-L. (1989). Political violence and mental health. International Journal of Mental Health, 17(4), 3-15.
77.
Punamaki, R.-L. & Suleiman, R. (1990). Predictors and effectiveness of coping with political violence among Palestinian children. British Journal of Social Psychology, 29, 67-77.
78.
Pynoos, R.S. & Eth, S. (1985). Children traumatized by witnessing acts of personal violence: Homicide, rape or suicide behavior. In R. S. Pynoos & S. Eth (Eds.), Post-traumatic stress disorder in children (pp. 168-186). Washington, D.C.: American Psychiatric Press.
79.
Rahe, R.H., Looney, J.G. & Ward, H.W. (1978). Psychiatric consultation in a refugee camp. American Journal of Psychiatry,134, 407-411.
80.
Rechtman, R. (1992). L'apparition des ancêtres et des défunts dans les expériences traumatiques: introduction à une ethnographie clinique chez les réfugiés cambodgiens de Paris. Cahiers d'anthropologie et biométrie humaine, 10(1-2),1-19.
81.
Ressler, E.M., Boothby, N. & Steinbock, D.J. (1988). Unaccompanied children: Care and protection in wars, natural disasters, and refugee movements. New York, NY: Oxford University Press.
82.
Richman, N. (1993). Annotation: Children in situations of political violence. Journal of Child Psychology and Psychiatry, 34(8),1286-1302.
83.
Rousseau, C. (1994). La place du non-dit: éthique et méthodologie de la recherche avec les enfants réfugiés. Canada's Mental Health , 41 (4),13-17.
84.
Rousseau, C., Corin, E. & Renaud, C. (1989). Conflit armé et trauma: une étude clinique chez des enfants réfugiés latino-américains. CanadianReview of Psychiatry, 34, 376-385.
85.
Rousseau, C., Drapeau, A. & Corin, E. (1993a). Influence of culture and context on pre- and post-migratory experience of school age refugee children. Unpublished manuscript.
86.
Rousseau, C., Drapeau, A. & Corin, E. (1993b). Les difficultés émotionnelles chez les enfants réfugiés du Sud-Est asiatique et d'Amérique centrale. Report submitted to the Conseil québécois de la recherche sociale, No. RS20051092.
87.
Rumbaut, R.G. (1991). The agony of exile: A study of the migratdion and adaptation of Indochinese refugee adults and children. In F. L. Ahearn Jr. & J. L. Athey (Eds.), Refugee children: Theory, research, and services (pp. 53-91). Baltimore, MD: Johns Hopkins University Press.
88.
Rutter, M. (1987). Psychosocial resilience and protective mechanisms . American Journal of Orthopsychiatry, 57, 316-331.
89.
Sack, W., Richard, H.A., Kinzie, H. & Roth-Ber, D.J. (1986). The psychiatric effects of massive trauma on Cambodian children: II. The family, the home and the school. Journal of the American Academy of Child and Adolescent Psychiatry, 25(3), 377-383.
90.
Sack, W.H., CLARKE, G., HIM, C., DICKASON, D., GOFF, B. LANHAM, K. (1993). A 6-year follow-up study of Cambodian refugee adolescents traumatized as children . Journal of the American Academy of Child and Adolescent Psychiatry, 32(2), 431-437.
91.
Sack, W.H., Mcsharry, S., Clarke, G.N., Kinney, R., Seeley, J. & Lewinsohn, P. (1994). The Khmer adolescent project: I. Epidemiologic findings in two generations of Cambodian refugees. Journal of Nervous and Mental Disease, 182(7), 387-395.
92.
Saladin d'Anglure, B. (1988). Enfants nomades au pays des Inuit Iglulik. Anthropologie et sociétés, 12(1), 125-166.
93.
Sigal, J.J., Silver, D., Rakoff, V. & Ellen, J. (1973). Some second generation effects of survival of the Nazi persecution. American Journal of Orthopsychiatry , 43(3), 320-327.
94.
Simon, J.R. (1985). Refugee women and their daughters: A comparison of Soviet, Vietnamese and native-born American families. In T.C. Owen (Ed.), Southeast Asian mental health: Treatment, prevention, services, training and research. Washington, D.C.: U.S. Department of Health and Human Services Utilization.
95.
Sluzki, C.E. (1979). Migration and family conflict. Family Process, 16(4), 379-390.
96.
Sussman, M.B. & Settles, B.H. (1993). Policy and research issues regarding family mobility and immigration. In B.H. Settles, D.E. Hanks III & M. B. Sussman (Eds.), Families on the move: Migration, immigration, emigration, and mobility (pp. 209-232). New York, NY: Haworth Press.
97.
Szapocznik, J. & Kurtines, W.M. (1980). Bicultural involvement and adjustment in Hispanic-American youths. International Journal of Intercultural Relations, 4, 353-365.
98.
Terr, L. (1983). Life attitudes, dreams, and psychic trauma in a group of "normal" children. Journal of the American Academy of Child And AdolescentPsychiatry, 22, 221-230.
99.
Tobin, J.J. & Friedman, J. (1984). Intercultural and developmental stresses confronting Southeast Asian refugee adolescents. Journal of OperationalPsychiatry, 15, 39-45.
100.
Tsoi, M.M.Y., Gabriel, K.K. & Felice, L.M. (1986). Vietnamese refugee children in camps in Hong Kong . Social Science and Medicine, 23(11), 1147-1150.
101.
Udwin, O. (1993). Annotation: Children's reactions to traumatic events. Journal of Child Psychology and Psychiatry, 34(2), 115-127.
102.
Vinar, M. & Vinar, M. (1989). Exil et torture. Paris: Éditions Denoël.
103.
Weisz, J.R., Suwanlert, S., Chaiyasit, W., Weiss, B., Achenback, T.M. & Trevathan, D. (1989). Epidemiology of behavioral and emotional problem among Thai and American children: Teacher reports for ages 6-11. Journal of Child Psychology and Psychiatry, 30(3), 471-484.
104.
Weisz, J.R., Suwanlert, S., Chaiyasit, W., Weiss, B. & Walter, B.R. (1987). Over and undercontrolled referral problems among children and adolescents from Thailand and the United States: The Wat and Wai of cultural differences. Journal of Consulting and Clinical Psychology, 55(5), 719-726.
105.
Westermeyer, J. (1990). Working with an interpreter in psychiatric assessment and treatment. Journal of Mental and Nervous Disease, 178, 745-749.
106.
Westermeyer, J. (1991). Psychiatric services for refugee children: An overview. In F.L. Ahearn Jr. & J.L. Athey (Eds.), Refugee children: Theory, research and services (pp. 127-162). Baltimore, MD: Johns Hopkins University Press.
107.
Williams, C.L. (1991). Toward the development of preventive interventions for youth traumatized by war and refugee flight. In F.L. Ahearn Jr. & J.L. Athey (Eds.), Refugee children: Theory, research, and services (pp. 201-217). Baltimore, MD: Johns Hopkins University Press.
108.
Williams, C.L. & Berry, J.W. (1991). Primary prevention of acculturative stress among refugees: Application of psychological theory and practice. American Psychologist, 46(6), 632-641.