Practitioner review: Assessment and treatment of refugee children and adolescents who have experienced war-related trauma

Journal of Child Psychology and Psychiatry and Allied Disciplines

Volumn 47, Issue 12, 2006, Pages 1197-1210

  Ehntholt, Kimberly A ^a   Yule, William ^a  

^a KING'S COLLEGE LONDON   (United Kingdom)

Author keywords

Adolescents; Assessment; Children; Post traumaticstress disorder; Refugee; Trauma; Treatment; War

Indexed keywords

PSYCHOTROPIC AGENT;

ANXIETY; BEHAVIOR THERAPY; CLINICAL ASSESSMENT; COGNITIVE THERAPY; CULTURAL FACTOR; DEPRESSION; EVIDENCE BASED MEDICINE; GRIEF; HOLISTIC CARE; HUMAN; MEDICOLEGAL ASPECT; MENTAL HEALTH; PERSONAL EXPERIENCE; POSTTRAUMATIC STRESS DISORDER; PSYCHOPHARMACOTHERAPY; PSYCHOTHERAPY; PSYCHOTRAUMA; REFUGEE; REVIEW; RISK ASSESSMENT; VIOLENCE; WAR;

ADOLESCENT; CHILD; COGNITIVE THERAPY; CULTURE; DESENSITIZATION, PSYCHOLOGIC; EYE MOVEMENTS; GRIEF; HUMANS; LIFE CHANGE EVENTS; NARRATION; QUESTIONNAIRES; REFUGEES; RISK FACTORS; SEVERITY OF ILLNESS INDEX; STRESS DISORDERS, POST-TRAUMATIC; WAR;

EID: 33847715776     PISSN: 00219630     EISSN: 14697610     Source Type: Journal    
DOI: 10.1111/j.1469-7610.2006.01638.x     Document Type: Review

References (111)

1. Agger, I., & Jensen, S.B. (1990). Testimony as ritual and evidence in psychotherapy for political refugees. Journal of Traumatic Stress, 3, 115-130.
2. Ajdukovic, M., & Ajdukovic, D. (1993). Psychological well-being of refugee children. Child Abuse and Neglect, 17, 843-854.
3. Almqvist, K., & Brandell-Forsberg, M. (1997). Refugee children in Sweden: Post-traumatic stress disorder in Iranian preschool children exposed to organized violence. Child Abuse and Neglect, 21, 351-366.
4. Almqvist, K., & Broberg, A.G. (1999). Mental health and social adjustment in young refugee children 3 1/2 years after their arrival in Sweden. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 723-730.
5. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. (4th edn). Washington, DC: Author.
6. Başoǧlu, M., Ekblad, S., Bäärnhielm, S., & Livanou, M. (2004). Cognitive-behavioural treatment of tortured asylum seekers: A case study. Journal of Anxiety Disorders, 18, 357-369.
7. Beiser, M., & Hyman, I. (1997). Refugees'time perspective and mental health. American Journal of Psychiatry, 154, 996-1002.
8. Beiser, M., Turner, R.J., & Ganesan, S. (1989). Catastrophic stress and factors affecting its consequences among Southeast Asian refugees. Social Science and Medicine, 28, 183-195.
9. Berman, H. (2001). Children and war: Current understandings and future directions. Public Health Nursing, 18, 243-252.
10. Birleson, P. (1981). The validity of depressive disorder in childhood and the development of a self-rating scale: A research report. Journal of Child Psychology and Psychiatry, 22, 703-88.
11. Brewin, C.R., Andrews, B., & Valentine, J.D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748-766.
12. Bryce, J.W., Walker, N., Ghorayeb, F., & Kanj, M. (1989). Life experiences, response styles and mental health among mothers and children in Beirut, Lebanon. Social Science and Medicine, 28, 685-695.
13. Chimienti, G., Nasr, J.A., & Khalifeh, I. (1989). Children's reactions to war-related stress. Social Psychiatry and Psychiatric Epidemiology, 24, 282-287.
14. Cienfuegos, A.J., & Monelli, C. (1983). The testimony of political repression as a therapeutic instrument. American Journal of Orthopsychiatry, 53, 43-51.
15. Cohen, J.A., Berliner, L., & March, J.S. (2000). Treatment of children and adolescents. In E.B. Foa, T.M. Keane, & M.J. Friedman (Eds.), Effective treatments for PTSD (pp. 106-138). New York: The Guilford Press.
16. Dybdahl, R. (2001). Children and mothers in war: An outcome study of a psychosocial intervention program. Child Development, 72, 1214-1230.
17. Dyregrov, A., Gupta, L., Gjestad, R., & Mukanoheli, E. (2000). Trauma exposure and psychological reactions to genocide among Rwandan children. Journal of Traumatic Stress, 13, 3-21.
18. Ehlers, A., & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345.
19. Ehntholt, K.A., Smith, P.A., & Yule, W. (2005). School-based cognitive-behavioural therapy group intervention for refugee children who have experienced war-related trauma. Clinical Child Psychology and Psychiatry, 10, 235-250.
20. Elbedour, S., Bensel, R.T., & Bastien, D.T. (1993). Ecological integrated model of children of war: Individual and social psychology. Child Abuse and Neglect, 17, 805-819.
21. Elbert, T., & Schauer, M. (2002). Burnt into memory. Nature, 419, 883.
22. Farhood, L., Zurayk, H., Chaya, M., Saadeh, F., Meshefedjian, G., & Sidani, T. (1993). The impact of war on the physical and mental health of the family: The Lebanese experience. Social Science and Medicine, 36, 1555-1567.
23. Fazel, M., Wheeler, J., & Danesh, J. (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: A systematic review. Lancet, 365, 1309-1314.
24. Felsman, J.K., Leong, F.T.L., Johnson, M.C., & Felsman, I.C. (1990). Estimates of psychological distress among Vietnamese refugees: Adolescents, unaccompanied minors and young adults. Social Science and Medicine, 31, 1251-1256.
25. Fox P.G., Cowell, J.M., & Montgomery, A.C. (1994). The effects of violence on health and adjustment of Southeast Asian refugee children: An integrative review. Public Health Nursing, 11, 195-201.
26. Garbarino, J., & Kostelny, K. (1996). The effects of political violence on Palestinian children's behavior problems: A risk accumulation model. Child Development, 67, 33-45.
27. Garmezy, N., & Rutter, M. (1985). Acute reactions to stress. In M. Rutter & L. Hersov (Eds.), Child and adolescent psychiatry, modern approaches (2nd edn, pp. 152-176). Oxford: Blackwell.
28. Giaconia, R.M., Reinherz, H.Z., Silverman, A.B., Pakiz, B., Frost, A.K., & Cohen, E. (1995). Traumas and posttraumatic stress disorder in a community population of older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1369-1380.
29. Goodman, R. (1994). A modified version of the Rutter Parent Questionnaire including extra items on children's strengths: A research note. Journal of Child Psychology and Psychiatry, 35, 1483-1494.
30. Gorman, W. (2001). Refugee survivors of torture: Trauma and treatment. Professional Psychology: Research and Practice, 32, 443-451.
31. Gorst-Unsworth, C., & Goldenberg, E. (1998). Psychological sequelae of torture and organised violence suffered by refugees from Iraq: Trauma-related factors compared with social factors in exile. British Journal of Psychiatry, 172, 90-94.
32. Hauff, E., & Vaglum, P. (1995). Organised violence and the stress of exile predictors of mental health in a community cohort of Vietnamese refugees three years after resettlement. British Journal of Psychiatry, 166, 360-367.
33. Heaphy, G., Ehntholt, K., & Sclare, I. (in press). Groupwork with unaccompanied young women. In R. Kohli & F. Mitchell (Eds.), Social work with unaccompanied asylum seeking children: Practice and policy issues. Basingstoke: Palgrave.
34. Heptinstall, E., Sethna, V., & Taylor, E. (2004). PTSD and depression in refugee children: Association with pre-migration trauma and post-migration stress. European Child and Adolescent Psychiatry, 13, 373-380.
35. Herman, J.L. (1997). Trauma and recovery from domestic abuse to political terror. New York: Basic Books.
36. Hodes, M. (2000). Psychologically distressed refugee children in the United Kingdom. Child Psychology and Psychiatry Review, 5, 57-68.
37. Hollifield, M., Warner, T.D., Lian, N., Krakow, B., Jenkins, J.H., Kesler, J., Stevenson, J., & Westermeyer, J. (2002). Measuring trauma and health status in refugees: A critical review. Journal of the American Medical Association, 288, 611-621.
38. Hubbard, J., Realmuto, G., Northwood, A., & Masten, A. (1995). Comorbidity of psychiatric diagnoses with post-traumatic stress disorder in survivors of childhood trauma. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1167-1173.
39. Jaffa, T. (1996). Case report: Severe trauma in a teenage refugee. Clinical Child Psychology and Psychiatry, 1, 347-351.
40. 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.
41. Kinzie, J.D., Sack, W.H., Angell, R.H., Manson, S., & Rath, B. (1986). The psychiatric effects of massive trauma on Cambodian children: I. The children. Journal of the American Academy of Child Psychiatry, 25, 370-376.
42. Kovacev, L., & Shute, R. (2004). Acculturation and social support in relation to psychosocial adjustment of adolescent refugees resettled in Australia. International Journal of Behavioral Development, 28, 259-267.
43. Kuterovac, G., Dyregrov, A., & Stuvland, R. (1994). Children in war: A silent majority under stress. British Journal of Medical Psychology, 67, 363-375.
44. Laor, N., Wolmer, L., Mayes, L.C., Golomb, A., Silverberg, D.S., Weizman, R., & Cohen, D.J. (1996). Israeli preschoolers under SCUD missile attack. Archives of General Psychiatry, 53, 416-423.
45. Layne, C.M., Pynoos, R.S., Saltzman, W.R., Arslanagić, B., Black, M., Savjak, N., Popvić, T., Duraković, E., Mušić, M., Ćampara, N., Djapo, N., & Houston, R. (2001). Trauma/Grief-focused group psychotherapy: School-based postwar intervention with traumatized Bosnian adolescents. Group Dynamics: Theory, Research and Practice, 5, 277-290.
46. Littlewood, R. (1992). DSM-IV and culture: Is the classification internationally valid ? Psychiatric Bulletin, 16, 257-261.
47. Lustig, S.L., Weine, S.M., Saxe, G.N., & Beardslee, W.R. (2004). Testimonial psychotherapy for adolescent refugees: A case series. Transcultural Psychiatry, 41, 31-45.
48. Macksoud, M.S. (1992). Assessing war trauma in children: A case study of Lebanese children. Journal of Refugee Studies, 5, 1-15.
49. Macksoud, M.S., & Aber, J.L. (1996). The war experiences and psychosocial development of children in Lebanon. Child Development, 67, 70-88.
50. McKelvey, R.S., & Webb, J.A. (1995). Unaccompanied status as a risk factor in Vietnamese Amerasians. Social Science and Medicine, 41, 261-266.
51. Mghir, R., Freed, W., Raskin, A., & Katon, W. (1995). Depression and posttraumatic stress disorder among a community sample of adolescent and young adult Afghan refugees. Journal of Nervous and Mental Disease, 183, 24-30.
52. Möhlen, H., Parzer, P., Resch, F., & Brunner, R. (2005). Psychosocial support for war-traumatized child and adolescent refugees: Evaluation of a short-term program. Australian and New Zealand Journal of Psychiatry, 39, 81-87.
53. Mollica, R.F., Poole, C., Son, L., Murray, C.C., & Tor, S. (1997). Effects of war trauma on Cambodian refugee adolescents'functional health and mental health status. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1098-1106.
54. Monroe, B., & Kraus, F. (Eds.). (2005). Brief interventions with bereaved children. Oxford: Oxford University Press.
55. Nader, K., Pynoos, R.S., Fairbanks, L., Al-Ajeel, M., & Al-Asfour, A. (1993). A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis. British Journal of Clinical Psychology, 32, 407-416.
56. National Institute for Clinical Excellence (NICE). (2005). Post-traumatic stress disorder (PTSD). The management of PTSD in adults and children in primary and secondary care. National Clinical Practice Guideline Number 26. London: Gaskell and the British Psychological Society.
57. Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004). A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology, 72, 579-587.
58. Onyut, L.P., Neuner, F., Schauer, E., Ertl, V., Odenwald, M., Schauer, M., & Elbert, T. (2005). Narrative exposure therapy as a treatment for child war survivors with posttraumatic stress disorder: Two case reports and a pilot study in an African settlement. BMC Psychiatry, 5, 1-9.
59. Oras, R., Cancela de Ezpeleta, S., & Ahmad, A. (2004). Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nordic Journal of Psychiatry, 58, 199-203.
60. O'Shea, B., Hodes, M., Down, G., & Bramley, J. (2000). A school-based mental health service for refugee children. Clinical Child Psychology and Psychiatry, 5, 189-201.
61. Otto, M.W., Hinton, D., Korbly, N.B., Chea, A., Ba, P., Gershuny, B.S., & Pollack, M.H. (2003). Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: A pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone. Behaviour Research and Therapy, 41, 1271-1276.
62. Papadopoulos, R. (1999). Working with Bosnian medical evacuees and their families: Therapeutic dilemmas. Clinical Child Psychology and Psychiatry, 4, 107-120.
63. Papageorgiou, V., Frangou-Garunovic, A., Iordanidou, R., Yule, W., Smith, P., & Vostanis, P. (2000). War trauma and psychopathology in Bosnian refugee children. European Child and Adolescent Psychiatry, 9, 84-90.
64. Paunovic, N., &Öst, L. (2001). Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees. Behaviour Research and Therapy, 39, 1183-1197.
65. Punamäki, R.L. (1996). Can ideological commitment protect children's psychosocial well-being in situations of political violence ? Child Development, 67, 55-69.
66. Qouta, S., Punamäki, R.L., & Sarraj, E.E. (2005). Mother-child expression of psychological distress in war trauma. Clinical Child Psychology and Psychiatry, 10, 135-156.
67. Quirk, G.J., & Casco, L. (1994). Stress disorders of families of the disappeared: A controlled study in Honduras. Social Science and Medicine, 39, 1675-1679.
68. Raval, H. (2005). Being heard and understood in the context of seeking asylum and refuge: Communicating with the help of bilingual co-workers. Clinical Child Psychology and Psychiatry, 10, 197-216.
69. Reynolds, C. R., & Richmond, B.O. (1978). What I think and feel: A revised measure of children's manifest anxiety. Journal of Abnormal Child Psychology, 6, 271-280.
70. Rousseau, C. (1995). The mental health of refugee children. Transcultural Psychiatric Research Review, 32, 299-331.
71. Rutter, J. (2003). Supporting refugee children in 21st century Britain: A compendium of essential information. Stoke on Trent: Trentham Books.
72. Sack, W.H., Angell, R.H., Kinzie, J.D., & Rath, B. (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 Psychiatry, 25, 377-383.
73. Sack, W.H., Clarke, G., Him, C., Dickason, D., Goff, B., Lanham, K., & Kinzie, J.D. (1993). A six year follow-up study of Cambodian refugee adolescents traumatized as children. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 431-437.
74. Sack, W.H., Clarke, G.N., & Seeley, J. (1996). Multiple forms of stress in Cambodian adolescent refugees. Child Development, 67, 107-116.
75. Sack, W.H., Him, C., & Dickason, D. (1999). Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1173-1179.
76. Sack, W.H., McSharry, S., Clarke, G.N., Kinney, R., Seeley, J., & Lewinsohn, P. (1994). The Khmer adolescent project. I. Epidemiological findings in two generations of Cambodian refugees. Journal of Nervous and Mental Disease, 182, 387-395.
77. Sack, W.H., Seeley, J.R., & Clarke, G.N. (1997). Does PTSD transcend cultural barriers? A study from the Khmer adolescent refugee project. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 49-54.
78. Saigh, P.A. (1991). The development of posttraumatic stress disorder following four different types of traumatization. Behaviour Research and Therapy, 29, 213-216.
79. Schauer, M., Neuner, F., & Elbert, T. (2005). Narrative exposure therapy. A short-term intervention for traumatic stress disorder after war, terror, or torture. Göttingen: Hogrefe & Huber Publishers.
80. Schauer, E., Neuner, F., Elbert, T., Ertl, V., Onyut, L.P., Odenwald, M., & Schauer, M. (2004). Narrative exposure therapy in children: A case study. Intervention, 2, 18-32.
81. Schreiber, S. (1995). Migration, traumatic bereavement and transcultural aspects of psychological healing: Loss and grief of a refugee woman from Begameder County in Ethiopia. British Journal of Medical Psychology, 68, 135-142.
82. Servan-Schreiber, D., Lin, B.L., & Birmaher, B. (1998). Prevalence of posttraumatic stress disorder in Tibetan refugee children. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 874-879.
83. Shapiro, F. (1995). Eye movement desensitization and reprocessing, basic principles, protocols and procedures. New York: Guilford Press.
84. Silove, D., McIntosh, P., & Becker, R. (1993). Risk of retraumatisation of asylum-seekers in Australia. Australian and New Zealand Journal of Psychiatry, 27, 606-612.
85. Silove, D., Sinnerbrink, I., Field, A., Manicavasagar, V., & Steel, Z. (1997). Anxiety, depression and PTSD in asylum-seekers: Associations with pre-migration trauma and post-migration stressors. British Journal of Psychiatry, 170, 351-357.
86. Sinnerbrink, I, Silove, D., Field, A., Steel, Z, & Manicavasagar, V. (1997). Compounding of premigration trauma and postmigration stress in asylum seekers. The Journal of Psychology, 131, 463-470.
87. Smith, P., Dyregrov, A., Yule, W., Perrin, S., Gjestad, R., & Gupta, L. (2000). Children and war: Teaching recovery techniques. Bergen, Norway: Foundation for Children and War. Retrieved 15 May 2005 from http://www.childrenandwar.org.
88. Smith, P., Perrin, S., Dyregrov, A., & Yule, W. (2003). Principal components analysis of the impact of event scale with children in war. Personality and Individual Differences, 34, 315-322.
89. Smith, P., Perrin, S., & Yule, W. (1999). Cognitive behaviour therapy for post traumatic stress disorder. Child Psychology and Psychiatry Review, 4, 177-182.
90. Smith, P., Perrin, S., Yule, W., Hacam, B., & Stuvland, R. (2002). War exposure among children from Bosnia-Hercegovina: Psychological adjustment in a community sample. Journal of Traumatic Stress, 15, 147-156.
91. Smith, P., Perrin, S., Yule, W., & Rabe-Hesketh, S. (2001). War exposure and maternal reactions in the psychological adjustment of children from Bosnia-Hercegovina. Journal of Child Psychology and Psychiatry, 42, 395-404.
92. Snodgrass, L.L., Yamamoto, J., Frederick, C., Ton-That, N., Foy, D.W., Chan, L., Wu, J., Hee Hahn, P., Shinh, D.Y., Nguyen, L.H., de Jonge, J., & Fairbanks, L. (1993). Vietnamese refugees with PTSD symptomatology: Intervention via a coping skills model. Journal of Traumatic Stress, 6, 569-575.
93. Sourander, A. (1998). Behaviour problems and traumatic events of unaccompanied refugee minors. Child Abuse and Neglect, 22, 719-727.
94. Summerfield, D. (2000). Childhood, war, refugeedom and 'trauma': Three core questions for mental health professionals. Transcultural Psychiatry, 37, 417-433.
95. Thabet, A.A.M., & Vostanis, P. (1999). Post-traumatic stress reactions in children of war. Journal of Child Psychology and Psychiatry, 40, 385-391.
96. Thabet, A.A., & Vostanis, P. (2000). Post traumatic stress disorder reactions in children of war: A longitudinal study. Child Abuse and Neglect, 24, 291-298.
97. Thomas, S., Thomas, S., Nafees, B., & Bhugra, D. (2004). 'I was running away from death'-the pre-flight experiences of unaccompanied asylum seeking children in the UK. Child: Care, Health and Development, 30, 113-122.
98. Tolmac, J., & Hodes, M. (2004). Ethnic variation among adolescent psychiatric in-patients with psychotic disorders. British Journal of Psychiatry, 184, 428-431.
99. Tousignant, M., Habimana, E., Biron, C., Malo, C., Sidoli-LeBlanc, E., & Bendris, N. (1999). The Quebec adolescent refugee project: Psychopathology and family variables in a sample from 35 nations. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1426-1432.
100. Tribe, R., & Raval, H. (Eds.). (2003). Working with interpreters in mental health. London: Brunner-Routledge.
101. Tufnell, G. (2003). Refugee children, trauma and the law. Clinical Child Psychology and Psychiatry, 8, 431-443.
102. Tufnell, G., Cottrell, D., & Georgiades, D. (1996). 'Good practice'for expert witnesses. Clinical Child Psychology and Psychiatry, 1, 365-383.
103. United Nations High Commissioner for Refugees (UNHCR). (1994). Refugee children: Guidelines on protection and care. Retrieved 2 May 2006 from http://www.unhcr.org/cgi-bin/texis/vtx/protect/ opendoc.pdf?tbl=PROTECTION&id=3b84c6c67.
104. United Nations High Commissioner for Refugees (UNHCR). (17 June 2005). 2004 Global Refugee Trends. Overview of refugee populations, new arrivals, durable solutions, stateless and other persons of concern to UNHCR. Geneva: UNHCR. Retrieved 26 June 2005 from http://www.unhcr.ch/ cgi-bin/texis/vtx/events/opendoc.pdf?tbl=STATISTICS&id=42b283744.
105. United Nations. Convention on the status of refugees 1951. New York: United Nations, 1951. (Protocol updating the convention published in 1967).
106. Vickers, B. (2005). Cognitive model of the maintenance and treatment of post-traumatic stress disorder applied to children and adolescents. Clinical Child Psychology and Psychiatry, 10, 217-234.
107. Weine, S.M., Kulenovic, A.D., Pavkovic, I., & Gibbons, R. (1998). Testimony psychotherapy in Bosnian refugees: A pilot study. American Journal of Psychiatry, 155, 1720-1726.
108. Westermeyer, J., & Janca, A. (1997). Language, culture and psychopathology: Conceptual and methodological issues. Transcultural Psychiatry, 34, 291-311.
109. Williams, C.L., & Westermeyer, J. (1983). Psychiatric problems among adolescent Southeast Asian refugees: A descriptive study. Journal of Nervous and Mental Disease, 171, 79-85.
110. World Health Organisation. (1992). The ICD-10 classification of mental and behavioural disorders. Geneva: World Health Organisation.
111. Yule, W. (2002). Alleviating the effects of war and displacement on children. Traumatology, 8, 25-43.