Department of Global Health and Population, Research Program on Children and Global Adversity, François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, Massachusetts 02115, USA.
J Adolesc Health. 2012 Oct;51(4):357-65. doi: 10.1016/j.jadohealth.2012.01.001. Epub 2012 Mar 22.
To examine the role of caregiver mental health and risk and protective factors in influencing levels of internalizing and externalizing emotional and behavioral symptoms over time among a sample of refugee adolescents.
Prospective study of 153 Kunama refugee adolescents receiving an emergency education intervention while living in a camp in Ethiopia. Surveys were collected in 2001 (T1) and 2002 (T2). Adolescent and caregiver mental health were assessed using a Kunamenga adaptation of the Youth Self Report; caregiver mental health was assessed using the Hopkins Symptom Checklist-25. Attitudes toward education, satisfaction with education programming, socioeconomic status, and perceptions of access to services were also explored as variables potentially influencing adolescent mental health at follow-up.
Caregiver distress was significantly associated with youth externalizing behavior symptoms (β = 8.34, p < .001) and internalizing symptoms (β = 4.02, p < .05). Caregiver perceived access to services had a protective effect on externalizing behaviors (β = -7.54, p < .05) and internalizing behaviors (β = -13.67, p < .001). Higher socioeconomic status (β = -1.47, p < .05) had a protective effect on internalizing symptoms. In terms of modifying effects, among youth with distressed caregivers, those who were satisfied with the International Rescue Committee education intervention had a lower internalizing score (β = -6.34, p < .001) compared with those who were not satisfied with the program.
This study presents a rare prospective investigation of caregiver-adolescent mental health during an active refugee displacement. Results suggest that programs targeting mental health in refugee children should consider children within the larger family system, including caregiver influence on child and adolescent mental health adjustment over time.
考察照料者心理健康以及风险和保护因素在影响难民青少年群体的内化和外化情绪与行为症状水平方面的作用，该研究采用了纵向研究设计。
本研究对 153 名居住在埃塞俄比亚难民营中的 Kunama 难民青少年进行了前瞻性研究，这些青少年接受了紧急教育干预。研究人员于 2001 年（T1）和 2002 年（T2）收集了调查数据。青少年和照料者的心理健康状况使用 Kunamenga 版本的青少年自我报告进行评估；照料者的心理健康状况使用 Hopkins 症状清单-25 进行评估。研究还探讨了与青少年心理健康相关的态度变量，如对教育的态度、对教育方案的满意度、社会经济地位和对服务获取的感知。
照料者的痛苦与青少年的外化行为症状（β=8.34，p<0.001）和内化症状（β=4.02，p<0.05）显著相关。照料者感知到的服务获取对外化行为（β=-7.54，p<0.05）和内化行为（β=-13.67，p<0.001）具有保护作用。较高的社会经济地位（β=-1.47，p<0.05）对内化症状具有保护作用。在调节效应方面，在照料者痛苦的青少年中，与对国际救援委员会教育干预不满意的青少年相比，对该项目满意的青少年的内化得分较低（β=-6.34，p<0.001）。
本研究是难民儿童心理健康方面一项罕见的前瞻性研究，研究对象为处于难民流离失所活跃时期的照料者和青少年。研究结果表明，针对难民儿童心理健康的项目应该考虑到儿童所处的更大的家庭系统，包括照料者对儿童和青少年心理健康调整的影响。
