Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychology, Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.
Eur J Psychotraumatol. 2021 Jun 9;12(1):1920200. doi: 10.1080/20008198.2021.1920200.
: In recent years, many adolescents have fled their home countries due to war and human rights violations, consequently experiencing various traumatic events and putting them at risk of developing mental health problems. The symptomatology of refugee youth was shown to be multifaceted and often falling outside of traditional diagnoses. : The present study aimed to investigate the symptomatology of this patient group by assessing the network structure of a wide range of symptoms. Further, we assessed clinicians' perceptions of symptoms relations in order to evaluate the clinical validity of the empirical network. : Empirical data on Post-Traumatic Stress Disorder (PTSD), depression and other trauma symptoms from = 366 refugee youth were collected during the routine diagnostic process of an outpatient centre for refugee youth in Germany. Additionally, four clinicians of this outpatient centre were asked how they perceive symptom relations in their patients using a newly developed tool. Separate networks were constructed based on 1) empirical symptom data and 2) clinicians' perceived symptom relations (PSR). : Both the network based on empirical data and the network based on clinicians' PSR showed that symptoms of PTSD and depression related most strongly within each respective cluster (connected mainly via , externalizing symptoms were somewhat related to PTSD symptoms and were central. Some differences were found within the clinicians' PSR as well as between the PSR and the empirical network. Still, the general PSR-network structure showed a moderate to good fit to the empirical data. : Our results suggest that and play a central role in the symptomatology of refugee children, which has tentative implications for diagnostics and treatment. Further, externalizing symptoms might be an indicator for PTSD-symptoms. Finally, using clinicians' PSR for network construction offered a promising possibility to gain information on symptom networks and their clinical validity.
近年来，许多青少年因战争和侵犯人权行为而逃离自己的国家，因此经历了各种创伤事件，使他们面临发展心理健康问题的风险。难民青年的症状表现表现出多面性，往往超出传统诊断的范围。
本研究旨在通过评估广泛症状的网络结构来研究该患者群体的症状表现。此外，我们评估了临床医生对症状关系的看法，以评估经验网络的临床有效性。
在德国一家难民青年门诊中心的常规诊断过程中，收集了 366 名难民青年的创伤后应激障碍（PTSD）、抑郁和其他创伤症状的经验数据。此外，还要求该门诊中心的四位临床医生使用新开发的工具来描述他们如何看待患者的症状关系。分别基于 1）经验症状数据和 2）临床医生感知的症状关系（PSR）构建网络。
基于经验数据和基于临床医生 PSR 的网络都表明，每个簇内的 PTSD 和抑郁症状相关最强（主要通过 连接），外化症状与 PTSD 症状有些相关，而 处于中心位置。在临床医生的 PSR 中以及 PSR 和经验网络之间都发现了一些差异。尽管如此，一般的 PSR 网络结构与经验数据具有中等至良好的拟合度。
我们的结果表明， 和 在外来难民儿童的症状表现中起着核心作用，这对诊断和治疗具有初步意义。此外，外化症状可能是 PTSD 症状的一个指标。最后，使用临床医生的 PSR 进行网络构建为获得有关症状网络及其临床有效性的信息提供了一种有希望的可能性。
