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Distorted Time Perspective in Adolescent Afghan and Syrian Refugees Is Associated With Psychological Distress
Abstract
Young refugees are a high-risk group for mental disorders, particularly for posttraumatic stress disorder (PTSD). Individuals with PTSD suffer from an altered time perspective with a focus on negative experiences in the past and a disregard for positive life events and the future. This study investigates time perspectives and psychological distress in 30 adolescent refugees from Syria and Afghanistan in Germany. Time perspective was assessed using the Zimbardo Time Perspective Inventory. The refugees exhibited a distorted time perspective that is common for individuals with PTSD: a high orientation toward the negative past and a low orientation toward the positive past and future. A high orientation toward the negative past was associated with high levels of general psychological distress, PTSD symptoms, and depression. A low orientation toward the future was related to high levels of anxiety. Taking time perspective and corresponding beliefs into consideration may be advantageous when treating refugees with trauma-related disorders.
... In terms of refugees, a study from Germany [28] indicates that adolescent refugees exhibit distorted time perspectives with a high orientation toward PN and PF and a low orientation toward PP, PH and F. In that study, a high orientation toward the PN was associated with high levels of PTSD symptoms and depression, while a low orientation toward F was related to high levels of anxiety. A study of time perspectives among adult Syrian refugees in Greece showed that levels of PN, PF, and F correlated with PTSD symptoms [29]. ...
... Depressive symptoms, as well as aggression, are associated with high orientation toward PN and PF and low orientation toward PP [22,25]. Such a distorted time perspective was found in adolescent refugees [28]. This raises the question of whether residency status is also associated with a distorted time perspective. ...
... Consistent with our second hypothesis, individuals with a secure status showed a relatively higher orientation toward PH. A higher level of PH indicates, for example, more happiness [28], more positive affect, and more optimism [61]. The present results underscore the importance of secure residency status for wellbeing. ...
Unaccompanied refugees are a high-risk group for trauma-induced psychiatric disorders. Besides traumatic experiences pre- and during migration, post-migration stressors such as insecure residency status affect refugees’ mental health and foster aggressive emotions. High levels of psychological distress and psychopathology distort time perspectives. Consequently, an insecure residency status linked to distress may influence a refugee’s time perspective. This study investigated psychological distress, PTSD symptoms, aggressive emotions, and time perspectives in 33 unaccompanied adolescent refugees with and without secure residency status in Germany. Refugees with precarious residency status showed higher levels of overall distress and aggression than individuals with secure residency status. Both groups revealed a distorted time perspective profile, but individuals with a residence permit showed a stronger orientation toward the present hedonistic perspective than those without a permit. Higher aggressive emotions were related to insecure status, higher levels of psychological distress, more pronounced PTSD symptoms, and lower orientation to future time perspective. Distorted time perspectives among refugees may be caused by traumatic experiences and having been uprooted, independently of their residency status in the host country. A higher future orientation may buffer the association between distorted time perspectives and aggressive emotions in the highly stressed group of unaccompanied adolescent refugees.
... People with PTSD have a time perspective profile with high scores on the Past Negative (PN) scale and low scores on the Past Positive (PP) and the Future (F) scales. The Present Fatalistic and the Past Negative correlate with the severity of traumatic events, anxiety, depression and PTSD symptoms (Papastamatelou et al., 2020;Walg et al., 2020;Zimbardo et al., 2012). Holman and Silver (1998) found that people with a time-oriented focus on the past had a higher level of distress than people with a focus on the present or the future one year after stressful events. ...
... Another possible prerequisite for a negative relationship between intolerance of uncertainty and the future time perspective is the fact that IU is associated with anxiety (Dugas et al., 1998;Freeston et al., 1994), and anxiety is associated with low scores on the Future scale (Walg et al., 2020). Studies by Durak Batıgün and Şenkal Ertürk (2021) and Rönnlund et al. (2017) found that intolerance of uncertainty is associated with negative beliefs and expectations from the future and with an increase in negative symptoms of perceived stress in adults. ...
... The correlation between IU and Future TP is direct (Table 1), and not inverse, as in other studies (Walg et al., 2020;Yang et al., 2021). These results may be caused by several factors. ...
Background
Time perspective (TP) theory suggests that people tend to categorize their experience in terms of the past, the present, and the future. Studies have shown that a balanced TP profile supports well-being while misbalance in the TP profile is associated with various psychopathology. On the other hand, an intolerance of uncertainty (IU) underpins a variety of affective disorders. There are still a lot of questions about the relationship between IU and the TP. The purpose of this study was to clarify the interrelation between the time perspective distortion and intolerance of uncertainty level and to examine the degree to which IU and TP scales are associated with posttraumatic stress symptoms in a military sample.
Participants and procedure
The sample of servicemen (N = 129) completed ZTPI, the IUS-12 and PCL-5 questionnaires. Correlational and regression analyses were conducted with IU scores, TP scales and DBTP and DBTP-r coefficients.
Results
IU total score correlates with Past Negative (PN), Present Hedonistic (PH), Present Fatalistic (PF), and Future (F) time perspectives in the military sample. Groups that differ in the level of IU have a significant difference in Past Negative TP. Regression analysis models using DBTP as well as DBTP-r coefficients showed similar results. Inhibitory IU, not Prospective IU, turned out to be a predictor of post-traumatic stress symptoms in this military, non-clinical sample.
Conclusions
Further studies should determine directions of associations between intolerance of uncertainty and time perspective.
... Dentro del vasto campo de investigación sobre PT, entre los estudios más relevantes, Stolarski et al. (2014) demostraron que el pasado negativo y el presente hedonista son predictores robustos de los estados emocionales actuales en jóvenes polacos. Por otro lado, se comprobó tanto en adultos argentinos (Brenlla et al., 2019;Germano y Brenlla, 2021) como en adolescentes sirios y afganos (Walg et al., 2020) que mayores niveles de pasado negativo y menores niveles de pasado positivo generan un aumento de malestar psicológico. Además, estudios realizados en ingleses y franceses vincularon mayor nivel de futuro y menor nivel de presente hedonista con conductas saludables como el ejercicio y la dieta (Price et al., 2017), y con conductas no saludables como el consumo frecuente de cannabis (Fieulaine y Martinez, 2011), el uso problemático del alcohol (McKay et al., 2018) y la adicción a internet (Kim et al., 2017). ...
... En primer lugar, los resultados mostraron que las variables se vincularon significativamente. Las relaciones halladas entre tempora-lidad subjetiva y MP coinciden con estudios previos (Germano y Brenlla, 2021;Walg et al., 2020). En segundo lugar, se encontró que, a mayor presencia de urgencia compulsiva e impulsividad por imprevisión, mayor MP; mientras que, a mayor nivel de AC, menor nivel de MP, lo cual también se vio anteriormente (Germano y Brenlla, 2021;Li et al., 2019). ...
El objetivo de este estudio fue conocer si la temporalidad subjetiva –perspectiva y foco temporales– y la capacidad de autocontrol e impulsividad repercuten en el malestar psicológico, en particular durante la pandemia por COVID-19. La conjetura teórica es que el tiempo psicológico está estrechamente vinculado a la autorregulación, que influye en el desarrollo de la impulsividad y el autocontrol e impacta en el malestar psicológico. Se diseñó un modelo y se realizó un estudio empírico cuantitativo, no experimental y transversal (N = 279; 78 % mujeres; ME = 30.14 años; DE = 11.21). Los resultados del análisis de correlación mostraron relaciones significativas entre las variables de interés. Para determinar las variables predictoras del malestar psicológico se realizó un análisis de regresión lineal múltiple. El 48 % de la varianza del malestar psicológico fue explicado por el pasado negativo, autocontrol e impulsividad, y focos temporales futuro y presente. Finalmente, se probó el modelo teórico diseñado para analizar los efectos directos e indirectos del malestar psicológico a través de un análisis de senderos que presentó un buen ajuste a los datos, ya que explicó el 50 % de la varianza de aquel. La perspectiva y el foco temporal explicaron el 53 % de la variabilidad del autocontrol, y presentaron efectos indirectos sobre el malestar psicológico a través del autocontrol. El autocontrol influyó de manera inversa en el malestar. Los hallazgos indican que el tiempo subjetivo y el autocontrol sirven para explicar estados psicológicos, incluso en pandemia, lo cual confirma estudios previos que muestran la importancia de las variables de personalidad –además de las biológicas y contextuales– en la aparición de malestar psicológico.
... We are particularly interested in how TP is related with various facets of psychological adaptation. Different studies have emphasized the importance of TP as a correlative or predictive variable in the analysis of: life satisfaction (Przepiorka and Sobol-Kwapinska, 2018), psychological adaptation (Marczak, Sorokowski, & Sobol-Kwapińska, 2020), subjective happiness (Drake, Duncan, Sutherland, Abernethy, & Henry, 2008), satisfaction with life (Boniwell, Osin, Linley, & Ivanchenko, 2010) and PD (Dany et al., 2016;Walg, Eder, Martin, & Hapfelmeier, 2020). ...
... Secondly, the regression analysis showed that past negative, past positive and self-control explain 31% of the variance of PD (Table 2). These results fit well with previous theories that reveal the links between TP and self-control (Baird et al., 2017;Dreves & Blackhart, 2019;Kim et al., 2017;Price et al., 2017;Xu et al., 2018) and the relationship between TP and PD (Dany et al., 2016;Walg et al., 2020). ...
Time perspective (TP) is a fundamental trait of human's psychological perception of time and can affect different aspects of psychological functioning. The current study proposes that TP and self-control can be considered as predictors of Psychological Distress (PD). 328 men and women from Buenos Aires, Argentina, completed the Zimbardo Time Perspective Inventory, which assesses five dimensions of TP, the Self-Control Scale and the Psychological Distress scale. Hierarchical regression analysis showed that past negative, past positive and self-control explain 31% of variance in PD. Afterwards, a path analysis was conducted. Results showed that future, past negative, and present orientations have a direct effect on self-control. Also, PD is predicted by past negative, past positive and self-control. Finally, future, past negative, and present orientations have an indirect effect on PD trough self-control. These findings support the idea that TP is related to self-control and suggest that both, TP and self-control, can be predictors of PD. These results add to the theoretical concept of TP and shed new light on the value of considering self-control as a mediator variable between TP and someone's psychological state. Theoretical and practical implications of these findings are discussed.
... Adaptive time perspective is the ability to relate to events, thoughts, and beliefs in the past, present, and future while avoiding a preoccupation with one specific time frame (Stolarski & Witowska, 2017). Trauma exposure is linked with an unbalanced or maladaptive time perspective, demonstrated in past negative domination and limited future orientation (Holman, 2015;Stolarski & Cyniak-Cieciura, 2016;Walg et al., 2020), which may lead to distorted time perception and elevated PTSD symptoms. Indeed, clinical interventions targeting these time-sense distortions are effective in reducing PTSD symptoms (Adenauer et al., 2011;Boniwell et al., 2014;Elbert et al., 2015;Tomich et al., 2022;Zimbardo et al., 2012). ...
Objective: This comprehensive review seeks to integrate knowledge on the dual role of time as a reactive and a constructive measure with literature on the distinctive encoding of traumatic memories. First, we discuss the dual role of time. Later, we show how encoding traumatic events may lead to chronic alteration in time perception. Finally, we review the potential of temporal metacognitive awareness as a therapeutic avenue to rectify chronic time dilation following trauma, ultimately mitigating posttraumatic symptoms. Method: A systematic search of electronic databases was conducted using four main terms: time perception, temporal encoding of traumatic memories, temporal metacognitive awareness, and temporal learning tasks as clinical interventions. Results: The review proposes that the interplay between the dual roles of time—reactive and constructive—alongside the elemental encoding of traumatic events can give rise to a self-perpetuating cycle. Within this cycle, overgeneralized fear could lead to neutral stimuli triggering and fortifying time dilation, thus contributing to the maintenance of posttraumatic stress disorder (PTSD) symptoms. Furthermore, we propose that cultivating temporal metacognitive awareness could potentially yield a positive impact on time dilation by embracing a more adaptable learning approach—one that places less emphasis on external signals and does not necessitate direct engagement with traumatic content. Strengthened temporal awareness might serve to mitigate chronic time dilation, potentially leading to a reduction in PTSD symptoms. Conclusion: The review emphasizes the need for further research to examine whether enhancing temporal metacognitive awareness for time duration may offer an innovative and effective avenue for alleviating PTSD symptoms in trauma-exposed individuals.
... With reference to the results of previous studies, a relationship model was developed between psychological time and depression in this study. First, biological, social, and psychological factors are not only important causes of depression (63, 64) but may also influence unbalanced TP and circadian rhythm (69, 101,102). For example, individuals with high levels of childhood trauma tend to develop unbalanced TP (102). ...
Psychological time reveals information about an individual’s psychological state and psychopathological traits and, thus, has become a new perspective through which the occurrence and development of depression can be examined. Psychological time includes time perception, time perspective, circadian rhythms, and passage of time. Patients with depression are characterized by inaccurate time interval estimation, habitual negative thoughts about the past and future, evening-type circadian rhythms, and slow passage of time. Habitual negative thoughts about the past and future and evening-type circadian rhythms influence the formation of depression, and poor time interval estimation and slow passage of time may result from depression. Further study is needed accurately exploring psychological time and influencing factors in patients with depression, and prospective cohort studies could further clarify this complex relationship. In addition, the study of psychological time has important implications for developing effective interventions to reduce depression.
... Concerning refugees, a study on TPs and PTSD-vulnerability among Syrian refugees in Greece revealed that high Past Negative, high Present Fatalistic, low Future, and low BTP predicted PTSD symptoms among Syrian refugees (Papastamatelou et al., 2021). Correspondingly, a study conducted on adolescent refugees from Syria and Afghanistan in Germany revealed that low Future appeared to be related to high levels of anxiety, and high Past Negative was associated with high levels of general psychological distress, PTSD symptoms, and depression (Walg et al., 2020). Thus, the described studies demonstrate that TP definitely impacts migration processes. ...
We assessed the role of Time Perspective (TP) and acculturative stress on adaptive and maladaptive coping strategies, across healthy and treatment-seeking Puerto Ricans living in the island of Puerto Rico (PR), as well as at the state of Connecticut in mainland United States (US). Participants were comprised of 197 adults from the island of PR, as well as 138 adults from Connecticut. TP was measured through five categories assessed by the Zimbardo TP Inventory (Past Positive, Past Negative, Present Fatalistic, Present Hedonistic, and Future), the Deviation from a Balanced Time Perspective-revisited (DBTPr) coefficient, and the Deviation from the Negative Time Perspective (DNTP) coefficient. Acculturative stress was measured with the Acculturative Distress Scale. Adaptive and maladaptive stress-coping were measured through the Brief COPE Inventory. DNTP predicted adaptive coping, whereas acculturative stress, Present Hedonistic, and DBTPr predicted maladaptive coping. Puerto Ricans living in Connecticut engaged more often in maladaptive coping than those in PR. Acculturative stress partially mediated the influence of DBTPr on maladaptive coping. DNTP mediated the influence of state on adaptive coping. DBTPr and acculturative stress totally mediated the influence of state on maladaptive coping. These findings suggest that assessing TP, levels of acculturative stress, and coping strategies could assist in tailoring evidence-based interventions to the specific needs of Puerto Rican populations. Doing so could be effective in promoting a Balanced Time Perspective, reducing acculturative stress, increasing adaptive coping, and improving mental as well as physical health, on Puerto Ricans living in PR or mainland US.
... 19 -Número 1 -junio/noviembre 2022 -(pp. 81-102) academic efficacy ; anxiety and depression ; psychological distress (Walg et al., 2020); and alcohol use (McKay et al., 2012). This background shows that subjective time has psychological consequences and should be studied deeply. ...
Temporal focus is the attention individuals devote to thinking about the past, present, and future. The goal of this study was to validate the Temporal Focus Scale for Argentina and analyze its psychometric properties. Two studies were carried out. Firstly, the factor structure, internal consistency, reliability, and external validity were tested (n=190). To assess external validity, the ZTPI, the self-control scale and the psychological distress scale K-10 were used. Among the main results, the parallel analysis suggested the structure of three factors that explained 72% of the total variance (KMO=.80; χ 2 (66)=1261.7; p<.001) and the semi-confirmatory factor analysis yielded measures proper setting (CFI=.97, RMSEA=.05). Reliability was tested using McDonald's omega and Cronbach's alpha coefficients (values from .81 to .89). The correlations showed that past focus is related to ZTPI negative past and K-10 (r=.58 and .46; p<.01); present focus with ZTPI fatalistic present, K-10 and self-control (r =-. 20,-.23 and .22; p<.01); and future focus with K-10 and ZTPI future (r = .21 and .22; p<.01). In the second study (n=660) a confirmatory factor analysis was performed with the three-factor structure, although there were problems with item 10. After removing item 10, the model with eleven items showed an acceptable fit (χ 2 /gl =4.27, CFI=.95, GFI=.95, NNFI=.94, RMSEA=.07). The internal consistency coefficients were higher than 0.76. In conclusion, this study provides an acceptable Argentinian version of the Temporal Focus Scale.
... This is a context which often contains both radical and protracted uncertainty (Horst and Grabska, 2015), where normative development is largely impossible, where it is difficult to develop useful strategies for the future, and where resilient strategies are hard to find. Thus, a sense of future possibilities so important for development in these phases is adversely affected (Walg et al., 2020). ...
Most studies on refugee populations are organized around trauma-related issues and focus on explaining pathological factors. Few studies are anchored in general developmental psychology with the aim of exploring normal age-specific developmental tasks and how the special circumstances associated with forced migration can influence how developmental tasks are negotiated. This study is part of a larger mixed method study seeking to identify resilience-promoting and resilience-inhibiting factors, on individual and contextual levels, among asylum seekers and refugees on the move (passing through Serbia) and settled in reception centers in Norway. A strategic sample of 20 adolescent and young adult refugees/asylum seekers during flight in Serbia (10) and after arrival in Norway (10) was chosen from a sample of 178 refugees interviewed in depth in Serbia and at receptions centers in Norway. The sample reflects the focus of this paper, which is to explore adolescent and young adult refugees/asylum seekers’ psychological and social needs and resources during flight to and after arrival in the host country, including how developmental tasks are negotiated. Through qualitative analysis, experiences associated with the developmental changes the participants experienced before, during, and after flight are contextualized. Their sense of self, their relationships with their families and their perceptions of their situation as adolescents or young adults in a highly unpredictable situation are presented in the light of relevant theory and findings from similar refugee studies. All the participants have fled from dangerous and intolerable situations in their home countries. They describe extreme dangers during flight in contexts that are unpredictable and where they feel lonely and unsupported. Most have unmet psychosocial needs and have received little support or help for their mental health issues during flight or after arrival in Norway. Suggestions for interventions and resilience-promoting actions are given based on the findings of the study.
... Further, the current SEM analysis found a partial indirect effect of past-negative TP between chronotype and BP in the post-COVID-19 outbreak sample. Some studies have shown that a high orientation towards the negative past is associated with increased stress and tension, especially in individuals with posttraumatic stress symptoms, 50 which may increase the risk of unhealthy behaviors. 45,51 Indeed, in the context of trauma exposure caused by the COVID-19 pandemic, past-negative-oriented people have a pessimistic view of their lives and the world. ...
Introduction
Bedtime procrastination (BP) has a close relationship with one’s chronotype, from a biological perspective on time. However, it remains unknown whether there is an association between BP and psychological time. Therefore, the aim of the present study was to evaluate the relationship between time perspective (TP) and BP and the effect of TP on the relationship between BP and chronotype by examining a sample of college students pre- and post-COVID-19 outbreak.
Methods
A total of 628 Chinese students (267 in pre-outbreak and 361 in post-outbreak) validly completed the Chinese version of the Bedtime Procrastination Scale, the Zimbardo Time Perspective Inventory (ZTPI), and the Morningness–Eveningness Questionnaire.
Results
Students with more BP behaviors exhibited greater deviation from a balanced TP, especially after the COVID-19 outbreak. Hierarchical regression analyses revealed that the past-negative and future orientations, as operationalized by the ZTPI, contributed independently to BP behaviors. The structural equation modeling analyses further demonstrated that morningness was significantly related to a more future-oriented TP, which in turn decreased BP in pre- and post-COVID-19 outbreak samples, while morningness was associated with a less past-negative-oriented TP, which in turn decreased BP only in the post-COVID-19 outbreak sample.
Conclusion
This study indicated that TP in students with BP predominantly focused on future orientation and that TP can mediate the relationship between chronotype and BP behaviors. However, the COVID-19 pandemic may disrupt the time flow and change the role of chronotype–TP in BP. These findings explain how individual differences in TP are associated with BP, which may be helpful in designing effective interventions to avoid BP, from the viewpoint of time perspective therapy.
... In a study by Walg et al. (2020), the TPs of 30 adolescent refugees from Syria and Afghanistan in Germany, as well as their psychological distress have been examined. ...
We tested the possible relationship between Time Perspectives (TPs) and PTSD-vulnerability among Syrian refugees in Greece. We have used the Standard Arabic version of the Zimbardo Time Perspectives Inventory (ZTPI) by Djarallah; the Posttraumatic Symptom Scale by Raphael et al., and the Generalized Self-Efficacy Scale by Schwarzer and Jerusalem. Our results indicate that Past Negative, Present Fatalistic, and Future are associated with PTSD and that the Deviance from a Negative Time Perspective (DNTP) as an overall configuration plays an essential role. Refugees could benefit from the implementation of TP therapy with the aim of reaching a Balanced Time Perspective.
Adolescent refugees confront a complex interplay of trauma arising from forced displacement, resettlement, and the challenges of transitioning from childhood to adulthood. Using photovoice methodology, this study engaged 14 Iraqi and Syrian adolescent refugees now residing in the United States with the aim to illuminate their well‐being experiences. Our findings show that temporal continuities and discontinuities in adolescent refugees' lives contributed to their sense of well‐being by helping satisfy their basic psychological needs for autonomy, competence, relatedness, and safety. Temporal continuities involved drawing upon past resources and formulating future career aspirations based on present experiences. Temporal discontinuities encompassed contrasting past and present and processing adversities endured. This study underscores that, beyond current circumstances, the interpretation of life experiences over extended timeframes influences the well‐being of adolescent refugees.
Purpose: This study was conducted to examine the effects of psychological symptoms of refugee adolescents on their substance use proclivity.Methods: The study was conducted as descriptive cross-sectional research. The study was conducted with refugee adolescents living in the southeast Anatolian region of Turkey. The Brief Symptom Inventory (BSI) and Substance Use Proclivity Scale were used to determine adolescents’ mental symptoms and substance use tendencies. Linear regression model and structural equation modeling were preferred in the analysis of the research.Results: It was determined that adolescents’ experienced psychological symptoms that were directly related to factors such as loss of relatives and length of stay in Turkey. In the model created for adolescents’ substance use tendencies, it was determined that psychological symptoms such as anxiety, depression, negative self-image and hostility were effective at a rate of 49.4%.Conclusions: It was found that refugee adolescents experienced intense mental symptoms despite the fact that many years have passed after war and migration. It was determined that the losses they experienced and smoking had most effect on these mental symptoms. It was found that the psycholo-gical symptoms of adolescents had a significant effect on their tendency to use substances
The article is devoted to the analysis of the current state of scientific and theoretical progress regarding development of ethnic languages in Ukraine. The aim is to view new tools for studying this issue through an open form of interaction between the state and interested subjects of public policy. Conclusions are made on the benefits of expanding the research base by including civil society institutions in communication with the authorities. The prospects of introduction the open public research platform in studying the development of ethnic languages in the context of Ukraine’s implementation of the European Charter for Regional or Minority Languages, the realization of public policy in general are outlined. Keywords: ethnic languages, public policy, government regulation, civil society institutions, research platform
Unaccompanied refugee minors are a particularly vulnerable group. The aim of this study is to increase our knowledge about possible pathways to well-being and integration for unaccompanied refugee minors as they strive to establish new lives in a host county. The present study followed a group of youth who fled to Norway without their caregivers at three time points; 6 months (n = 95; M age = 13.8, 80% boys), 2 years (n = 78; M age = 16.5, 83% boys), and 5 years (n = 47; M age 20.0, 83% boys) after arrival. Linear mixed effects models were used to assess whether age, gender, and trauma exposure prior to arrival were associated with levels and changes in symptoms of posttraumatic stress (PTS), depression, anxiety, and externalizing symptoms over time. Regression analyses were conducted to examine whether daily hassles, perceived social support, and new trauma experiences predict PTS, internalization, externalization, and somatization. The mean levels of depression had decreased significantly at 5 years, but mean levels of anxiety, PTS, and externalizing symptoms did not. Females and severely trauma exposed had higher levels of symptoms. Higher age was associated with less change in symptoms of depression and posttraumatic stress over time. Five years after arrival, many still experienced clinical levels of mental health problems, and level of daily hassles was an important predictor. Support may be needed not only at arrival to handle mental health problems in general and posttraumatic stress in particular, but also after resettlement. Help to manage daily hassles may be especially important to ensure well-being and integration.
Background
Studies throughout Europe have shown that asylum-seeking children and adolescents (ASC) are at risk of developing mental disorders. The most common mental-health problems in ASC include posttraumatic stress symptoms (PTSS), internalizing symptoms such as depression and anxiety, and externalizing behaviour. Being an unaccompanied refugee minor (URM) was found to be highly predictive for higher levels of psychological distress within ASC. Nevertheless, and even though Germany is Europe’s biggest host country for ASC, studies that reliably examine the mental health of both URM and accompanied refugee minors (ARM) in Germany with psychometrically tested measures are still lacking.
Methods
A cross-sectional survey in 19 facilities for minor refugees in Bavaria, Germany, screening for PTSS, depression, anxiety, externalizing behaviour, and post-migration factors was conducted. Participants were 98 ASC (URM, n = 68; ARM, n = 30) primarily from Afghanistan, Syria, and Eritrea. In 35.7% of interviews, interpreters were involved.
Results
Both URM and ARM reported high levels of psychological distress and large numbers of potentially traumatic events, with 64.7% of URM and 36.7% of ARM scoring above the clinical cut-off for PTSS, 42.6% of URM and 30% of ARM for depression, and 38.2% of URM and 23.3% of ARM for anxiety. The total number of traumatic experiences was found to be the most robust predictor for PTSS, depression, and anxiety. Lower levels of individual resources, lower levels of social support in the host country, and poorer German language proficiency were associated with higher levels of psychological distress within both groups. URM reported significantly more traumatic events than ARM.
Conclusions
ASC in Germany are severely distressed and burdened by the experiences of various types of potentially traumatic events. The levels of distress found in the current study correspond with rates that have been reported in previous studies with ASC throughout Europe. Limitations of the present study include the convenience sample and the cross-sectional nature of findings.
The European Union member states received about 385,000 asylum applications from children and adolescents below 18 years in 2015, and 398,000 in 2016. The latest political crises and war have led to an upsurge in refugee movements into European countries, giving rise to a re-evaluation of the epidemiology of psychiatric disorders and mental health problems among young refugees and asylum seekers. We systematically searched five electronic databases and reference lists of pertinent review articles. We then screened the results of forward citation tracking of key articles for relevant studies in the field for the period from January 1990 to October 2017. We dually reviewed citations and assessed risk of bias. We reported the results narratively, as meta-analyses were impeded due to high heterogeneity. We included 47 studies covered in 53 articles. Overall, the point prevalence of the investigated psychiatric disorders and mental health problems varied widely among studies (presenting interquartile ranges): for posttraumatic stress disorder between 19.0 and 52.7%, for depression between 10.3 and 32.8%, for anxiety disorders between 8.7 and 31.6%, and for emotional and behavioural problems between 19.8 and 35.0%. The highly heterogeneous evidence base could be improved by international, methodologically comparable studies with sufficiently large sample sizes drawn randomly among specific refugee populations. The prevalence estimates suggest, nevertheless, that specialized mental health care services for the most vulnerable refugee and asylum-seeking populations are needed.
Registration
The systematic review protocol was registered in PROSPERO on October 19th, 2017 with the number: CRD42017080039 and is available from: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=80039
One in four asylum applicants in Europe are children, and 23% of whom are unaccompanied and may be at increased risk of mental illness. This study contributes to the limited evidence base by comparing the incidence of psychiatric disorders among unaccompanied and accompanied refugee children. We linked a cohort of refugee children who obtained right of residency in Denmark between 01 January 1993 and 31 December 2010 to the Danish Psychiatric Central Register, and calculated incidence rates per 100,000 person years and incidence rate ratios of overall psychiatric disorder, psychotic disorders, affective disorders, and neurotic disorders for accompanied and unaccompanied minors using Poisson regression. We adjusted the analyses for sex, age at residency, and age at arrival (aIRR). Stratified analyses were conducted by nationality. Unaccompanied minors had significantly higher rates of any psychiatric disorder (aIRR: 1.38, 95% CI 1.14-1.68) and neurotic disorders (aIRR: 1.67, 95% CI 1.32-2.13) than accompanied minors. Among children from Afghanistan, unaccompanied minors had significantly higher rates of any psychiatric disorder (aIRR: 2.23, 95% CI 1.26-3.93) and neurotic disorders (aIRR: 3.50, 95% CI 1.72-7.11). Among children from Iraq, unaccompanied minors had higher rates of any psychiatric disorder (aIRR: 2.02, 95% CI 1.18-3.45), affective disorders (aIRR: 6.04, 95% CI 2.17-16.8), and neurotic disorders (aIRR: 3.04, 95% CI 1.62-5.70). Unaccompanied children were found to experience a higher incidence of any psychiatric disorder and neurotic disorders. Strategies are needed to address the specific mental health and social needs of unaccompanied minors.
This systematic review gathers data from the existing literature on the prevalence and course of psychiatric disorders among unaccompanied refugee minors (URMs). The databases PsychINFO, PubMed, Scopus and Web of Science were searched and reference lists of papers were also manually examined to identify relevant articles. Peer-reviewed journal articles included focused on the mental health of URMs, who were forced to leave their place of residence because of threats of wars. A narrative synthesis was done to analyse the data presented in the studies. Results from the fifteen studies included in the review highlighted the high prevalence of post-traumatic stress disorders (PTSD), depression, and anxiety among URMs. The association between internalizing disorders and exposure to trauma, and time since displacement were examined. Separation from family members, death of parents and close relatives, level of exposure to armed conflicts, and threats to a person were the most frequent stressful life events (SLE) among URMs before migration. Although the number of research done on this vulnerable population is increasing overtime, the review highlights the need for further examination of refugee mental health and the factors affecting symptoms of PTSD, depression, and anxiety.
Das Training richtet sich an jugendliche Flüchtlinge mit Traumafolgestörungen wie posttraumatische Belastungsstörung, depressive Störungen oder Angststörungen. Ziel des Trainings ist eine emotionale und psychische Stabilisierung der Teilnehmenden. Das Training kann sowohl im Gruppensetting als auch in der Einzeltherapie durchgeführt werden. Da die Versorgungsangebote für die Hochrisiko-gruppe der unbegleiteten minderjährigen Flüchtlinge ausgebaut werden müssen, richtet sich dieses Manual nicht nur an Kinder-und JugendpsychiaterInnen, psychologische PsychotherapeutInnen und Kinder-und Jugendlichenpsychothera-peutInnen, sondern auch an pädagogische MitarbeiterInnen von Wohngruppen und Clearingstellen. Das Trainingskonzept wurde so entwickelt, dass keine bedeutsamen psychotherapeutischen Kompetenzen zur Durch-führung erforderlich sind. Das Training ist spracharm konzipiert und stützt sich auf Bildmaterialien und Videoclips, so-dass der Einsatz von Dolmetschern verzichtbar ist. So kann das Training direkt vor Ort in den Wohngruppen von MitarbeiterInnen angeboten werden, die den Jugend-lichen vertraut sind. Das vorliegende Stabilisierungstraining soll auf diese Weise einen Beitrag zur besseren Versorgung der traumatisierten Flüchtlinge leisten. 2017 wurde das Trainingskonzept mit dem Innovationspreis der Fachgruppe Psychiatrie der Stadt Wuppertal ausgezeichnet. Bezugsquelle: Herold Fulfillment GmbH Raiffeisenallee 10 | 82041 Oberhaching | cip-medien@herold-va.de | Tel. 0 89-61 38 71 24 | Fax 0 89-61 38 71 20 | www.cip-medien.com 2016 Marco Walg StabiliSierungStraining für jugendliche Flüchtlinge mit Traumafolgestörungen CIP-Medien, München 2017 Broschur DIN A 4 | 142 Seiten ISBN 978-3-86294-053-0 | 40,– € Das Stabilisierungstraining für jugendliche Flüchtlinge mit Traumafolgestörungen wurde 2016 in die Landesinitiative " Gesundes Land Nordrhein-Westfalen " aufgenommen. Es wurde als " vorbildlich für die Weiterentwicklung des nord-rhein-westfälischen Gesundheitswesens " bewertet.
Refugees demonstrate high rates of post-traumatic stress disorder (PTSD) and other psychological disorders. The recent increase in forcible displacement internationally necessitates the understanding of factors associated with refugee mental health. While pre-migration trauma is recognized as a key predictor of mental health outcomes in refugees and asylum seekers, research has increasingly focused on the psychological effects of post-migration stressors in the settlement environment. This article reviews the research evidence linking post-migration factors and mental health outcomes in refugees and asylum seekers. Findings indicate that socioeconomic, social, and interpersonal factors, as well as factors relating to the asylum process and immigration policy affect the psychological functioning of refugees. Limitations of the existing literature and future directions for research are discussed, along with implications for treatment and policy.
Early research on the mental health of civilians displaced by armed conflict focused primarily on the direct effects of exposure to war-related violence and loss. Largely overlooked in this
war exposure model
were the powerful effects of ongoing stressors related to the experience of displacement itself. An
ecological model
of refugee distress is proposed, drawing on research demonstrating that mental health among refugees and asylum seekers stems not only from prior war exposure, but also from a host of ongoing stressors in their social ecology, or displacement-related stressors. Implications of this model for addressing the mental health and psychosocial needs of refugees and other displaced populations are considered.
In the current studies, we explore the relationship between anxiety / perceived stress and time perspectives. Study 1 tested the relationship between the dimensions of the Zimbardo Time Perspective Inventory (ZTPI) and anxiety in a male sample. Study 2 examined the relationship between time perspectives and perceived stress in a sample of students. Both studies considered the Deviation of the Balanced Time Perspective (DBTP). In Study 1 psychiatrists of the Mental Health Centre of the Armed Forces in Athens diagnosed gen-eralised anxiety in a number of male participants of the overall sample (n=204). All participants completed a validated Greek translation of the ZTPI. In Study 2 a sample of students (n= 71) of Panteion University completed the Greek translations of the ZTPI and the Perceived Stress Scale (PSS-14 items). In Study 1 a negative correlation between Future orientation and anxiety was found. The DBTP was higher in persons with anxiety. In Study 2 the Past Negative and Present Fatalistic orientations correlated with high-perceived stress as assumed. Furthermore, high-perceived stress was associated with a higher DBTP. The ZTPI is particularly important for the explanation of perceived stress. DBTP, Past Negative and Present Fatalistic perspectives are important factors of influence. The measurement of anxiety should be reexamined .
Based on Zimbardo’s Temporal Theory, Time Perspective Therapy (TPT) was developed by Richard and Rosemary Sword as a new therapeutic clinical skill as described in The Time Cure (Zimbardo et al., The time cure: Overcoming PTSD with the new psychology of time perspective therapy. Jossey-Bass, San Francisco, 2012) A 4 year pilot study which evaluated the effectiveness of TPT by following 29 veterans clinically diagnosed with chronic and severe PTSD indicates long-lasting decreases of self-reported depression, anxiety, and PTSD symptoms. In addition, participants reported affirmative shifts in their time perspectives that trended towards the healthier ideal. The importance of the ZTPI as a groundbreaking tool in determining clinical evaluations and change, as well as two actual case studies are detailed in this chapter.
One of the symptoms of trauma is said to be a “sense of foreshortened future.” Without further qualification, it is not clear how to interpret this. In this paper, we offer a phenomenological account of what the experience consists of. To do so, we focus on the effects of torture. We describe how traumatic events, especially those that are deliberately inflicted by other people, can lead to a loss of “trust” or “confidence” in the world. This undermines the intelligibility of one’s projects, cares, and commitments, in a way that amounts to a change in the structure of temporal experience. The paper concludes by briefly addressing the implications of this for how we respond to trauma, as well as offering some remarks on the relationship between trauma and psychosis.
Background
The current study reports on the development of an Arabic version of the Revised version of the Impact of Events Scale (IES-R). The IES-R was developed to assist in exploring the relationship between posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) among a sample of 40 Middle Eastern participants from a refugee background.Method
The psychometric properties were investigated on two recently translated Arabic versions of the Posttraumatic Growth Inventory (PTGI) and the adapted IES-R. The current IES-R was developed using World Health Organization (WHO) principles in establishing the comprehensibility, reliability, and validity of translated scales.ResultsGood discriminant validity and good reliability for the scale were identified. Factors analysis supported a four-factor solution for the PTGI and a three-factor solution for the IES-R; however, the small sample size suggests the obtained factor structure is likely unstable.Conclusion
The Arabic version of the IES-R is a promising scale to assess posttraumatic stress symptoms in Middle Eastern Refugees.
Recent research has focused on behavioral correlates of temporal perspective (TP), suggesting that this individual difference has an influence on many health-related behaviors such as smoking and substance use, physical activity or life satisfaction. It is suggested that a consistently biased temporal orientation is associated with some psychiatric disorders and mediated by personality factors. However, few studies have explored the relationship between personality and TP from a psychobiological approach. The aim of the study was to examine the relationship between the Zimbardo Time Perspective Inventory (ZTPI) and Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) in a sample of 196 undergraduate students through a multiple regression analyses. Results showed that: Past-Negative correlated positively with Neuroticism-Anxiety and negatively with Activity; Present Hedonistic correlated positively with Impulsive-Sensation Seeking and Sociability in a very high degree; and Future correlated positively with Neuroticism-Anxiety and Activity, and negatively with Impulsive-Sensation Seeking. Results are discussed in terms of the definition of both scales, their relationships and their implications in applied fields.
The study aimed at examining the diagnostic utility of the Impact of Event Scale-Revised (IES-R) as a screening tool for post-traumatic stress disorder (PTSD) in survivors of war. The IES-R was completed by two independent samples that had survived the war in the Balkans: a sample of randomly selected people who had stayed in the area of former conflict (n = 3,313) and a sample of refugees to Western European countries (n = 854). PTSD was diagnosed using the MINI International Neuropsychiatric Interview. Prevalence of PTSD was 20.1% in the Balkan sample and 33.1% in the refugee sample. Results revealed that when considering a minimum value of specificity of 0.80, the optimally sensitive cut-off score for screening for PTSD in the Balkan sample was 34. In both the Balkan sample and the refugee sample, this cut-off score provided good values on sensitivity (0.86 and 0.89, respectively) and overall efficiency (0.81 and 0.79, respectively). Further, the kappa coefficients for sensitivity for the cut-off of 34 were 0.80 in both samples. Findings of this study support the clinical utility of the IES-R as a screening tool for PTSD in large-scale research studies and intervention studies if structured diagnostic interviews are regarded as too labor-intensive and too costly.
Time perspective theory assumes that behaviour is influenced by how individuals link their behaviour to their past, present, and future. This paper explores the concept of time perspective (Zimbardo and Boyd, 1999) within a psychiatric context. We compared 76 individuals, in treatment (n = 32) or not in treatment (n = 44). The participants completed the time perspective questionnaire ZTPI, the NEO-PI-R (personality traits), an instrument to measure personality problems SIPP-118, and the BDI-II (depression). We found correlations between measures of psychopathology and Past Positive, Past Negative and Present Fatalistic time perspectives. Particularly Past Negative appeared to be indicative for psychiatric problems.
Two studies were conducted investigating the relationship between the Zimbardo Time Perspective Inventory (ZTPI) scales and well-being measures in British (N = 179) and Russian (N = 289) student samples. On the basis of person-oriented approach, a cluster-analysis operationalization of Balanced Time Perspective (BTP) using ZTPI was proposed and validated, demonstrating more evidence for its validity than the previously suggested cut-off-point approach. Four distinct time perspective patterns were discovered in both samples: future-oriented, present-oriented, balanced and negative. The clusters revealed significant differences in well-being, with members of the BTP cluster demonstrating the highest scores in both samples. The relationship between ZTPI and Temporal Life Satisfaction Scale in the British sample was found to be non-uniform for past, present and future. Based on these findings, a distinction between three aspects of time perspective is theoretically proposed, and its implications for the future development of the ZTPI are discussed.
Examined a German version of the revised Impact of Event Scale (IES-R). Human Ss: 128 male and female German adults (political prisoners in the former East Germany) (mean age 53.3 yrs). 30 male and female German adults (crime victims) (mean age 46.5 yrs). Ss completed German versions of the IES-R in the form of self-report questionnaires, and posttraumatic stress disorder (PTSD) in Ss was assessed by a structured clinical interview. The reliability, validity, and diagnostic sensitivity of the IES-R were examined. Difficulties with factorial validity and the underrepresentation of numbing symptoms were addressed. Tests used: The IES-R (D. S. Weiss and C. R. Marmar, 1996), the Diagnostic Interview of Psychological Disorders (J. Margraf et al., 1991), Beck Depression Inventory, and Symptom Checklist-90-Revised. (English abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Time perspective (TP), a fundamental dimension in the construction of psychological time, emerges from cognitive processes partitioning human experience into past, present, and future temporal frames. The authors' research program proposes that TP is a pervasive and powerful yet largely unrecognized influence on much human behavior. Although TP variations are learned and modified by a variety of personal, social, and institutional influences, TP also functions as an individual-differences variable. Reported is a new measure assessing personal variations in TP profiles and specific TP "biases." The 5 factors of the Zimbardo Time Perspective Inventory were established through exploratory and confirmatory factor analyses and demonstrate acceptable internal and test-retest reliability. Convergent, divergent, discriminant, and predictive validity are shown by correlational and experimental research supplemented by case studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In this study, we developed and evaluated a Swedish version of the Zimbardo Time Perspective Inventory (ZTPI; Zimbardo & Boyd, 1999). The original version of the ZTPI was extended by including a Future Negative scale, and the psychometric properties of both versions were examined in a sample of 419 adults aged between 18 and 80 years. Confirmatory factor analysis (CFA) provided support both for the original five-factor solution proposed by Zimbardo and Boyd (1999) in a Swedish sample and for a six-factor solution with the Future Negative scale as an independent factor. These findings extend the original ZTPI and suggest that negative feelings about the future constitute a central dimension of the temporal perspective. The Swedish Zimbardo Time Perspective Inventory (S-ZTPI) provides a reliable and valid instrument for measuring time perspective in the context of Swedish research and to be beneficial in its application in multiple areas of psychology and related disciplines.
In this article we examine the factorial structure of the Greek version of the Zimbardo Time Perspective Inventory (ZTPI; Zimbardo and Boyd in J Personal Soc Psychol 77:1271–1288, 1999), in a sample of 337 university students, using principal axis factoring (PAF) with oblique rotation, and its dimensionality using parallel analysis. Moreover, we evaluate the internal consistency reliability, the convergent validity (through associations with mental health indicators such as dispositional optimism, self-esteem, trait anxiety, depression, and proactive coping), as well as discriminant, and differential validity of this instrument. The results indicated that the ZTPI had a 5-factor structure (past negative, past positive, present fatalistic, present hedonistic, future). Correlational analyses indicated that an aversive view of the past, and a fatalistic attitude toward life were positively and significantly associated with trait anxiety and depression, while they were negatively correlated with self-esteem, proactive coping, and dispositional optimism. Future time perspective was positively associated with proactive coping, whereas a positive attitude toward the past was negatively associated with depression and trait anxiety. Psychometric properties of the five ZTPI scales were satisfactory (Cronbach’s alphas ranging from .710 to .845), thus facilitating the robust investigation of time perspective in Greek speaking populations. However confirmatory factor analyses revealed that the “positive attitude toward the past” dimension might not be a good indicator of time perspective. We discuss the theoretical implications of these findings for future studies of time perspective.
Seglem, K. B., Oppedal, B. & Raeder, S. (2011). Predictors of depressive symptoms among resettled unaccompanied refugee minors. Scandinavian Journal of Psychology 52, 457–464.
This study investigated the level and predictors of depressive symptoms among unaccompanied refugee minors after resettlement in Norway. Participants (N = 414) were resettled in 26 municipalities from all regions of the country. The average length of resettlement time was 3.4 years. They originated from 33 different countries, mainly Afghanistan (n = 116), Somalia (n = 74), Sri Lanka (n = 41) and Iraq (n = 43). Participants completed a self-report questionnaire administered in groups. Findings show that unaccompanied minors are a high-risk group for mental health problems also after resettlement in a new country. A multilevel model predicting depressive symptoms from individual and contextual demographic factors indicated that, controlling for post-traumatic stress, females had more symptoms than males and Somalis had fewer symptoms than participants from other countries. Variation in symptom levels as a function of gender and ethnic background indicates that some groups may have inherent protective or vulnerability factors that need to be further studied to understand differences in psychosocial adaptation among unaccompanied minors. Further, findings imply that researchers, policy makers and mental health care workers need to expand their attention beyond the first phases of arrival of unaccompanied asylum seeking and refugee minors to the continuing experience of mental health problems after resettlement.
Éste artículo evalúa la validez de constructo y la validez discriminante del Inventario de Perspectiva Temporal
de Zimbardo (Zimbardo Time Perspective Inventory, ZTPI) de una muestra de 247 estudiantes brasileños. La
estructura de cinco-factores de ZTPI, definidos por Pasado-Negativo, Presente-Hedonístico, Futuro, Pasado-
Positivo y Presente-Fatalista, provee un ajuste aceptable de los datos, y pareció ser mejor estadísticamente que
el ajuste de los modelos alternativos. El Presente-Hedonístico fue positivamente correlacionado con el consumo
de alcohol y negativamente con la religiosidad, el Futuro fue correlacionado positivamente con la preocupación
por la salud y negativamente con el consumo de alcohol, y el Pasado-Positivo fue positivamente correlacionado
con el uso del reloj. Los resultados encontrados concuerdan con los estudios anteriores, indicando que las cinco
dimensiones de perspectiva del tiempo pueden ser identificadas cognitivamente. Además los patrones de
correlación con otras variables son comparables a través de otras culturas.
Previous studies about unaccompanied refugee minors (URMs) showed that they are a highly vulnerable group who have greater psychiatric morbidity than the general population. This review focuses on mental health issues among URMs. Articles in databases PsycINFO, Medline and PubMed from 1998 to 2008 addressing this topic were reviewed. The literature had a considerable emphasis on the assessment of PTSD symptoms. Results revealed higher levels of PTSD symptoms in comparison to the norm populations and accompanied refugee minors. In several studies, age and female gender predicted or influenced PTSD symptoms. The existing literature only permits limited conclusions on this very hard to reach population. Future research should include the analysis of long-term outcomes, stress management and a more thorough analysis of the whole range of psychopathology. Additionally, the development of culturally sensitive norms and standardized measures for diverse ethnic groups is of great importance.
The article describes features of trauma memories in post-traumatic stress disorder (PTSD), including characteristics of unintentional re-experiencing symptoms and intentional recall of trauma narratives. Reexperiencing symptoms are usually sensory impressions and emotional responses from the trauma that appear to lack a time perspective and a context. The vast majority of intrusive memories can be interpreted as re-experiencing of warning signals, i.e., stimuli that signalled the onset of the trauma or of moments when the meaning of the event changed for the worse. Triggers of re-experiencing symptoms include stimuli that have perceptual similarity to cues accompanying the traumatic event. Intentional recall of the trauma in PTSD may be characterised by confusion about temporal order, and difficulty in accessing important details, both of which contribute to problematic appraisals. Recall tends to be disjointed. When patients with PTSD deliberately recall the worst moments of the trauma, they often do not access other relevant (usually subsequent) information that would correct impressions/predictions made at the time. A theoretical analysis of re-experiencing symptoms and their triggers is offered, and implications for treatment are discussed. These include the need to actively incorporate updating information ("I know now ...") into the worst moments of the trauma memory, and to train patients to discriminate between the stimuli that were present during the trauma ("then") and the innocuous triggers of re-experiencing symptoms ("now").
About 13 million people are classified as refugees worldwide, and many more former refugees have been granted citizenship in their new countries. However, the prevalence of post-traumatic stress disorder, major depression, or psychotic illnesses in these individuals is not known. We did a systematic review of surveys about these disorders in general refugee populations in western countries.
We searched for psychiatric surveys that were based on interviews of unselected refugee populations and that included current diagnoses of post-traumatic stress disorder, major depression, psychotic illnesses, or generalised anxiety disorder. We did computer-assisted searches, scanned reference lists, searched journals, and corresponded with authors to determine prevalence rates of these mental disorders and to explore potential sources of heterogeneity, such as diagnostic criteria, sampling methods, and other characteristics.
20 eligible surveys provided results for 6743 adult refugees from seven countries, with substantial variation in assessment and sampling methods. In the larger studies, 9% (99% CI 8-10%) were diagnosed with post-traumatic stress disorder and 5% (4-6%) with major depression, with evidence of much psychiatric comorbidity. Five surveys of 260 refugee children from three countries yielded a prevalence of 11% (7-17%) for post-traumatic stress disorder. Larger and more rigorous surveys reported lower prevalence rates than did studies with less optimum designs, but heterogeneity persisted even in findings from the larger studies.
Refugees resettled in western countries could be about ten times more likely to have post-traumatic stress disorder than age-matched general populations in those countries. Worldwide, tens of thousands of refugees and former refugees resettled in western countries probably have post-traumatic stress disorder.
In a previous community-based, national study among Iraqi asylum seekers, a long asylum procedure was found to have a higher risk for common psychiatric disorders than adverse life events in Iraq. In the present article, the postmigration period is considered in more detail and evaluated in relationship with psychiatric disorders. Respondents were interviewed with fully structured, culturally validated, translated questionnaires. With the use of a Post- migration Living Problems questionnaire, worries about all kinds of problems were gathered. Psychiatric (DSM-IV) disorders were measured with the Composite International Diagnostic Interview 2.1. Factor analysis was done on the postmigration living problems, and in univariate and multivariate analyses, associations with psychopathology were calculated. Results show that clusters of postmigration living problems could be identified: family issues, discrimination, asylum procedure, socioeconomic living conditions, socioreligious aspects, and work-related issues. There was a significant relationship between all clustered postmigration living problems and psychopathology, except for socioreligious aspects. Multivariate logistic regression showed that lack of work, family issues, and asylum procedure stress had the highest odds ratios for psychopathology. The findings appeal to governments to shorten the asylum procedures, allow asylum seekers to work, and give preference to family reunion. Mental health workers should recognize the impact of postmigration living problems and consider focusing their treatment on coping with these problems instead of traumas from the past.
We investigated the sociodemographic and clinical characteristics of asylum-seeking and refugee children and adolescents referred to a child and adolescent psychiatry service in the Netherlands. Children with families and unaccompanied minors were compared. Unaccompanied minors had significantly higher frequencies of symptoms and psychiatric disorders than the children with families, both considered a high-risk population for mental health problems.
Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial Abstract. Unaccompanied minor refugees (UMR) are a group particularly vulnerable to mental illness. They pose a great challenge not only for child and youth psychiatric and psychotherapeutic care, but also for youth-welfare institutions. The study examines the effectiveness of Stabilization Training for Adolescent Refugees with Trauma Induced Disorders in inpatient youth-welfare facilities. Methods: We conducted a randomized controlled trial with pre-post design in a naturalistic setting, randomly assigning 9 housing groups for UMRs to the intervention or waiting control condition. The mental stress of 46 UMRs was assessed by both self-report and educational staff-report. Two educational staff members conducted the Stabilization Training for Adolescent Refugees with Trauma Induced Disorders as an intervention in each of the respective residential groups. Results: Participation in training led to a reduction in subjective general psychological stress. At the end of the training, psychological stress in self-judgment was significantly lower in the intervention group than in the waiting control condition. The effectiveness of the training is apparently not reflected by educational staff assessments. Conclusions: Stabilization training is a suitable instrument for the preclinical care of UMR and thus an essential basis for further psychotherapy.
Background:
Today, almost half of all refugees worldwide are children and adolescents, nearly a quarter of whom arrive in Europe as Unaccompanied Refugee Minors (URM). Many URMs have experienced the cumulative stress of being exposed both to the adverse environmental conditions which drive forced migration, and to the traumatic experience of displacement and resettlement. These experiences, coupled with other developmental stressors, may impede their overall development and increase their likelihood of mental health problems. Despite the evident vulnerability of URMs, much controversy currently surrounds the legitimacy of their arrival in host countries and their mental health is given little consideration.
Objective:
This review synthesises and examines the limited published literature on the impact of traumatic refugee experiences on the mental health and development of URMs.
Methods:
Academic databases and other sources were searched using key terms relating to URMs and mental health.
Results:
The findings confirm in large part that being a URM negatively influences mental health development, and that adolescence and being female are particular indicators of increased risk of psychiatric disorders. However, cultural differences in measurement and assessment of mental health are important confounding factors.
Conclusions:
The current literature on youth in transit consistently paints a picture of how experiences URMs face can place a great burden on their mental health - clearly depicting an urgent need to consider their mental health within the current climate. The pressing need for improved care based on best practice is discussed.
Objective:
This article is the first investigation into the proportion of unaccompanied refugee minors suffering from psychiatric disorders in Germany. Method: In a retrospective study done between 2013 and 2015, any refugees showing symptoms of a psychiatric disorder during their stay in a residential refugee center were referred to an Outpatient Department of Child and Adolescent Psychiatry for diagnostic assessment. To this end, special consultation hours were arranged. Besides the diagnoses, the number of emergency consultations occurring before and after the implementation of the special consultation hours was recorded.
Results:
Of the 75 refugee minors (75 %) referred, 56 were suffering from a psychiatric disorder, with posttraumatic stress disorder and depression being the most common diagnoses. Following implementation of the consultation hours, the number of refugee patients initially admitted in the Child and Adolescent Psychiatry on an emergency basis fell.
Conclusions:
Unaccompanied refugee minors are a highly vulnerable group that poses great challenges to clinical care. The implementation of special consultation hours is a constructive option for meeting these challenges. In particular, this special offer enables improvement of crisis management in the case of emergency consultations.
Objective. This article reviews available qualitative studies that report young refugees' ways of dealing with adversity to address their sources of resilience. Design. We searched five electronic databases. Twenty-six empirical studies were included in the review. A meta-ethnography approach was used to synthesize these qualitative studies. Results. Six sources of resilience emerged: (1) social support, (2) acculturation strategies, (3) education, (4) religion, (5) avoidance, and (6) hope. These sources indi‐ cated social as well as personal factors that confer resilience in young refugees, but most of them also had counterproductive aspects. Conclusion. The results, from an ecological developmental perspective, stressed the interplay between protective and risk processes in the mental health of young refugees who had resettled in Western countries, and they emphasized the variability as well as the universality of resilience-promoting processes. Further research is needed to explore the cultural shape of resilience and the long-term consequences of war and migration on young refugees.
Objective:
This article reviews available qualitative studies that report young refugees' ways of dealing with adversity to address their sources of resilience.
Design:
We searched five electronic databases. Twenty-six empirical studies were included in the review. A meta-ethnography approach was used to synthesize these qualitative studies.
Results:
Six sources of resilience emerged: (1) social support, (2) acculturation strategies, (3) education, (4) religion, (5) avoidance, and (6) hope. These sources indicated social as well as personal factors that confer resilience in young refugees, but most of them also had counterproductive aspects.
Conclusion:
The results, from an ecological developmental perspective, stressed the interplay between protective and risk processes in the mental health of young refugees who had resettled in Western countries, and they emphasized the variability as well as the universality of resilience-promoting processes. Further research is needed to explore the cultural shape of resilience and the long-term consequences of war and migration on young refugees.
A primary goal of scale development is to create a valid measure of an underlying construct. We discuss theoretical principles, practical issues, and pragmatic decisions to help developers maximize the construct validity of scales and subscales. First, it is essential to begin with a clear conceptualization of the target construct. Moreover, the content of the initial item pool should be overinclusive and item wording needs careful attention. Next, the item pool should be tested, along with variables that assess closely related constructs, on a heterogeneous sample representing the entire range of the target population. Finally, in selecting scale items, the goal is unidimensionality rather than internal consistency; this means that virtually all interitem correlations should be moderate in magnitude. Factor analysis can play a crucial role in ensuring the unidimensionality and discriminant validity of scales. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style review was conducted searching nine major databases, bibliographies, and grey literature from 2003 to 2008. Included studies had to meet the reporting standards of STROBE and investigate mental health in non-clinical samples of asylum seeking and refugee children residing in OECD countries. A total of twenty-two studies were identified of 4,807 retrieved citations, covering 3,003 children from over 40 countries. Studies varied in definition and measurement of problems, which included levels of post-traumatic stress disorder from 19 to 54%, depression from 3 to 30%, and varying degrees of emotional and behavioral problems. Significant factors influencing levels of distress appear to include demographic variables, cumulative traumatic pre-migration experiences, and post-migration stressors. Importantly, the research base demands greater contextual and methodological refining such that future research would have greater generalizability and clinical implications.
Generalized Anxiety Disorder (GAD) and excessive worrying are characterized by a preoccupation with the future. Thus, enhanced identification of potential future punishments or omissions of reward may be related to the disorder. To test this hypothesis, n=47 students meeting GAD criteria according to the GADQ-IV (GAD analogues) or not (control participants) performed the Iowa Gambling Task, which has been related to sensitivity to future consequences. In order to disentangle sensitivity to future loss and sensitivity to high short-term loss magnitudes, which could also lead to enhanced Iowa Gambling Task performance, participants also performed a modified version of the task with reversed contingencies. In both versions, GAD analogues learned to avoid decisions with high probability of long-term loss significantly faster than control participants. Results, therefore, indicate that GAD is characterized by enhanced processing of potential future losses rather than sensitivity to large short-term loss.
The relations between temporal orientation and long-term psychological distress were studied cross-sectionally and longitudinally in 3 samples of traumatized individuals: adult victims of childhood incest, Vietnam War veterans, and residents of 2 southern California communities devastated by fire. Results indicated that a past temporal orientation--focusing attention on prior life experiences--was associated with elevated levels of distress long after the trauma had passed, even when controlling for the degree of rumination reported. Temporal disintegration at the time of the trauma--whereby the present moment becomes isolated from the continuity of past and future time--was associated with a high degree of past temporal orientation over time and subsequent distress. Temporal disintegration was highest among individuals who had experienced the most severe loss, had previously experienced chronic trauma, and had had their identities threatened by their traumatic experience.
This study examined the factor structure, internal consistency, concurrent validity, and discriminative validity of the Impact of Event Scale-Revised (IES-R, [Weiss, D. S. & Marmar, C. R. (1997). The Impact of Event Scale-Revised. In: J. P. Wilson & T. M. Keane (Eds.). Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford Press]) in a sample of 182 individuals who had experienced a serious motor vehicle accident. Results supported the three-factor structure of the IES-R, Intrusion, Avoidance, and Hyperarousal, with adequate internal consistency noted for each subscale. Support was obtained for the concurrent and discriminative validity, as well as the absence of social desirability effects. Although some differences were noted between the IES-R Avoidance subscale and diagnostically based measures of this cluster of symptoms, these differences do not necessarily signify measurement problems with the IES-R. The IES-R seems to be a solid measure of post-trauma phenomena that can augment related assessment approaches in clinical and research settings.
Insights into features of anxiety through multiple aspects of psychological time
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Diagnostic and statistical manual of mental disorder
American Psychiatric Association (2013) Diagnostic and statistical manual of mental
disorder (5th ed). Washington, DC: American Psychiatric Association.
Aktuelle Zahlen zu Asyl
Bundesamt für Migration und Flüchtlinge (2018) Aktuelle Zahlen zu Asyl, Ausgabe
November 2018. Available at: http://www.bamf.de/SharedDocs/Anlagen/DE/
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__blob=publicationFile. Accessed October 4, 2019.
Ergänzende Informationen zur Asylstatistik für das
- Deutscher Bundestag
Deutscher Bundestag (2019) Ergänzende Informationen zur Asylstatistik für das
Jahr 2018. Available at: http://dip21.bundestag.de/dip21/btd/19/087/1908701.
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Correlations between time perspective and personality traits in different age groups
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Time perspective theory; review, research and application: Essays in honor of
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Time perspective theory; review, research and application: Essays in honor of Philip G. Zimbardo
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Demand for help and provision of services in the care of unaccompanied refugee minors: A systematic review
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The time paradox: The new psychology of time that will change your life
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Time perspective theory; review, research and application: Essays in honor of
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