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Promoting Mental Health for Children and Their Caregivers Affected by the Syrian Conflict

  • Aala El-Khani
  • Rachel Calam
Chapter
Part of the Integrating Psychiatry and Primary Care book series (IPPC)

Abstract

The humanitarian crisis afflicting Syria is one of the gravest catastrophes worldwide, leading to the largest refugee displacement of our time and resulting in mass displacement of Syria’s population, both internally and as global refugees. Children are innocent victims of this conflict and are at particular risk of harm to their mental health and physical development. Two of the most important and modifiable factors related to psychological difficulties in children affected by armed conflict are parental support and monitoring. Improvements in these areas present great potential for preventive intervention. Although its importance is not often acknowledged, the care children receive from parents and primary caregivers during and after conflict can act as a significant protective barrier. Exploration of the impact of war and conflict on families often fails to recognize the significant link between this care and their emotional development and recovery from war trauma. Still, the challenges and stresses of war and displacement often affect parents’ capacity to provide children with the care they need. In this chapter, we explore the parenting challenges of Syrian families affected by conflict. We examine opportunities to design and deliver support for parents in this context, grounded in theory-based parenting principles and empirically identified needs. This design is constructed in order to inform interventions and policies that are family and system-focused, as well as culturally and contextually appropriate.

Keywords

Syria Conflict War Child Parenting Caregiver Intervention Program Refugee Displacement 

References

  1. Abou-Saleh M, Hughes P. Mental health of Syrian refugees: looking backwards and forwards. Lancet Psychiatry. 2015;2(10):870–1.  https://doi.org/10.1016/S2215-0366(15)00419-8.CrossRefPubMedGoogle Scholar
  2. Ajduković M, Ajduković D. Psychological well-being of refugee children. Child Abuse Negl. 1993;17(6):843–54.CrossRefGoogle Scholar
  3. Ajdukovic M, Dean A. Impact of displacement on the psychological well-being of refugee children. Int Rev Psychiatry. 1998;10(3):186–95.  https://doi.org/10.1080/09540269874763.CrossRefGoogle Scholar
  4. Almoshmosh N. The role of war trauma survivors in managing their own mental conditions, Syria civil war as an example. Avicenna J Med. 2016;6(2):54–9.  https://doi.org/10.4103/2231-0770.179554.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Annan J, Blattman C, Mazurana D, Carlson K. Civil war, reintegration, and gender in Northern Uganda. J Confl Resolut. 2011;55(6):877–908.  https://doi.org/10.1177/0022002711408013.CrossRefGoogle Scholar
  6. Attanayake V, McKay R, Joffres M, Singh S, Burkle F Jr, Mills E. Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. Med Confl Surviv. 2009;25(1):4–19.CrossRefGoogle Scholar
  7. Baird M, Boyle J. Well-being in Dinka refugee women of Southern Sudan. J Transcult Nurs. 2012;23(1):14–21.CrossRefGoogle Scholar
  8. Barenbaum J, Ruchkin V, Schwab-Stone M. The psychosocial aspects of children exposed to war: practice and policy initiatives. J Child Psychol Psychiatry. 2004;45(1):41–62.CrossRefGoogle Scholar
  9. Barlow J, Smailagic N, Ferriter M, Bennett C, Jones H. Group-based parent-training programmes for improving emotional and behavioural adjustment in children from birth to three years old. Cochrane Libr. 2010. doi: https://doi.org/10.1002/14651858.CD003680.pub2.
  10. Basoglu M, Mineka S. Psychological preparedness for trauma as a protective factor in survivors of torture. Year Book Psychiatry Appl Ment Health. 1999;1999(5):229–30.Google Scholar
  11. Betancourt T, Khan K. The mental health of children affected by armed conflict: protective processes and pathways to resilience. Int Rev Psychiatry. 2008;20(3):317–28.CrossRefGoogle Scholar
  12. Betancourt T, Williams T. Building an evidence base on mental health interventions for children affected by armed conflict. Intervention (Amstelveen, Netherlands). 2008;6(1):39.  https://doi.org/10.1097/WTF.0b013e3282f761ff.CrossRefGoogle Scholar
  13. Betancourt T, Agnew-Blais J, Gilman S, Williams D, Ellis B. Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone. Soc Sci Med. 2010;70(1):17–26.  https://doi.org/10.1016/j.socscimed.2009.09.038.CrossRefPubMedGoogle Scholar
  14. Betancourt T, Salhi C, Buka S, Leaning J, Dunn G, Earls F. Connectedness, social support and internalising emotional and behavioural problems in adolescents displaced by the Chechen conflict. Disasters. 2012;36(4):635–55.  https://doi.org/10.1111/j.1467-7717.2012.01280.x.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Betancourt T, Meyers-Ohki S, Charrow A, Tol W. Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care. Harv Rev Psychiatry. 2013;21(2):70.CrossRefGoogle Scholar
  16. Betancourt T, Abdi S, Ito B, Lilienthal G, Agalab N, Ellis H. We left one war and came to another: resource loss, acculturative stress, and caregiver–child relationships in Somali refugee families. Cultur Divers Ethnic Minor Psychol. 2015;21(1):114.  https://doi.org/10.1037/a0037538.CrossRefPubMedGoogle Scholar
  17. Bonanno G. Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? Am Psychol. 2004;59(1):20.  https://doi.org/10.1037/0003-066X.59.1.20.CrossRefPubMedGoogle Scholar
  18. Brand S, Schechter J, Hammen C, Brocque R, Brennan P. Do adolescent offspring of women with PTSD experience higher levels of chronic and episodic stress? J Trauma Stress. 2011;24(4):399–404.  https://doi.org/10.1002/jts.20652.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Bronfenbrenner U. The ecology of human development. Cambridge: Harvard University Press; 1979.Google Scholar
  20. Cartwright K, El-Khani A, Subryan A, Calam R. Establishing the feasibility of assessing the mental health of children displaced by the Syrian conflict. Glob Ment Health. 2015;2:e8.CrossRefGoogle Scholar
  21. Catani C, Jacob N, Schauer E, Kohila M, Neuner F. Family violence, war, and natural disasters: a study of the effect of extreme stress on children’s mental health in Sri Lanka. BMC Psychiatry. 2008;8(1):1.  https://doi.org/10.1186/1471-244X-8-33.CrossRefGoogle Scholar
  22. Chrisman A, Dougherty J. Mass trauma: disasters, terrorism, and war. Child Adolesc Psychiatr Clin N Am. 2014;23(2):257–79.  https://doi.org/10.1016/j.chc.2013.12.004.CrossRefPubMedGoogle Scholar
  23. Corps M. Advancing adolescence: getting Syrian refugee and host-community adolescents back on track. Portland, OR: Mercy Corps; 2014.Google Scholar
  24. Cowan C, Cowan P, Barry J. Couples’ groups for parents of preschoolers: ten-year outcomes of a randomized trial. J Fam Psychol. 2011;25(2):240.  https://doi.org/10.1037/a0023003.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Cummings E, Taylor L, Merrilees C, Goeke-Morey M, Shirlow P, Cairns E. Relations between political violence and child adjustment: a four-wave test of the role of emotional insecurity about community. Dev Psychol. 2013;49(12):2212.  https://doi.org/10.1037/a0032309.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Davidson G, Murray K, Schweitzer R. Review of refugee mental health assessment: best practices and recommendations. J Pac Rim Psychol. 2010;4(1):72–85.  https://doi.org/10.1375/prp.4.1.72.CrossRefGoogle Scholar
  27. De Jong J, Komproe I, Van Ommeren M. Common mental disorders in postconflict settings. Lancet. 2003;361(9375):2128–30.  https://doi.org/10.1016/S0140-6736(03)13692-6.CrossRefPubMedGoogle Scholar
  28. Dekel R, Goldblatt H. Is there intergenerational transmission of trauma? The case of combat veterans’ children. Am J Orthopsychiatry. 2008;78(3):281.  https://doi.org/10.1037/a0013955.CrossRefPubMedGoogle Scholar
  29. Diab M, Peltonen K, Qouta S, Palosaari E, Punamäki R. Effectiveness of psychosocial intervention enhancing resilience among war-affected children and the moderating role of family factors. Child Abuse Negl. 2015;40:24–35.CrossRefGoogle Scholar
  30. Dimitry L. A systematic review on the mental health of children and adolescents in areas of armed conflict in the Middle East. Child Care Health Dev. 2012;38(2):153–61.  https://doi.org/10.1111/j.1365-2214.2011.01246.x.CrossRefPubMedGoogle Scholar
  31. Drury J, Williams R. Children and young people who are refugees, internally displaced persons or survivors or perpetrators of war, mass violence and terrorism. Curr Opin Psychiatry. 2012;25(4):277–84.CrossRefGoogle Scholar
  32. Dubow E, Boxer P, Huesmann L, Shikaki K, Landau S, Gvirsman S, et al. Exposure to conflict and violence across contexts: relations to adjustment among Palestinian children. J Clin Child Adolesc Psychol. 2009a;39(1):103–16.  https://doi.org/10.1080/15374410903401153.CrossRefGoogle Scholar
  33. Dubow E, Huesmann L, Boxer P. A social-cognitive-ecological framework for understanding the impact of exposure to persistent ethnic–political violence on children’s psychosocial adjustment. Clin Child Fam Psychol Rev. 2009b;12(2):113–26.  https://doi.org/10.1007/s10567-009-0050-7.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Edward K, Warelow P. Resilience: when coping is emotionally intelligent. J Am Psychiatr Nurses Assoc. 2005;11(2):101–2.  https://doi.org/10.1177/1078390305277526.CrossRefGoogle Scholar
  35. Ekblad S. Psychosocial adaptation of children while housed in a Swedish refugee camp: aftermath of the collapse of Yugoslavia. Stress Med. 1993;9(3):159–66.  https://doi.org/10.1002/smi.2460090306.CrossRefGoogle Scholar
  36. El-Khani A, Cartwright K, Redmond A, Calam R. Daily bread: a novel vehicle for dissemination and evaluation of psychological first aid for families exposed to armed conflict in Syria. Glob Ment Health. 2016a;3:e15.  https://doi.org/10.1017/gmh.2016.9.CrossRefGoogle Scholar
  37. El-Khani A, Ulph F, Peters S, Calam R. Syria: coping mechanisms utilised by displaced refugee parents caring for their children in pre-resettlement contexts. Intervention. 2016b. doi: https://doi.org/10.1097/WTF.0000000000000136.CrossRefGoogle Scholar
  38. El-Khani A, Ulph F, Peters S, Calam R. Syria: the challenges of parenting in refugee situations of immediate displacement. Intervention. 2016c;14(2):99–113.  https://doi.org/10.1097/WTF.0000000000000118.CrossRefGoogle Scholar
  39. Flouri E, Midouhas E, Joshi H, Tzavidis N. Emotional and behavioural resilience to multiple risk exposure in early life: the role of parenting. Eur Child Adolesc Psychiatry. 2015;24(7):745–55.  https://doi.org/10.1007/s00787-014-0619-7.CrossRefPubMedGoogle Scholar
  40. Folkman S, Moskowitz J. Coping: pitfalls and promise. Annu Rev Psychol. 2004;55:745–74.  https://doi.org/10.1146/annurev.psych.55.090902.141456.CrossRefPubMedGoogle Scholar
  41. Furlong M, McGilloway S, Bywater T, Hutchings J, Smith S, Donnelly M. Group parenting programmes for improving behavioural problems in children aged 3 to 12 years. Cochrane Database Syst Rev. 2012;(2):CD008225.Google Scholar
  42. Goodman J. Coping with trauma and hardship among unaccompanied refugee youths from Sudan. Qual Health Res. 2004;14(9):1177–96.  https://doi.org/10.1177/1049732304265923.CrossRefPubMedGoogle Scholar
  43. Gorst-Unsworth C, Goldenberg E. Psychological sequelae of torture and organised violence suffered by refugees from Iraq. Trauma-related factors compared with social factors in exile. Br J Psychiatry. 1998;172(1):90–4.  https://doi.org/10.1192/bjp.172.1.90.CrossRefPubMedGoogle Scholar
  44. Harpaz-Rotem I, Rosenheck R, Desai R. Assessing the effects of maternal symptoms and homelessness on the mental health problems in their children. Child Adolesc Mental Health. 2009;14(4):168–74.  https://doi.org/10.1111/j.1475-3588.2008.00519.x.CrossRefGoogle Scholar
  45. Hassan G, Kirmayer K, Ventevogel P. Culture, context and the mental health and psychosocial wellbeing of Syrians. Geneva: UNHCR; 2015.Google Scholar
  46. Hijazi Z, Weissbecker I. Syria crisis: addressing regional mental health needs and gaps in the context of the Syria Crisis. Washington, DC: International Medical Corps; 2015.Google Scholar
  47. IMC & JHA. Displaced Syrians in Jordan: a mental health and psychosocial information gathering exercise. Analysis and interpretations of findings. Amman: International Medical Corps; 2013.Google Scholar
  48. IMC & UNICEF. Mental health/psychosocial and child protection for Syrian adolescent refugees in Jordan. 2014. http://reliefweb.int/organization/imc.Google Scholar
  49. Internal Displacement Monitoring Centre. Displacement caused by conflict and natural disasters, achievements and challenges. Geneva: Internal Displacement Monitoring Centre; 2012.Google Scholar
  50. James L, Sovcik A, Garoff F, Abbasi R. The mental health of Syrian refugee children and adolescents. Forced Migrat Rev. 2014;(47):42.Google Scholar
  51. Jordan BK, Marmar CR, Fairbank JA, Schlenger WE, Kulka RA, Hough RL, et al. Problems in families of male Vietnam veterans with posttraumatic stress disorder. J Consult Clin Psychol. 1992;60(6):916.CrossRefGoogle Scholar
  52. Jordans M, Pigott H, Tol W. Interventions for children affected by armed conflict: a systematic review of mental health and psychosocial support in low- and middle-income countries. Curr Psychiatry Rep. 2016;18(1):1–5.  https://doi.org/10.1007/s11920-015-0648-z.CrossRefGoogle Scholar
  53. Kakuma R, Minas H, van Ginneken N, Dal Poz M, Desiraju K, Morris J, et al. Human resources for mental health care: current situation and strategies for action. Lancet. 2011;378(9803):1654–63.  https://doi.org/10.1016/S0140-6736(11)61093-3.CrossRefPubMedGoogle Scholar
  54. Kaminski JW, Valle LA, Filene JH, Boyle CL. A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol. 2008;36(4):567–89.CrossRefGoogle Scholar
  55. Khamis V. Does parent’s psychological distress mediate the relationship between war trauma and psychosocial adjustment in children? J Health Psychol. 2014;21(7):1361–70.  https://doi.org/10.1177/1359105314553962.CrossRefPubMedGoogle Scholar
  56. Khawaja N, White K, Schweitzer R, Greenslade J. Difficulties and coping strategies of Sudanese refugees: a qualitative approach. Transcult Psychiatry. 2008;45(3):489–512.  https://doi.org/10.1177/1363461508094678.CrossRefPubMedGoogle Scholar
  57. Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515–25.CrossRefGoogle Scholar
  58. Kiliç C, Kiliç E, Aydin I. Effect of relocation and parental psychopathology on earthquake survivor-children’s mental health. J Nerv Ment Dis. 2011;199(5):335–41.  https://doi.org/10.1097/NMD.0b013e3182174ffa.CrossRefPubMedGoogle Scholar
  59. Kirmayer L, Narasiah L, Munoz M, Rashid M, Ryder A, Guzder J, et al. Common mental health problems in immigrants and refugees: general approach in primary care. Can Med Assoc J. 2011;183(12):E959–67.  https://doi.org/10.1503/cmaj.090292.CrossRefGoogle Scholar
  60. Klarić M, Klarić B, Stevanović A, Grković J, Jonovska S. Psychological consequences of war trauma and postwar social stressors in women in Bosnia and Herzegovina. Croat Med J. 2007;48(2):167–76. http://hrcak.srce.hr/12928.PubMedPubMedCentralGoogle Scholar
  61. Kline P, Mone E. Coping with war: three strategies employed by adolescent citizens of Sierra Leone. Child Adolesc Soc Work J. 2003;20(5):321–33.  https://doi.org/10.1023/A:1026091712028.CrossRefGoogle Scholar
  62. Kohrt B, Jordans M, Tol W, Speckman R, Maharjan S, Worthman C, et al. Comparison of mental health between former child soldiers and children never conscripted by armed groups in Nepal. JAMA. 2008;300(6):691–702.CrossRefGoogle Scholar
  63. Laor N, Wolmer L, Cohen D. Mothers’ functioning and children’s symptoms 5 years after a SCUD missile attack. Am J Psychiatry. 2001;158(7):1020–6.  https://doi.org/10.1176/appi.ajp.158.7.1020.CrossRefPubMedGoogle Scholar
  64. Larson J, Farrag M, Jamil H, Kafaji T, Abdulkhaleq H, Hammad A. Hope and fostering the well-being of refugees from Iraq. Ethn Dis. 2007;17(2):83.Google Scholar
  65. Lauterbach D, Bak C, Reiland S, Mason S, Lute M, Earls L. Quality of parental relationships among persons with a lifetime history of posttraumatic stress disorder. J Trauma Stress. 2007;20(2):161–72.  https://doi.org/10.1002/jts.20194.CrossRefPubMedGoogle Scholar
  66. Lazarus R, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.Google Scholar
  67. Macksoud M. Assessing war trauma in children: a case study of Lebanese children. J Refug Stud. 1992;5(1):1–5.  https://doi.org/10.1093/jrs/5.1.1.CrossRefGoogle Scholar
  68. Marlowe J. Beyond the discourse of trauma: shifting the focus on Sudanese refugees. J Refugee Stud. 2010;23(2):183–98.CrossRefGoogle Scholar
  69. Marshall G, Schell T, Elliott M, Berthold S, Chun C. Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005;294(5):571–9.  https://doi.org/10.1001/jama.294.5.571.CrossRefPubMedGoogle Scholar
  70. Marwa MK. Psychological distress among Syrian refugees: science and practice. Paper presented at the 12th World Congress on Stress, Trauma and Coping, Baltimore, US; Feb 2013.Google Scholar
  71. McElroy T, Muyinda H, Atim S, Spittal P, Backman C. War, displacement and productive occupations in northern Uganda. J Occup Sci. 2012;19(3):198–212.  https://doi.org/10.1080/14427591.2011.614681.CrossRefGoogle Scholar
  72. McMichael C, Manderson L. Somali women and well-being: social networks and social capital among immigrant women in Australia. Hum Organ. 2004;63(1):88–99.  https://doi.org/10.17730/humo.63.1.nwlpjdj4d4l9756l.CrossRefGoogle Scholar
  73. Miller K, Rasmussen A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med. 2010;70(1):7–16.  https://doi.org/10.1016/j.socscimed.2009.09.029.CrossRefPubMedGoogle Scholar
  74. Mollica R, Donelan K, Tor S, Lavelle J, Elias C, Frankel M, et al. The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps. JAMA. 1993;270(5):581–6.  https://doi.org/10.1001/jama.1993.03510050047025.CrossRefPubMedGoogle Scholar
  75. Mollica R, Cardozo BL, Osofsky H, Raphael B, Ager A, Salama P. Mental health in complex emergencies. Lancet. 2004;364(9450):2058–67.CrossRefGoogle Scholar
  76. Neugebauer R, Fisher P, Turner J, Yamabe S, Sarsfield J, Stehling-Ariza T. Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide. Int J Epidemiol. 2009;38(4):1033–45.  https://doi.org/10.1093/ije/dyn375.CrossRefPubMedGoogle Scholar
  77. Norris FH, Stevens SP, Pfefferbaum B, Wyche KF, Pfefferbaum RL. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am J Community Psychol. 2008;41(1–2):127–50.CrossRefGoogle Scholar
  78. Olema DK, Catani C, Ertl V, Saile R, Neuner F. The hidden effects of child maltreatment in a war region: correlates of psychopathology in two generations living in Northern Uganda. J Trauma Stress. 2014;27(1):35–41.CrossRefGoogle Scholar
  79. Özer B, Sirin S, Oppedal B. Bahçeşehir study of Syrian refugee children in Turkey. Istanbul: Bahçeşehir University; 2013. www.fhi.no/dokumenter/4a7c5c4de3.pdf.Google Scholar
  80. Panter-Brick C, Eggerman M, Gonzalez V, Safdar S. Violence, suffering, and mental health in Afghanistan: a school-based survey. Lancet. 2009;374(9692):807–16.  https://doi.org/10.1016/S0140-6736(09)61080-1.CrossRefPubMedPubMedCentralGoogle Scholar
  81. Panter-Brick C, Grimon M, Eggerman M. Caregiver—child mental health: a prospective study in conflict and refugee settings. J Child Psychol Psychiatry. 2014;55(4):313–27.  https://doi.org/10.1111/jcpp.12167.CrossRefPubMedGoogle Scholar
  82. Peltonen K, Punamäki RL. Preventive interventions among children exposed to trauma of armed conflict: a literature review. Aggress Behav. 2010;36(2):95–116.CrossRefGoogle Scholar
  83. Pfefferbaum B. Posttraumatic stress disorder in children: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 1997;36(11):1503–11.  https://doi.org/10.1016/S0890-8567(09)66558-8.CrossRefPubMedGoogle Scholar
  84. Pham P, Vinck P, Stover E. Returning home: forced conscription, reintegration, and mental health status of former abductees of the Lord’s Resistance Army in northern Uganda. BMC Psychiatry. 2009;9(1):1.  https://doi.org/10.1186/1471-244X-9-23.CrossRefGoogle Scholar
  85. Porter M, Haslam N. Forced displacement in Yugoslavia: a meta-analysis of psychological consequences and their moderators. J Trauma Stress. 2001;14(4):817–34.  https://doi.org/10.1023/A:1013054524810.CrossRefPubMedGoogle Scholar
  86. Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA. 2005;294(5):602–12.  https://doi.org/10.1001/jama.294.5.602.CrossRefPubMedGoogle Scholar
  87. Qouta S, Punamäki R, El Sarraj E. Child development and family mental health in war and military violence: the Palestinian experience. Int J Behav Dev. 2008;32(4):310–21.  https://doi.org/10.1177/0165025408090973.CrossRefGoogle Scholar
  88. Reed R, Fazel M, Jones L, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet. 2012;379(9812):250–65.  https://doi.org/10.1016/S0140-6736(11)60051-2.CrossRefPubMedGoogle Scholar
  89. Saile R, Neuner F, Ertl V, Catani C. Prevalence and predictors of partner violence against women in the aftermath of war: a survey among couples in Northern Uganda. Soc Sci Med. 2013;86:17–25.  https://doi.org/10.1016/j.socscimed.2013.02.046.CrossRefPubMedGoogle Scholar
  90. Sangalang C, Vang C. Intergenerational trauma in refugee families: a systematic review. J Immigr Minor Health. 2016;19(3):745–54.  https://doi.org/10.1007/s10903-016-0499-7.CrossRefGoogle Scholar
  91. Schnurr P, Friedman M, Green B. Post-traumatic stress disorder among World War II mustard gas test participants. Mil Med. 1996;161(3):131–6.CrossRefGoogle Scholar
  92. Schweitzer R, Melville F, Steel Z, Lacherez P. Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Aust N Z J Psychiatry. 2006;40(2):179–87.  https://doi.org/10.1080/j.1440-1614.2006.01766.x.CrossRefPubMedGoogle Scholar
  93. Schweitzer R, Greenslade J, Kagee A. Coping and resilience in refugees from the Sudan: a narrative account. Aust N Z J Psychiatry. 2007;41(3):282–8.  https://doi.org/10.1080/00048670601172780.CrossRefPubMedGoogle Scholar
  94. Seino K, Takano T, Mashal T, Hemat S, Nakamura K. Prevalence of and factors influencing posttraumatic stress disorder among mothers of children under five in Kabul, Afghanistan, after decades of armed conflicts. Health Qual Life Outcomes. 2008;6(1):1.  https://doi.org/10.1186/1477-7525-6-29.CrossRefGoogle Scholar
  95. Shachar-Dadon A, Gueron-Sela N, Weintraub Z, Maayan-Metzger A, Leshem M. Pre-conception war exposure and mother and child adjustment 4 years later. J Abnorm Child Psychol. 2016;45(1):1–2.  https://doi.org/10.1007/s10802-016-0153-9.CrossRefGoogle Scholar
  96. Shonkoff JP, Fisher PA. Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. Dev Psychopathol. 2013;25(4pt2):1635–53.CrossRefGoogle Scholar
  97. Sirin S, Rogers-Sirin L. The educational and mental health needs of Syrian refugee children. Washington, DC: Migration Policy Institute; 2015.Google Scholar
  98. Smith P, Perrin S, Yule W, Rabe-Hesketh S. War exposure and maternal reactions in the psychological adjustment of children from Bosnia-Hercegovina. J Child Psychol Psychiatry. 2001;42(3):395–404.  https://doi.org/10.1111/1469-7610.00732.CrossRefPubMedGoogle Scholar
  99. Steel Z, Silove D, Phan T, Bauman A. Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet. 2002;360(9339):1056–62.  https://doi.org/10.1016/S0140-6736(02)11142-1.CrossRefPubMedGoogle Scholar
  100. Steel Z, Chey T, Silove D, Marnane C, Bryant R, Van Ommeren M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537–49.  https://doi.org/10.1001/jama.2009.1132.CrossRefPubMedGoogle Scholar
  101. Stover C, Hall C, McMahon T, Easton C. Fathers entering substance abuse treatment: an examination of substance abuse, trauma symptoms and parenting behaviors. J Subst Abus Treat. 2012;43(3):335–43.  https://doi.org/10.1016/j.jsat.2011.12.012.CrossRefGoogle Scholar
  102. Thabet A, Vostanis P. Post traumatic stress disorder reactions in children of war: a longitudinal study. Child Abuse Negl. 2000;24(2):291–8.  https://doi.org/10.1016/S0145-2134(99)00127-1.CrossRefPubMedGoogle Scholar
  103. Thabet A, Abed Y, Vostanis P. Comorbidity of PTSD and depression among refugee children during war conflict. J Child Psychol Psychiatry. 2004;45(3):533–42.  https://doi.org/10.1111/j.1469-7610.2004.00243.x.CrossRefPubMedGoogle Scholar
  104. Thabet A, Ibraheem A, Shivram R, Winter E, Vostanis P. Parenting support and PTSD in children of a war zone. Int J Soc Psychiatry. 2009;55(3):226–37.  https://doi.org/10.1177/0020764008096100.CrossRefPubMedGoogle Scholar
  105. Thabet M, Aziz A, Abu-Khusah A, Vostanis P. The relationship between mothers’ mental health and the prevalence of depression and anxiety of preschool children after the War on Gaza Strip. Arab J Psychiatry. 2014;25(1):61–70.CrossRefGoogle Scholar
  106. Thorleifsson C. Coping strategies among self-settled Syrians in Lebanon. Forced Migrat Rev. 2014;(47):23.Google Scholar
  107. Tol W, Barbui C, Galappatti A, Silove D, Betancourt T, Souza R, et al. Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet. 2011;378(9802):1581–91.CrossRefGoogle Scholar
  108. Tol W, Song S, Jordans M. Annual research review: resilience and mental health in children and adolescents living in areas of armed conflict–a systematic review of findings in low- and middle-income countries. J Child Psychol Psychiatry. 2013;54(4):445–60.  https://doi.org/10.1111/jcpp.12053.CrossRefPubMedGoogle Scholar
  109. Trickey D, Siddaway AP, Meiser-Stedman R, Serpell L, Field AP. A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clin Psychol Rev. 2012;32(2):122–38.CrossRefGoogle Scholar
  110. UN OCHA. OCHA Syrian report. United Nations Office for the Coordination of Humanitarian Affairs. 2016. http://www.unocha.org/syrian-arab-republic/syria-country-profile/about-crisis.
  111. UNHCR. Gender based violence. Echoes from Syria (Protection Sector); 2014. pp. 1–5.Google Scholar
  112. UNHCR. United nations and partners in Syria 2011–2016. 2016. http://www.unocha.org/Syria/UNandPartners.pdf.
  113. Ventevogel P, Jordans M, Eggerman M, van Mierlo B, Panter-Brick C. Child mental health, psychosocial well-being and resilience in Afghanistan: a review and future directions. In: Handbook of resilience in children of war. New York: Springer; 2013. p. 51–79.  https://doi.org/10.1007/978-1-4614-6375-7_5.CrossRefGoogle Scholar
  114. Vossoughi N, Jackson Y, Gusler S, Stone K. Mental health outcomes for youth living in refugee camps: a review. Trauma Violence Abuse. 2016;  https://doi.org/10.1177/1524838016673602.CrossRefGoogle Scholar
  115. Vukcevic M, Dobric J, Puric D. Psychological characteristics of asylum seekers from Syria. Survey of the mental health of asylum seekers in Serbia. Belgrade: UNHCR Serbia; 2014. p. 73–85.Google Scholar
  116. White M. Working with people who are suffering the consequences of multiple trauma: a narrative perspective. Int J Narrative Ther Commun Work. 2004;2004(1):45.Google Scholar
  117. WHO. Mental health: new understanding, new hope. In: World health report 2001. Geneva, Switzerland: World Health Organization; 2001.Google Scholar
  118. WHO, & IMC. Assessment of mental health and psychosocial support needs of displaced Syrians in Jordan. Geneva, Switzerland: World Health Organization and International Medical Corps; 2014.Google Scholar
  119. Williams N. Establishing the boundaries and building bridges. A literature review on ecological theory: implications for research into the refugee parenting experience. J Child Health Care. 2009;14(1). doi: https://doi.org/10.1177/1367493509347116.CrossRefGoogle Scholar
  120. Williams N. Child welfare and the UNHCR: a case for pre-resettlement refugee parenting education. Dev Pract. 2012;22(1):110–22.  https://doi.org/10.1080/09614524.2012.630980.CrossRefGoogle Scholar
  121. Zwi M, Jones H, Thorgaard C, York A, Dennis J. Parent training interventions for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 5 to 18 years. Cochrane Libr. 2011. doi: https://doi.org/10.1002/14651858.CD003018.pub3.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Aala El-Khani
    • 1
  • Rachel Calam
    • 1
  1. 1.Division of Psychology and Mental Health, Faculty of Biology, Medicine, and HealthThe University of ManchesterManchesterUK

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