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Predictors of Psychological Risk and Resilience Over Time Among Syrian Refugee Children in Lebanon

Wed, April 7, 10:00 to 11:30am EDT (10:00 to 11:30am EDT), Virtual

Abstract

Introduction: At least 500,000 Syrian refugee children are currently living in Lebanon, many in informal camps (United Nations High Commissioner for Refugees; UNHCR, 2020). These children have experienced potentially traumatic and protracted war exposure, in addition to ongoing post-displacement adversity. However, while some children develop significant psychological problems, others appear to adapt (Çeri, Nasıroğlu, Ceri, & Çetin, 2018). Our aims were to investigate how mental health and resilience in Syrian refugee children develop over time, and identify what factors predict those outcomes.
Hypotheses: We hypothesised that approximately half of our sample would be resilient at a single time point but that there would be changes in mental health between waves. We also expected that both individual and social factors would predict mental health outcomes.
Study population: Our sample included 1581 Syrian refugee children aged 8-16 living in informal tented settlements in Lebanon and their primary caregiver. Settlements were selected to represent a range of vulnerabilities according to the UNHCR index (UNHCR, 2017). Follow-up data was collected from 1008 (64%) of the original sample one year later.
Methods: Data was collected via interview with each child and their primary caregiver separately. Children reported symptoms of post-traumatic stress disorder (PTSD) and depression, and a range of psychosocial factors such as self-esteem and loneliness. Caregivers reported their child’s externalising behaviour problems, and further social and environmental factors such as their living environment. Cut-offs for the mental health questionnaires were validated against clinical interviews in a sub-sample. Children’s war exposure was measured using a combination of child and caregiver report, to improve reliability of the measure (Oh et al., 2018). All measures were repeated in Wave 1 and Wave 2. At Wave 1, children were classed as resilient if they reported war exposure and fell below the cut-offs for PTSD, depression, and externalising behaviour problems. If a child scored above any single cut-off they were classed as potentially at risk. We performed logistic regression analyses controlling for war exposure to see what psychosocial factors predicted resilience group membership. Wave 2 data analysis to investigate risk and resilient groups and predictors of mental health over time is currently in progress. We have applied the same risk and resilience classification at Wave 2 and plan to create groups based on their mental health trajectories between waves. We will then perform multinomial logistic regression analyses to investigate predictors of trajectory class membership.
Results: 19.5% of the Wave 1 sample met our resilience criteria. Logistic regression analyses at Wave 1 showed that both individual and social factors significantly predicted resilience group membership when controlling for war exposure. For example, self-esteem increased the odds of being in the resilience group (OR = 1.52, 95% CI[1.31, 1.77]), while environmental sensitivity, a common temperament trait (OR = 0.73, 95% CI[0.64, 0.83]), and child abuse and neglect (OR = 0.95, 95% CI[0.94, 0.97]) decreased the odds. These results help us understand risk and resilience in Syrian refugee children over time, and identify potential factors to target for mental health interventions.

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