Broadening horizons: Shedding light on pubertal timing and mental health in war-affected refugee children.

• In Event: Emerging Approaches to Research on Pubertal Timing

Abstract

Introduction: Ninety percent of adolescents live in low- and middle-income countries, yet this population is poorly described in the pubertal timing literature. Non-WEIRD populations often face elevated poverty, less stable environments, and more violent conflict than WEIRD populations and these factors are known to impact both pubertal timing and mental health. Here, we investigate how the Syrian Civil War has impacted Syrian refugee children’s developmental trajectories and whether these altered trajectories have mental health implications. We also examine whether post-war experiences present opportunities to improve—or worsen—these impacts.

Hypotheses: We first tested whether the effects of refugee war and displacement on mental health are mediated by pubertal timing. We then tested whether post-war environment risk and protective factors moderate the effects of war exposure on both pubertal timing and mental health. This study focused on caregiving quality and social support (both positive and negative) of the post-war environment.

Study Population: This study is based on data from the longitudinal Biological Pathways of Risk and Resilience in Syrian Refugee Children (BIOPATH) study led by Dr. Michael Pluess at Queen Mary University of London. Syrian refugee families were recruited from temporary settlements in Lebanon over two years. Inclusion criteria were: (1) family has a child between 8 and 16 years of age, (2) family left Syria within previous four years, and (3) at least one caregiver could answer questions about the child. In Wave 1 (winter 2017-18), 1,596 child-caregiver pairs participated in the study; one year later, we followed up with 1,009 of these pairs in Wave 2 of data collection (winter 2018-19).

Methods: Children and caregivers completed a battery of questionnaires (child report, parent report, and parent report on child). Children were measured biometrically (height, weight, hip/waist circumference), provided hair samples (to measure DHEA, cortisol, and testosterone), and provided saliva samples for genome-wide single nucleotide polymorphism genotyping, epigenetic analyses, and telomere analysis. The current study used a subset of these measures, particularly: 1) war exposure questionnaire, 2) hair hormones, 3) biometric assessments (height, weight, hip/waist circumference), 3) pubertal development, 4) perceived refugee environment, 5) caregiving quality, 6) quality of social relationships, and 7) mental health (depression, anxiety, PTSD, and externalizing behavior.

Results: Preliminary analyses suggest that pubertal timing plays a stronger mediating role between war exposure and mental health in girls compared with boys. The post-war environment played different roles for boys versus girls as well. Among boys, social support, engaged parenting, and a well-resourced refugee camp environment reduced the impact of war exposure on pubertal timing and mental health. Girls, however, did not benefit from positive post-war qualities and experienced worse outcomes when exposed to abusive parenting, conflicts with caregivers, and peer bullying. These findings suggest that interventions designed to support war-affected youth may need to develop unique programming for boys and girls.

Authors

• Candace Jasmine Black, Queen Mary University of London
  Presenting Author

• Fiona S McEwen, Queen Mary University of London

• Demelza Smeeth, Queen Mary University of London

• Cassandra Popham, Queen Mary University of London

• Elie Karam, Institute for Development, Research, Advocacy and Applied Care

• Michael Pluess, Queen Mary University of London