Syrian and Iraqi caregiver-child perimigration stress and wellbeing in resettlement: A community-engaged assessment

• In Event: Refugee caregiver-child mental health: Pathways to promote well-being across migration

Abstract

Introduction: 
Every year, X number of refugee children are resettled in western countries. Refugee caregivers are known to face considerable displacement-related stress (DS) on the journey to resettlement (Miles et al., 2019) and about half of refugees are minors, indicating that the vast majority of refugees are caregivers and children. There are limited tools available to measure the impact of these experiences on caregiver-child mental health and limited knowledge of the unique risk and protective factors impacting caregiver wellbeing in resettlement. This project explores relations between perimigration stress and caregiver-child wellbeing in a resettlement context using a community-based participatory research design. 

Methods: 
A sample of 75 refugee caregivers (74% Syrian and Iraqi, 92% female) with an average age of 33 (Range=21-47) participated in a Community-Based Participatory Research survey study. The project was designed and implemented in an iterative series of steps utilizing a community-based participatory research design. Caregivers completed measures on child internalizing and externalizing (CBCL; Achenbach et al., 2001, or BITSEA; Briggs-Gowan et al., 2004), perceived stress (PSS-4; Cohen et al., 1983), depression (CESD-10; Radloff, 1977), anxiety (GAD-7; Spitzer et al., 2006), the use of positive religious coping (Abbreviated RCOPE; Pargament et al., 2011), protective parenting beliefs (PAPF; Kiplinger & Harper Browne, 2014), discrimination, (RISE; Jini & Puma, 2018), and parent-child stress experiences in displacement (DEQ, Miles et al., in prep). Relations between DS and parent and child mental health were examined using multiple linear regression, moderation, and mediation analyses with bootstrapping. Direct paths between DS and parent-child mental health and parent mental health and child mental health were tested. Next, parent mental health was tested as a mediator of DS on child mental health. Religious coping, parental resilience, and discrimination were tested as moderators on all direct paths. 

Results: 
Parent DS was associated with elevated perceived stress and this relationship was moderated by religious coping such that greater religious coping predicted lower stress when DS was higher. Greater child DS was linked with elevated caregiver depression, anxiety, and perceived stress; however, parental resilience moderated the effect of child DS on parent stress such that its protective effects were lower when child DS was higher. Discrimination moderated the effect of child DS on parent anxiety, such that lowered child DS only predicted less caregiver anxiety when discrimination was also low. Parent depression partly mediated the effect of child DS on child internalizing symptoms. Parent anxiety predicted child somatic symptoms and this relationship was moderated by discrimination such that children had higher somatic symptoms when parents reported both greater anxiety and discrimination.

Discussion: 
Parent mental health in resettlement appears to be negatively impacted by child exposure to adversity during migration. However, these relations were often dependent on other risk and protective influences, notably parental resilience and discrimination. Experiences of discrimination also meaningfully impact the effect of parent mental health on indicators of child mental health. This project contributes critically needed information on links between displacement and wellbeing in resettlement as well as possible intervention targets for psychosocial programming.

Authors

• Elly Miles, Urban Institute
  Presenting Author

• Lydia J. Mathis, University of Denver

• Julie Olomi

• Anne DePrince, University of Denver

• Paul Stein

• Abir Alkabani

• Soad Altaai

• Mohamed Juma

• Sarah E Watamura, University of Denver