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Mental illness in refugee families

Mental illness in refugee families: Understanding children’s Vulnerability

Children in refugee families are especially vulnerable to parental mental illness (see Thomas & Lau, 2001, who review much of the literature in this section). They are more likely to have parents with a psychological disorder than the general community  and to suffer froman increased incidence of disorders themselves, when compared with non refugee peers.The coincidence of parental and child psychological disorder due to bothhaving been exposed to trauma is illustrated, for example, by the study of ahighly traumatised group of Cambodian refugees reported by Sack et al.(1994). Post-traumatic stress disorder rates for mothers and fathers were 53per cent and 29 per cent respectively, and depression rates were 23 per centand 14 per cent respectively, while their children aged 13–25 years had an 18per cent prevalence of post-traumatic stress disorder and an 11 per cent rateof depressive disorder. Studies of psychological morbidity among adultrefugees assessed in their country of asylum have found variable prevalencerates of up to two-thirds or higher of the population examined (see Carlson &Rosser-Hogan, 1993; Westermeyer, 1988; Hauff & Vaglum, 1994). The most common disorders in refugee populations are depression, post-traumaticstress disorder and other anxiety disorders, and rates of comorbidity are typically high (for example, Hubbard et al., 1995). Some studies have found that symptoms diminish rapidly after settlement (Beiser, 1988; Westermeyeret al., 1989), but other findings describe the persistence of high rates ofdisorder over many years (Hauff & Vaglum, 1995; Chung & Kagawa-Singer,1993). Levels of pre-migration trauma are positively correlated with rates of disorder, and psychosocial stressors associated with settlement variables strongly mediate psychological well-being (Steel & Silove, 2000). Child refugees from many different countries of origin have also been found to exhibit high rates of psychological disorder following migration, with the expected positive correlation between levels of exposure to trauma and post traumatic stress disorder prevalence (Thomas & Lau, 2001; Slone, Adiri &Arian, 1998). Broad cross-cultural similarity in the forms of psychologicaldisturbance have been found. Symptom patterns appear in general terms tofollow those seen in Western populations; that is, anxiety reactions, phobias,play with traumatic themes, aggressive behaviour, regression and social withdrawal among pre-school-aged children; and by adolescence children begin to display a similar symptom picture to that of adults, but with more pronounced effects in the areas of personality development, identityf ormation and anti-social behaviour (for example, Thomas & Lau, 2001).

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