Academic journal article International Journal of Population Research

Resilience and Its Association with Depression, Emotional and Behavioural Problems, and Mental Health Service Utilisation among Refugee Adolescents Living in South Australia

Academic journal article International Journal of Population Research

Resilience and Its Association with Depression, Emotional and Behavioural Problems, and Mental Health Service Utilisation among Refugee Adolescents Living in South Australia

Article excerpt

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Tahereh Ziaian 1 and Helena de Anstiss 1 and Georgia Antoniou 2 and Peter Baghurst 2 and Michael Sawyer 3

Recommended by Cherylynn Bassani

1, School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, City East Campus, North Terrace, Adelaide, SA 5000, Australia 2, Public Health Research Unit, Women's and Children's Hospital, Children, Youth and Women's Health Service, 72 King William Road, North Adelaide, SA 5006, Australia 3, Research and Evaluation Unit, Women's and Children's Hospital, Children, Youth and Women's Health Service, 72 King William Road, North Adelaide, SA 5006, Australia

Received 10 December 2011; Revised 14 March 2012; Accepted 15 March 2012

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Approximately 13,750 refugees arrive in Australia each year, with children and adolescents comprising at least half of this number [1]. Current knowledge suggests that some of these young new arrivals may be at elevated risk of mental health problems associated with a range of traumatic experiences before, during, and after migration [2, 3]. For example, two Australian studies on the prevalence of psychiatric disorders in refugee children reported rates of 18% [4] and 32% [5] for any psychiatric disorder. The most commonly reported mental health problems in refugee children are posttraumatic stress disorder and depression though studies have found widely varying rates of incidence. For instance, 18% of Iranian refugee children in Sweden, 25% of Bosnian children, and 57% of Cuban refugee children in the US were found to suffer from PTSD [6-8]. Depressive disorders, including major depression, were reported among 17% of Bosnian adolescents [8] and 12.9% Cambodian children exiled in the US ([9]; see also, [10]); while 11.5% Tibetan refugee children in India were also diagnosed as suffering from both PTSD and major depression [11]. A systematic review combining data from five studies with 260 refugee children from Bosnia, Central America, Iran, Kurdistan, and Rwanda, and residing in Canada, Sweden, and the US, found a mean rate of 11% for PTSD [12]. A dose-effect relationship has also been indicated with increasing exposure to traumatic experiences predicting more PTSD symptoms (e.g., [6, 13]). A recent Australian study demonstrated a rate of 7.2% for depression in refugee children and adolescents [14].

Although most young refugees exposed to trauma do not develop mental health problems [15, 16], resilience and coping are largely neglected in refugee research, theory, and practice [17-19]. Resilience is broadly defined as the ability of a person to successfully adapt to or recover from stressful or traumatic experiences [20]. For example, it is a school-aged child's ability to make friends, engage in academic pursuits, be guided by primary caregivers, and engage in other behaviours acceptable in his or her society, as well as, be resistant to psychological illness, despite experiencing significant adversity (e.g., war, political oppression, poverty, and child abuse). Although initially, resilience theory focused on personal attributes such as self-esteem, self-efficacy, and hardiness [21], resilience is currently recognised as a multidimensional construct including personal characteristics and skills (e.g., active problem solving) as well as external protective factors such as a supportive family and social environment [22]. It is also conceptualised as a dynamic process that fluctuates according to age, gender, individual circumstance and developmental, historical, and cultural context ([23]; see also [20]).

Although increasing exposure to traumatic experiences has been related to higher levels of psychiatric symptoms in both young and adult refugees, a number of protective/risk factors have been found to impact on their psychological well being. …

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