Understanding Social Influences on Child PTSD Among Afghan Refugee Families Affected by Trauma

了解社会对受创伤影响的阿富汗难民家庭儿童创伤后应激障碍的影响

• 批准号: 2689613
• 金额: --
• 依托单位: University of Bath
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2689613
• 关键词: Understanding; Social; Influences; Child; PTSD

Context of the ResearchChildren growing up in war-affected regions in low- and middle-income countries (LMICs) are more susceptible to trauma exposure due to regional conflict, housing insecurity, poverty, and community violence (Hofman et al., 2005). In such high-adversity contexts, ground-level accessible psychological services are extremely limited and members of children's social environment, predominantly parents and peers, are likely to be their key source of support following traumatic events (Saxena et al., 2007).A large body of research has found that a majority of children exposed to acute traumatic events identify parents as their principal source of emotional support (Dixon et al., 2016), and that parent-child conversations about traumatic experiences and associated emotions are common (Alisic et al., 2017). Parental PTSD is also prevalent among war-affected families, and there is increasing recognition that parental PTSD may influence children's coping strategies and recovery due to impacts on parenting styles (Williamson et al., 2017). Moreover, peer support and good-quality friendships are also important to protect children's mental health in war-affected contexts (Peltonen et al., 2010). The literature suggests negative peer relations may mediate associations between war-related trauma and posttraumatic stress (Diab et al., 2018). In contrast, peer support can promote children's mental health and help them overcome negative outcomes associated with traumatic experiences.In sum, whereas social support has been established as a key influence on child PTSD in low risk, HICs communities, much less is known about this among vulnerable families in LMIC, conflict-affected contexts where children are likely to be exposed to multiple traumas. As a result of 41 years of war in Afghanistan, Afghan refugees have suffered collective and intergenerational trauma, even several years after resettlement (Roozbeh et al., 2018). This research comprises an investigation of caregiver and peer factors in relation child PTSD and trajectories of posttrauma recovery among Afghan refugees in Iran.Objectives and Methods1. To explore perspectives of refugee children and their caregivers on trauma and perceived social support.2. To examine trauma related aspects of caregiver and peer support as predictors of initial child PTSD symptoms posttrauama, and symptom change over time.3. To explore pathways from caregiver trauma and PTSD to child symptoms, through parental responding.Phase one:Objective 1 will be explored via qualitative interviews with trauma-exposed children, aged 6 to 17, and their primary caregivers living in two provinces of Iran. The interviews will explore refugee caregivers' perceptions of their child's PTSD, parental support, child's perspective on peer support, coping strategies, and ideal ways of support following trauma.Phase two:Objectives 2 and 3 will be met through a prospective longitudinal study of Afghan children and their caregivers in two provinces of Iran, where Afghan refugee families face additional difficulties. We aim to recruit children and their primary caregivers via HAMI NGO offices in Khorasan, one of the main board crossing points for newly arrived asylum seekers.Potential ApplicationsThere is a huge gap between the quality of life for refugees resettled in HICs and those in the LMICs. While 85% of refugees worldwide are hosted in LMICs (UNHCR, 2020), most of our knowledge of social influences on child PTSD comes from HIC communities. This study will make a substantial contribution to our theoretical understanding of PTSD among trauma-exposed refugee families in LMICs. Crucially, the focus on hard-to-reach and understudied groups at extremely high risk will generate new data highly relevant to the development of public policy and novel intervention approaches.

研究背景在低收入和中等收入国家（LMICs）受战争影响地区长大的儿童更容易受到区域冲突、住房不安全、贫困和社区暴力造成的创伤（Hofman等人，2005年）。在这种高度逆境的情况下，基层可获得的心理服务极其有限，儿童社会环境的成员，主要是父母和同龄人，可能是他们在创伤事件后的主要支持来源（Saxena等人，大量的研究发现，大多数暴露于急性创伤事件的儿童将父母视为他们情感支持的主要来源（狄克逊等人，2016年），并且关于创伤经历和相关情绪的亲子对话是常见的（Alisic et al.，2017年）。父母的PTSD在受战争影响的家庭中也很普遍，并且越来越多的人认识到父母的PTSD可能会影响儿童的应对策略和恢复，这是由于对父母教养方式的影响（威廉姆森等人，2017年）。此外，同伴支持和高质量的友谊对于在受战争影响的环境中保护儿童的心理健康也很重要（Peltonen等人，2010年）。文献表明，消极的同伴关系可能介导与战争有关的创伤和创伤后应激之间的关联（Diab等人，2018年）。相比之下，同伴支持可以促进儿童的心理健康，帮助他们克服与创伤经历相关的负面结果。总之，尽管社会支持已被确立为低风险、高收入国家社区儿童创伤后应激障碍的关键影响因素，但在低收入国家、受冲突影响的环境中，儿童可能遭受多种创伤的弱势家庭对此知之甚少。由于阿富汗41年的战争，阿富汗难民遭受了集体和代际创伤，即使在重新安置后几年也是如此（Roophih等人，2018年）。本研究包括一项调查的照顾者和同伴因素的关系儿童创伤后应激障碍和创伤后恢复的轨迹之间的阿富汗难民在Iran.ObjectiveandMethod1。探讨难民儿童及其照顾者对创伤与知觉社会支持的看法.探讨创伤相关方面的照顾者和同伴支持作为儿童创伤后应激障碍症状的预测因子，以及症状随时间的变化。探索途径照顾者创伤和创伤后应激障碍的儿童症状，通过parental responsibility.Phase 1：目标1将探讨通过定性访谈创伤暴露的儿童，年龄在6至17岁，他们的主要照顾者生活在伊朗的两个省。访谈将探讨难民照顾者的看法，他们的孩子的创伤后应激障碍，父母的支持，孩子的观点对同伴的支持，应对策略，和理想的方式支持后traumatic.Phase第二阶段：目标2和3将通过一个前瞻性的纵向研究阿富汗儿童和他们的照顾者在伊朗的两个省，阿富汗难民家庭面临额外的困难。我们的目标是通过位于呼罗珊的HAMI非政府组织办事处招募儿童及其主要照顾者，呼罗珊是新抵达的寻求庇护者的主要过境点之一。潜在的申请重新安置在高收入国家和低收入国家的难民的生活质量存在巨大差距。虽然全球85%的难民被收容在低收入国家（联合国难民署，2020年），但我们对儿童创伤后应激障碍的社会影响的大部分知识来自高收入国家社区。本研究将为我们对中低收入国家创伤暴露难民家庭中PTSD的理论理解做出重大贡献。至关重要的是，对难以接触和研究不足的极高风险群体的关注将产生与制定公共政策和新的干预方法高度相关的新数据。