The investigation of change mechanisms in trauma-focused interventions for traumatized refugee minors

难民未成年人是经历创伤事件和报告创伤后应激障碍(PTSD)或抑郁症等与创伤有关的疾病的高度脆弱群体。关于如何成功地治疗儿童和青少年的这些障碍，有大量的研究，一些研究已经调查了对难民未成年人的最先进的干预措施。然而，在个人尤其是基于群体的干预中，关于症状减轻和改变机制的预测因子(调节因子)的文献中存在着显著的差距。因此，我们知道哪些干预措施有效，但不知道它们是如何发挥作用的。因此，这项研究金提案旨在对受创伤的未成年人难民进行以证据为基础、以创伤为重点的团体干预，调查潜在的主持人和调解人。在研究问题1中，我将调查在治疗过程中创伤后应激障碍和抑郁症状减轻的几个关键调节因素。除了精神病理学，还将调查所谓的移民后应激源(例如，与家庭分离或歧视)、社会人口因素和日常功能。在研究问题2中，抑郁将被评估为创伤后应激障碍症状变化的中介因素，因为这些疾病有几个共同的特征，以创伤为重点的干预措施导致两个障碍患者的症状减轻。这项奖学金将嵌入根特大学的欧洲地平线2020项目“难民健康学校”(https://refugeeswellschool.org)，)中，主要项目协调员是Ilse Derluyn教授。该项目的总体目标是评估以学校为基础的预防性干预措施在促进难民和移民青少年心理健康方面的作用，并在不同欧洲国家的不同常规教育环境中成功实施这些干预措施。这项研究金提案对于调查创伤干预措施的主持人和调解人特别有益，因为该项目的样本量相对较高，具有多样性和代表性，包括居住在不同欧洲国家的未成年难民。这项建议的结果将对一般以创伤为重点的干预措施的发展、评估和传播产生重要影响。他们还可能指导从业者在未来实施以创伤为重点的干预措施，因为结果可能会阐明在提供治疗期间应关注哪些个人因素这一重要问题。在个人层面上，根特大学拟议的奖学金将帮助我扩大我对难民心理健康和以创伤为重点的干预措施的知识，提高我的方法技能，并为进一步的项目和合作创造机会。此外，该奖学金将使我拥有广泛的技能组合，以便在德国追求成功的研究事业，并能够为未来自己的研究项目获得资金。

Refugee minors constitute a highly vulnerable population for experiencing traumatic events and reporting trauma-related disorders such as posttraumatic stress disorder (PTSD) or depression. There is a large body of research on how to successfully treat these disorders in children and adolescents and several studies have already investigated state-of-the-art interventions in refugee minors. There is, however, a significant gap in the literature regarding predictors (moderators) of the symptom reduction and change mechanisms (mediators) in individual and especially group-based interventions. Hence, we know which interventions work, but not how they work. This fellowship proposal therefore aims at investigating potential moderators and mediators in an evidence-based trauma-focused group intervention for traumatized refugee minors. In research question 1, I will investigate several crucial moderators of PTSD and depression symptom reduction in the course of treatment. Next to psychopathology, so-called post-migration stressors (e.g. separation from family or discrimination), socio-demographic factors and daily functioning will be investigated. In research question 2, depression will be evaluated as a mediator of PTSD symptom change as these disorders share several characteristics and trauma-focused interventions result in symptom reductions in both disorders.This fellowship will be embedded in the European Horizon 2020 project “RefugeesWellSchool” (https://refugeeswellschool.org), at the Ghent University with Prof. Dr. Ilse Derluyn being the main project coordinator. This project’s overall objective is to evaluate the role of preventive, school-based interventions in promoting refugee and migrant adolescent’s mental well-being, and successfully implementing them in diverse routine educational settings in different European countries. This fellowship proposal is particularly beneficial for investigating moderators and mediators of trauma-focused interventions because the project has a comparatively high, heterogeneous and representative sample size including refugee minors who live in different European countries. The findings of this proposal will have important implications for the development, evaluation, and dissemination of trauma-focused interventions in general. They also may guide practitioners in implementing trauma-focused interventions in the future, as the results might shed light on the important question which individual factors to focus on during the delivery of a treatment.On a personal level, the proposed fellowship at Ghent University will help me to expand my knowledge about refugee mental health and trauma-focused interventions, improve my methodological skills, and create opportunities for further projects and collaborations. Moreover, the fellowship will equip me with a broad portfolio of skills to pursue a successful research career in Germany and to be able to acquire funding for own research projects in the future.