Refugee children from the Middle East

OBJECTIVE: To map the frequency (prevalence) of torture victims among parents in asylum seeking Middle Eastern refugee families, to map the occurrence (prevalence) of experiences of war and other forms of organised violence among the children in these families, to map the occurrence (prevalence) of emotional symptoms and behavioural problems among the children, and to identify risk indicators and modifying factors for anxiety symptoms among the children. DESIGN: Interview with parents using a structured interview questionnaire developed for this study. Validated through a blinded semi-structured interview conducted with approximately 1/3 of the families. AUSPICES: The study has been carried out by the Rehabilitation and Research Centre for Torture Victims (RCT) in cooperation with the Danish Red Cross. MATERIAL: Structured interviews with parents regarding 311 children aged 3-15 from 149 families, all registered as asylum seekers from the Middle East between February 1, 1992 and April 30, 1993. The response was 90.4%. PRINCIPAL VARIABLES: Background (past-past)--social and demographic data; trauma complex (past)--war-related life circumstances (conditions) and experiences of war and other forms of organized violence such as loss, separation, direct exposure to violence and witnessing acts of violence (specific events and changes of life conditions); present life context (past-present)--family circumstances upon arrival in Denmark; effect (present)--the child's current psychological state. RESULTS: 28% of the parents (44% of the fathers and 13% of the mothers) had been tortured, to the effect that 51% of the children were part of a family including a survivor of torture. The most frequent specific types of violence-related events or circumstances were 'lived in a refugee camp outside the home country' (92%), 'lived under conditions of war' (89%) and 'been on the run with parents' (89%). Twenty percent of the children had lost one parent, and another 60% had been separated from one parent for more than a month. The highest prevalence of emotional symptoms were found within the anxiety dimension, as 67% of the children were assessed as being clinically anxious. The most important risk indicators for anxiety were 'lived in a refugee camp outside the home country', 'part of a torture surviving family', 'lack of opportunities for play with other children', 'beaten/kicked by an official', and 'loss of father'. Current parental behaviour was also an important risk indicator for anxiety, if the mother or father hit or punished the child more than was the case prior to arrival in Denmark. The most important anxiety-modifying factor was arrival in Denmark in the company of both parents. CONCLUSIONS: Asylum seeking refugee children from the Middle East have had many experiences of war and other forms of organised violence. The children frequently reacted with anxiety and with other symptoms of emotional instability. Prevalent anxiety symptoms correlated both with previous living conditions and present family situation. Living under prolonged conditions influenced by war and other forms of organised violence (prevalence) were found to a higher degree to be risk indicators for anxiety than were specific events or changes of life conditions (incidence).