Authors: Goldin, Stephen¹; Hagglof, Bruno¹; Levin, Lilian¹; Persson, Lars Åke²

Source: Nordic Journal of Psychiatry, Volume 62, Number 3, 2008 , pp. 204-216(13)

Publisher: Informa Healthcare

Abstract:

This study compares clinician appraisal of Bosnian refugee children with independent parent, child and teacher reports. From whom and by what means can children “at risk” be reasonably identified? Forty-eight Bosnian refugee children (aged 7-20), resettled in Sweden 1994-95, were assessed clinically by means of a semi-structured interview. Thereafter, standardized mental health questionnaires were administered to parents (Achenbach's Child Behavior Checklist), children (Achenbach's Youth Self-Report and Macksoud's Posttraumatic Stress Reaction Checklist) and teachers (clinician designed School Competence Scale and Achenbach's Teacher's Report Form). On clinician interview, nearly half of the children (48%) were identified with one or more mental health problem “demanding further attention”. Depressiveness was the single most prevalent symptom (31%); followed by post-traumatic stress (23%), and anxiety-regressiveness (15%). At the same time, 75% of the children were rated by teachers as “quite competent” in school. Parent, child and clinician appraisals of primary school children showed broad similarities. Teachers reported a similar prevalence of child distress, but identified different symptoms and different children demanding attention. Evaluation of teenage youths showed greater disparity: teenagers labeled their own symptoms more often as post-traumatic stress reactions and teachers identified few youths in need of attention. Inter-relatedness among parent, child and clinician appraisals supports the robustness of our semi-structured interview. At the same time, apartness of teacher report underscores the need to incorporate an outside-world vantage point in the process of risk assessment. Also, a more concrete presentation of post-traumatic stress reactions and a higher “further attention” threshold for inward emotional problems seem called for.

Keywords: Children and adolescents; Mental health; Multiple informants; PTSD; Refugees

Document Type: Research article

DOI: http://dx.doi.org/10.1080/08039480801983604

Affiliations: 1: Division of Child and Adolescent Psychiatry, Department of Clinical Sciences, Umeå University, Sweden 2: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Sweden

Publication date: 2008-01-01

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