War trauma, psychopathology and social support Claire Arnold D.Clin.Ps

202 Pages·2013·4.75 MB·English

Volume 1
Unaccompanied asvlum seekers and refugee minors:
War trauma, psychopathology and social support
Claire Arnold
D.Clin.Psv. thesis. 2005
University College London
UMI Number: U592589
All rights reserved
INFORMATION TO ALL USERS
The quality of this reproduction is dependent upon the quality of the copy submitted.
In the unlikely event that the author did not send a complete manuscript
and there are missing pages, these will be noted. Also, if material had to be removed,
a note will indicate the deletion.
Dissertation Publishing
UMI U592589
Published by ProQuest LLC 2013. Copyright in the Dissertation held by the Author.
Microform Edition © ProQuest LLC.
All rights reserved. This work is protected against
unauthorized copying under Title 17, United States Code.
ProQuest LLC
789 East Eisenhower Parkway
P.O. Box 1346
Ann Arbor, Ml 48106-1346
Overview
The literature review presents a summary of the multiple risk factors experienced by
unaccompanied asylum-seeking and refugee minors during pre-migration, flight and
resettlement periods. The impact of such experiences is evaluated in relation to
psychological well-being. Two models of social support, the stress buffering model and
the main effect model are examined in relation to this population. The potential
difficulties in accessing and utilising social support are discussed.
The empirical paper assesses exposure to war trauma and psychological well-being in a
sample of 44 unaccompanied youngsters who have sought asylum in the UK. The
benefits of received and perceived social support are also explored. Results of the study
indicated that participants reported high incidents of exposure to war trauma, and
symptoms of posttraumatic stress disorder (PTSD), depression and anxiety. There was a
significant association between exposure to trauma and PTSD symptoms. High levels of
perceived social support were associated with lower levels of depression and PTSD
symptoms of intrusion. Findings are discussed in relation to future research and clinical
implications
The critical review considers the potential benefits of conducting research with
unaccompanied asylum-seekers and refugees. Methodological challenges and
limitations of the current study are discussed.
Table of Contents
Page
Table of Contents i
Contents of Tables iv
Contents of Figures vi
Acknowledgements vii
Part 1 (Review paper): Unaccompanied minor asylum seekers 1
and refugees: potential benefits of social support in a high risk
population
Abstract 2
Introduction 3
Section 1: Experiences and psychosocial well-being of unaccompanied 6
minor asylum seekers and refugees
Section 2: The role of social support for unaccompanied asylum seekers 28
and refugees
Conclusion: Clinical and research implications 46
References (Part 1) 52
i
Page
Part 2 (Empirical Paper): Young unaccompanied asylum 69
seekers and refugees in the UK: War trauma, psychopathology
and social support
Abstract 70
1. Introduction 71
2. Method 79
2.1 Participants 79
2.2 Procedures 81
2.3 Ethical approval 82
2.4 Materials 83
2.5 Power analysis 87
2.6 Data analysis 88
3. Results 89
3.1 Distribution of variables 89
3.2 Hypothesis One: Unaccompanied asylum-seeking and refugee youngsters 90
will report exposure to a high number of war traumas
3.3 Hypothesis Two: Unaccompanied asylum-seeking and refugee youngsters 93
will report high rates of PTSD, depression and anxiety symptoms.
3.4 Hypothesis Three: Unaccompanied asylum-seeking and refugee youngsters 98
who report more exposure to war trauma will also report more symptoms of
PTSD, depression and anxiety
ii
3.5 Hypothesis Four: Unaccompanied asylum-seeking and refugee youngsters 99
with high levels of received and perceived social support will report fewer
symptoms of posttraumatic stress disorder, depression and anxiety.
4. Discussion 109
References (Part 2) 128
Part 3 (Critical appraisal paper): Research with young unaccompanied 142
asylum seekers and refugees: The benefits and challenges
Critical appraisal paper 143
References (Part 3) 158
Appendices 162
Appendix 1: Abbreviations list 163
Appendix 2: Countries of origin / languages of participants (Table) 164
Appendix 3: Information and consent forms 166
Appendix 4: Letters of ethical approval 173
Appendix 5: Questionnaire booklet 174
Appendix 6:Normality of key variables (Table) 183
Appendix 7: Case studies 184
iii
Content of Tables
Page
Table 1: Demographic characteristics of participants 80
Table 2: Rates of most frequently experienced trauma (WTQ) 91
Table 3: Participants knowledge regarding parental well-being 92
Table 4: Self-reported symptoms of PTSD (RIES), depression (DSRS) 93
and anxiety (RCMAS)
Table 5: Correlations between PTSD severity subscales and total score, 94
as measured for the Revised Impact of Event Scale
Table 6: Associations between gender, age and asylum-status and 97
self-reported symptoms of PTSD (RIES), depression (DSRS) and
anxiety (RCMAS)
Table 7: Received social support (RSS) 100
Table 8: Perceived social support (MSPSS total and subscale scores means) 101
iv
Page
Table 9: Correlations between MSPSS total and subscales 102
Table 10: Associations between social support and symptoms of 104
PTSD (RIES), depression (DSRS) and anxiety (RCMAS)
Table 11: Multiple regression analysis - overall PTSD symptoms. 106
Predictor variables: exposure to war trauma (WTQ), perceived social support
from significant person (MSPSS significant person) and asylum status (ILR)
Table 12: Multiple regression analysis - PTSD arousal symptoms. 107
Predictor variables: exposure to war trauma (WTQ) and perceived social
support from a significant person (MSPSS significant person)
Table 13: Multiple regression analysis - PTSD intrusion symptoms 108
Predictor variables: exposure to war trauma (WTQ), perceived social support
from a significant person (MSPSS significant person) and asylum status (ILR)
Appendix 2, Table 1: Home countries of participants 164
Appendix 2, Table 2: First language of participants 165
Appendix 6, Table 1: Normality of key variables 183
v
Content of Figures
Page
Figure 1: Revised Children’s Manifest Anxiety Scale (RCMAS): 90
Distribution of outcome scores
vi
Acknowledgments
I would like to thank Dr Kimberley Ehntholt for her support as my field supervisor. Her
research and clinical expertise in the area of asylum-seeking and refugee children has
been invaluable, as has her ongoing support and encouragement throughout this study. I
would also like to thank Dr Stephen Butler for his support as my UCL supervisor; for his
theoretical knowledge in the field of developmental psychology and enthusiasm for this
study. In addition, I would like to acknowledge the support and constructive comments
that I have received from my personal tutor, Dr Chris Barker.
Special thanks go to Lewisham Asylum Team, Croydon Leaving Care Team, Brixton
Children’s Looked After Mental Health Services, Lewisham College, City and Islington
College and Elizabeth Garrett Anderson School for their assistance in the recruitment
process. In particular, I would like to acknowledge the cooperation and hard work of
Annette Duncan (Lewisham College), David Gallagher (City and Islington College) and
Sophie Wales (Elizabeth Garrett Anderson School).
I would also like to thank my family and friends, for their patience, understanding and
moral support over the last three years.
Finally, but most importantly, I would like to say a special thank you to all of the young
people who took part in the study, without whom this research would not have been
possible. It was both an honour and a privilege to have heard your stories.
vii