Cited by 634Migration, Health and TraumaMigration and Exile StudiesEducation and experiences of immigrants and refugees

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Psychological Distress in Refugee Children: A Systematic Review

Bronstein, Israel, Montgomery, Paul·2011·Clinical Child and Family Psychology Review

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Abstract

Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style review was conducted searching nine major databases, bibliographies, and grey literature from 2003 to 2008. Included studies had to meet the reporting standards of STROBE and investigate mental health in non-clinical samples of asylum seeking and refugee children residing in OECD countries. A total of twenty-two studies were identified of 4,807 retrieved citations, covering 3,003 children from over 40 countries. Studies varied in definition and measurement of problems, which included levels of post-traumatic stress disorder from 19 to 54%, depression from 3 to 30%, and varying degrees of emotional and behavioral problems. Significant factors influencing levels of distress appear to include demographic variables, cumulative traumatic pre-migration experiences, and post-migration stressors. Importantly, the research base demands greater contextual and methodological refining such that future research would have greater generalizability and clinical implications.

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Background
Psychosocial interventions in schools with newcomers: A structured conceptualization of system, design, and individual needs
Crooks, C. V., Smith, A. C. G., Link, N., Orenstein, S., & Hoover, S. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.104894 · Cited by 24
“After resettling, re-fugee children and youth face stressors such as the loss of homeland, family, friends, and material possessions, acculturation, and exposure to community violence (Bronstein & Montgomery, 2011; Kirmayer et al., 2011; Lustig et al., 2004).”
Background
Interventions to Improve the Economic Self-sufficiency and Well-being of Resettled Refugees: A Systematic Review
Ott, E., & Montgomery, P. (2015) · Campbell Systematic Reviews · doi:10.4073/csr.2015.4 · Cited by 22
“…on refugees and the suggested terminology for limiting studies to those using quantitative methodology (Bollini, Pampallona, Wanner, & Kupelnick, 2009; Bronstein & Montgomery, 2011; Clark & Mytton, 2007; Fazel, Wheeler, & Danesh, 2005; Gagnon & Tuck, 2004; Lipsey & Wilson, 2001; Littell, Corcoran,…”
Self-citation
Are all children treated equally? Psychiatric care and treatment receipt among migrant, descendant and majority Swedish children: a register-based study
Gubi, E., Sjöqvist, H., Dalman, C., Bäärnhielm, S., & Hollander, A. (2022) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796022000142 · Cited by 22
“, 2015) and extensive evidence shows that resettled refugee children face greater risks of mental illness compared to their majority peers (Bronstein and Montgomery, 2011).”
Background
Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety–A secondary analysis of the Better Care study
Hornfeck, F., Eglinsky, J., Garbade, M., Rosner, R., Kindler, H., Pfeiffer, E., & Sachser, C. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1149634 · Cited by 22
‘There is No Mother to Take Care of You’. Views of Unaccompanied Children on Healthcare, Their Mental Health and Rearing Environment
Zijlstra, E. A., Menninga, M., Os, E., Rip, J., Knorth, E. J., & Kalverboer, M. (2018) · Residential Treatment for Children & Youth · doi:10.1080/0886571x.2018.1559118 · Cited by 22
“The period spent in the host country is also stressful and their mental health problems may increase because of the long period of uncertainty about a residence permit, among other things (Bronstein & Montgomery, 2011).”
Background
Identifying psychological trauma among Syrian refugee children for early intervention: Analyzing digitized drawings using machine learning
Baird, S., Panlilio, R., Seager, J. E., Smith, S. L., & Wydick, B. (2022) · Journal of Development Economics · doi:10.1016/j.jdeveco.2022.102822 · Cited by 21
The role of socioemotional wellbeing difficulties and adversity in the L2 acquisition of first-generation refugee children
Paradis, J., Soto‐Corominas, A., Vitoroulis, I., Al‐Janaideh, R., Chen, X., Gottardo, A., Jenkins, J. M., & Georgiades, K. (2022) · Bilingualism Language and Cognition · doi:10.1017/s136672892200030x · Cited by 29
“…often persist after resettlement, and refugee children display higher levels of socioemotional wellbeing difficulties, anxiety, depression and post-traumatic stress disorder than children born in the host country (Bronstein & Montgomery, 2011; Fazel & Stein, 2002; Hadfield et al., 2017).”
Background
Verhaltensauffälligkeiten und Lebensqualität bei männlichen unbegleiteten minderjährigen Flüchtlingen in Jugendhilfe einrichtungen in Deutschland
Möhrle, B., Dölitzsch, C., Fegert, J. M., & Keller, F. (2016) · Kindheit und Entwicklung · doi:10.1026/0942-5403/a000206 · Cited by 21
The Mental Health of Children and Parents Detained on Christmas Island: Secondary Analysis of an Australian Human Rights Commission Data Set.
Mares, S. P. (2016) · Europe PMC (PubMed Central) · Cited by 22
Intersectionality in education
Varsik, S., & Gorochovskij, J. (2023) · OECD education working papers · doi:10.1787/dbb1e821-en · Cited by 33
Group music therapy with uprooted teenagers: The Importance of structure
Wiess, C., & Bensimon, M. (2019) · Nordic Journal of Music Therapy · doi:10.1080/08098131.2019.1695281 · Cited by 20
“This may increase the occurrence of anxiety disorders, depression, post-traumatic stress disorders (PTSD), attention disorders, and behavioral problems (Berger, 2008; Bronstein & Montgomery, 2011; Erol, Şimşek, Öner, & Munir, 2005; Fazel & Stein, 2002; Heptinstall, Sethna, & Taylor, 2004).”
Background
SALaMA study protocol: a mixed methods study to explore mental health and psychosocial support for conflict-affected youth in Detroit, Michigan
Stark, L., Robinson, M. V., Seff, I., Hassan, W., & Allaf, C. (2020) · BMC Public Health · doi:10.1186/s12889-020-8155-5 · Cited by 20
What do we Know about Bullying in Syrian Adolescent Refugees? A Cross Sectional Study from Turkey
Yılmaz, R., & Uytun, M. Ç. (2020) · Psychiatric Quarterly · doi:10.1007/s11126-020-09776-9 · Cited by 21
Distorted Time Perspective in Adolescent Afghan and Syrian Refugees Is Associated With Psychological Distress
Walg, M., Eder, L. L., Martin, A., & Hapfelmeier, G. (2020) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001194 · Cited by 21
The asylum‐process, bicultural identity and depression among unaccompanied young refugees☆
Oppedal, B., Ramberg, V., & Røysamb, E. (2020) · Journal of Adolescence · doi:10.1016/j.adolescence.2020.07.007 · Cited by 26
Migrant and asylum-seeker children returned to Kosovo and Albania: predictive factors for social–emotional wellbeing after return
Zevulun, D., Post, W. J., Zijlstra, E. A., Kalverboer, M., & Knorth, E. J. (2017) · Journal of Ethnic and Migration Studies · doi:10.1080/1369183x.2017.1391076 · Cited by 20
“…social – emotional problems before repatriation to the country of origin, such as through adversities in the country of origin before they fled, the journey itself, and during their stay in the host country (Bronstein and Montgomery 2011; Fazel et al. 2012; Hodes 2000; Van Os et al. 2016).”
Background
Protective factors associated with resilience among unaccompanied refugee minors after settling in Norway: a matched cross-sectional study
Heimli, O. M., Kvestad, I., Bøe, T., Sayyad, N., Nilsen, S. A., Randal, S. B., & Askeland, K. G. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-023-02364-9 · Cited by 19
Between happiness and sorrow: Phenomenal characteristics of autobiographical memories concerning war episodes and positive events in the Gaza Strip
Manzanero, A. L., Fernández, J., Gómez, M. L. N., Álvarez, M. A., El‐Astal, S., Hemaid, F., & Veronese, G. (2018) · Memory Studies · doi:10.1177/1750698018818221 · Cited by 20
Relationship between perceived discrimination and mental health of migrant children: A meta-analysis of Chinese students
Han, Y., Hengfu, W. E. N., CHENG, S., ZHANG, C., & Li, X. (2020) · Acta Psychologica Sinica · doi:10.3724/sp.j.1041.2020.01313 · Cited by 19
Psychological Resilience in Response to Adverse Experiences
Popham, C. M., McEwen, A. F. S., & Pluess, M. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780190095888.003.0022 · Cited by 20
Social context factors and refugee children’s emotional health
Emerson, S. D., Gagné, M. H., Guhn, M., Oberle, E., Georgiades, K., Milbrath, C., Janus, M., Schonert-Reichl, K. A., & Gadermann, A. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02173-y · Cited by 19
“Indeed, much research pertaining to refugee children focuses on mental health problems and other challenges [1].”
Background
Neighbourhood and family correlates of immigrant children’s mental health: a population-based cross-sectional study in Canada
Sim, A. L., & Georgiades, K. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04096-7 · Cited by 19
“Extant research on mental health risk associated with refugee status is mixed, with some studies showing comparable levels of mental health between refugee children and the general population while others indicating elevated risk among refugees [15, 52].”
Provider Perspectives of Services Addressing the Mental Health Needs of Resettled Refugee Youth
Forrest-Bank, S. S., Held, M. L., & Jones, A. E. (2019) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-019-00602-1 · Cited by 19
Conceptualising educational provision for unaccompanied asylum-seeking children in England
Ott, E., & O’Higgins, A. (2019) · Oxford Review of Education · doi:10.1080/03054985.2019.1607274 · Cited by 19
“Research has documented the high prevalence of mental health problems among UASC children in care compared to children in the general population, children in care, or refugee children living with their families (Bronstein & Montgomery, 2011).”
Background
An exploratory study on the mental health of immigrants, refugees and non-status people living with HIV in Toronto
Wong, J. P., Li, A. T.-W., Poon, M. K.-L., & Fung, K. P.-L. (2013) · International Journal of Migration Health and Social Care · doi:10.1108/ijmhsc-07-2013-0026 · Cited by 18
Impacts of a Support Intervention for Zimbabwean and Sudanese Refugee Parents: “I Am Not Alone”
Stewart, M., Makwarimba, E., Letourneau, N. L., Kushner, K. E., Spitzer, D. L., Dennis, C.-L., & Shizha, E. (2015) · Canadian Journal of Nursing Research · doi:10.1177/084456211504700409 · Cited by 18
Education, immigration and rising mental health inequality in Sweden
Linder, A., Spika, D., Gerdtham, U., Fritzell, S. C., & Heckley, G. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113265 · Cited by 18
Health-related quality of life in refugee minors from Syria, Iraq and Afghanistan resettled in Sweden: a nation-wide, cross-sectional study
Solberg, Ø., Sengoelge, M., Johnson-Singh, C. M., Vaez, M., Eriksson, A.-K., & Saboonchi, F. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02050-8 · Cited by 18
From Victim to Perpetrator of Trauma: Lived Experiences of Gang-Involved Urban Refugee Youth in Kenya
Im, H., Caudill, C., & Ferguson, A. (2016) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2016.1194939 · Cited by 19
“This compounds hardships and stressors, including economic hardship, discrimination, inadequate level of social support, and family relational issues (Bronstein & Montgomery, 2011; Pernice & Brook, 1996).”
Background
Gesundheitliche Situation und Versorgung unbegleiteter minderjähriger Flüchtlinge – eine Näherung anhand qualitativer und quantitativer Forschung in der Stadt Bielefeld
Spallek, J., Tempes, J., Ricksgers, H., Marquardt, L., Prüfer-Krämer, L., & Krämer, A. (2016) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-016-2339-2 · Cited by 17
An expanded framework for preparing teachers to educate children of immigrant backgrounds
Sattin-Bajaj, C., Alcazar, J. B., Hong, D., & Romo-González, M. (2023) · Teaching and Teacher Education · doi:10.1016/j.tate.2023.104120 · Cited by 20
Neuropsychological Effects of Posttraumatic Stress Disorder in Children and Adolescents
Turley, M. R., & Obrzut, J. E. (2012) · Canadian Journal of School Psychology · doi:10.1177/0829573512440420 · Cited by 17
“Recently, Bronstein and Montgomery (2011) reviewed the literature that estimated the occurrence of PTSD in refugee populations amongst people 25 years of age and younger.”
BackgroundMethodInfluential
Integratives Störungsmodell als Grundlage der Therapieplanung
Rief, W., & Strauss, B. M. (2018) · Psychotherapeut · doi:10.1007/s00278-018-0295-z · Cited by 17
Exploring the intersection of human rights, health, disability and refugee status: an arts-based approach
Wells, R., Murad, M., Higgins, M., Smith, L., Lenette, C., Lappin, J., Dew, A., Boydell, K., Bibby, H., Cassaniti, M., et al. (2020) · Australian Journal of Human Rights · doi:10.1080/1323238x.2021.1882044 · Cited by 17
“Young people from refugee backgrounds are particularly at risk of psychological distress and disorder compared to the general population (Lau et al. 2018; Bronstein and Montgomery 2011).”
Background
Previous experience, trickle-down training and systemic ad hoc-ery: educators’ knowledge acquisition when teaching refugee pupils in one local authority in England
Prentice, C. M., & Ott, E. (2021) · Teachers and Teaching · doi:10.1080/13540602.2021.1946034 · Cited by 17
“…refugees and asylum seekers present higher levels of mood and anxiety disorders and post-traumatic stress disorder than the population at large (Bronstein & Montgomery, 2011; Fazel et al., 2005; Jakobsen et al., 2014), with the stress of settling into a new country known to be a contributor…”
Background
Pilot Wellness Program With Adapted Social–Emotional Learning and COVID-19 Curriculum for Refugee Youth
Rosenberg, J., Ryan, P. M., O’Brien, C., Ganjavi, F., & Sharifi, M. (2021) · Health Education & Behavior · doi:10.1177/10901981211048830 · Cited by 17
“…peers to receive timely diagnoses and treatment for mental and/or behavioral health problems, despite facing multiple risk factors including potential exposure to trauma during premigration migration and postmigration stages (Alemi et al., 2014; Alemi & Stempel, 2018; Bronstein & Montgomery, 2011).”
Background
African Immigrant Parents’ Perspectives on the Factors Influencing Their Children’s Mental Health
Salami, B. O., Alaazi, D. A., Ibrahim, S., Yohani, S. C., Scott, S. D., Vallianatos, H., Urichuk, L., & Islam, B. (2021) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02130-y · Cited by 24
Fear Not the Trauma Story: A Trauma-Informed Perspective to Supporting War-Affected Refugees in Schools and Classrooms
Montero, M. K., & Zouhouri, A. A. (2022) · Educational linguistics · doi:10.1007/978-3-030-86963-2_6 · Cited by 18
Understanding mechanisms of change in a family-based preventive mental health intervention for refugees by refugees in New England
DiClemente-Bosco, K., Neville, S. E., Berent, J. M., Farrar, J., Mishra, T., Abdi, A., Beardslee, W. R., Creswell, J. W., & Betancourt, T. S. (2022) · Transcultural Psychiatry · doi:10.1177/13634615221111627 · Cited by 17
“%) than non-refugee children (6–9% and 2–9%, respectively) (Bronstein & Montgomery, 2011; Kien et al., 2018).”
A pilot study on ecological momentary assessment in asylum-seeking children and adolescents resettled to Germany: Investigating compliance, post-migration factors, and the relation between daily mood, sleep patterns, and mental health
Müller, L., Gossmann, K., Schmid, R., Rosner, R., & Unterhitzenberger, J. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246069 · Cited by 15
“We used the included subscales for anxiety (range 10–40, cut-off 20) and depression (range 15–60, cut-off 33) as they represent two major symptom clusters among ASCs [27].”
BackgroundMethodInfluential
Could the BIC-Q be a decision-support tool to predict the development of asylum-seeking children?
Zijlstra, E. A., Kalverboer, M., Post, W. J., ten Brummelaar, M., & Knorth, E. J. (2013) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2013.01.005 · Cited by 16
“As a result, these children often struggle with behavioural problems (Bronstein and Montgomery, 2011; De Haene and Grietens, 2005; Derluyn and Broekaert, 2008; Kalverboer and Zijlstra, 2008a).”
Background
Merging perspectives: obstacles to recovery for youth from refugee backgrounds with comorbidity
Posselt, M., Procter, N. G., de Crespigny, C., & Galletly, C. A. (2015) · Australasian Psychiatry · doi:10.1177/1039856215584512 · Cited by 16

Authors: Bronstein, I., & Montgomery, P.
Affiliations: University of Oxford (GB)
Corresponding author: Bronstein, Israel
ORCID: Bronstein, Israel
Montgomery, Paul
Venue: Clinical Child and Family Psychology Review
Publisher: Springer Science and Business Media LLC
Published: 2011-03
Volume: 14
Issue: 1
Pages: 44-56
ISSN: 1096-4037 (ISSN-L)
1573-2827
DOI: 10.1007/s10567-010-0081-0
OpenAlex: W2099969597
Cited by: 634
References: 83
Citations by year: 2026: 26 · 2025: 34 · 2024: 44 · 2023: 60 · 2022: 53 · 2021: 65 · 2020: 128 · 2019: 50 · 2018: 35 · 2017: 33 · 2016: 35 · 2015: 31 · 2014: 14 · 2013: 16 · 2012: 10
FWCI: 1.21
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Clinical Child and Family Psychology Review (publishedVersion)
PubMed (publishedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Social Sciences › Sociology and Political Science › Migration and Exile Studies
Social Sciences › Education › Education and experiences of immigrants and refugees
Keywords: refugee children, psychological distress, mental health, post-traumatic stress disorder, depression, emotional and behavioral problems, asylum seekers, pre-migration trauma, post-migration stressors, Western countries
MeSH terms: Age Factors, Child, Depression, Female, Humans, Male, Psychiatric Status Rating Scales, Refugees, Sex Factors, Stress Disorders, Post-Traumatic, Stress, Psychological, Resilience, Psychological

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Psychological Distress in Refugee Children: A Systematic Review

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