ArticleBMC psychiatry2021
Survival states as indicators of learning performance and biological stress in refugee children: a cross-sectional study with a comparison group.
Article in BMC psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 13 citations in OpenAlex.
- Aggressive behaviour during a standardized play observation in 3 to 6-year-old children with and without refugee experience: an observational study.Child and adolescent psychiatry and mental health · 2026Article
- Exploring Mental Health and Development in Refugee Children Through Systematic Play Assessment.Child psychiatry and human development · 2025Article
- Correlation of screen exposure to stress, learning, cognitive and language performance in children.European child & adolescent psychiatry · 2025Article
- Young children's development after forced displacement: a systematic review.Child and adolescent psychiatry and mental health · 2024Review
- Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches.European child & adolescent psychiatry · 2022Article
- Non-verbal cognitive development, learning, and symptoms of PTSD in 3- to 6-year-old refugee children.European journal of pediatrics · 2022Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOur goal was to accurately detect young children at risk for long-term psychiatric disturbances after potentially traumatic experiences in the course of relocation. In addition to detailed assessment of parent-rated parent and child symptomatology, we focused on disruptive behaviors in the education environment summarized as survival states, as these frequently lead to clinical referral.
methodsWe screened 52 refugee children aged 3-7 (M = 5.14 years, SD = 1.17) for symptoms of Posttraumatic Stress Disorder (PTSD) with the Child and Adolescent Trauma Screening (CATS) in parent rating. The parents' mental health was assessed using the Refugee Health Screener (RHS-15). Furthermore, the child's educators were asked to evaluate the pathological survival states of the child and we made a general assessment of the children's symptoms with the Strengths and Difficulties Questionnaire (SDQ) rated by parents and educators. Children in the refugee sample completed a working memory learning task (Subtest Atlantis from the Kaufmann Assessment Battery for Children, KABC-II) and delivered saliva samples for testing of the cortisol level.
resultsThe parental rating of their child's PTSD symptoms was significantly related to their own mental well-being (r = .50, p < .001). Children with survival states in educator ratings exhibited weaker learning performance (F = 3.49, p < .05) and higher evening cortisol levels (U = 113, z = - 1.7, p < .05, one-tailed).
conclusionsSurvival states are promising indicators for children's learning performance and distress level complementary to parent rating of child PTSD, which is highly intercorrelated with the parents' own symptom load.
trial registrationTrial registration number: DRKS00021150 on DRKS Date of registration: 04.08.2020 retrospectively registered.
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