Aggressive behaviour during a standardized play observation in 3 to 6-year-old children with and without refugee experience: an observational study.

backgroundExposure to refugee and traumatic experiences in early childhood can dysregulate the stress response system and lower children’s threshold for aggression. This study examines differences in amount and patterns of aggressive play in children with and without refugee or traumatic experiences, while also assessing how other environmental factors, such as flight duration as a marker of cumulated adverse experiences, time spent in the host country, parental distress, and screen exposure, are associated with such behaviour.

methodsIn standardized 10 min free individual play sessions, episodes of aggressive behaviours were observed in 62 children with refugee experience and 64 children from a clinically referred comparison group without refugee experience (aged 3–6 years) and coded into four categories: physical, verbal, instrumental, and symbolic. Emotional states were documented to clarify the background mood and context of the aggressive episodes. Parents reported sociodemographic data, screen time, and filled out the Child and Adolescent Trauma Screening for children aged 3–6 (CATS 3–6), assessing potentially traumatic experiences of their children with corresponding symptoms, and the Refugee Health Screener (RHS) for information on their own mental health and distress levels. We correlated these factors with our structured observations of aggressive episodes during children’s play in a standardized situation.

resultsNo significant difference in the distribution of aggressive behaviour episodes between the refugee and comparison groups was observed, even after accounting for gender. Symbolic aggression was more frequent among boys from the comparison group (p = 0.014), while no group or gender effects emerged for other aggression categories. Amount of aggressive behaviour was not related to parent-rated traumatic experiences or symptoms, but a significant correlation appeared, with the reported amount of screen time within the male sub-group (ρ = 0.209, p =0 .027).

conclusionRefugee and traumatic experiences showed no association with increased aggressive behaviour, whereas higher screen time was observed alongside elevated amounts of aggressive episodes among boys in our study. Children from both, refugee and clinical comparison group predominantly engaged in non-violent play in calm, low demand setting, highlighting potential protective role of safe, stimulating environments. Trial registration German clinical trials register, registration number: DRKS00025734, date: 07–23-2021.