Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents

Figures & data

Table 1. Sociodemographic characteristics of participating families.

	Families (N = 230)
	Children(n = 230)	Mothers(n = 230)	Fathers(n = 230)
Age, M (SD)	12.11 (2.03)	34.49 (8.48)		41.52 (11.00)
Country of birth, % (n)
Burundi	65.7 (151)	92.6 (213)		90.4 (208)
Tanzania	34.3 (79)	3.9 (9)		7.8 (18)
Other	0	3.5 (8)		1.7 (4)
Educational level, % (n)^a
No schooling	12.6 (29)	34.8 (80)		23.0 (53)
Primary, class 1-3	49.1 (113)	22.6 (52)		16.6 (38)
class 4-6	38.3 (88)	30.0 (69)		39.2 (90)
Some secondary		11.7 (27)		16.9 (39)
Completed secondary		0.9 (2)		4.3 (10)
Relationship to child, % (n)
Biological Parent		84.3 (194)		83.0 (191)
Relative		6.0 (14)		5.6 (13)
Step parent		3.0 (7)		3.9 (9)
Foster parent		6.5 (15)		7.4 (17)
Number of people in household, % (n)^b
3 to 5	15.7 (36)
6 to 9	70.0 (161)
≥ 10	14.3 (33)
Household income p. month (USD)^b
No income	32.2 (74)
Up to 20	60.9 (140)
≥ 20	6.9 (16)

^aParents’ responses refer to their highest level achieved. ^b Information on households is averaged across parents.

Table 2. Prevalence of PTSD and other mental health problems among children and parents.

	Children (n = 230)				Mothers (n = 230)				Fathers (n = 230)
	%	n	M	SD	%	n	M	SD	%	n	M	SD
PTSD Measures
DSM-5 diagnosis	5.7^a (2.2)^b	13 (5)			32.6^c	75			29.1^c	67
Symptom severity			14.59^a	11.33			38.51^c	19.31			33.04^c	16.51
Functional Impairment	42.6	98			50.9	117			50.4	116
SDQ
Total difficulties score	10.9^d	25	10.65	5.06	15.9^e	36	10.84	6.04	11.5^e	26	9.30	5.56
BSI-18
Global Severity Index					87.4^f	201	31.21	16.49	83.9^g	193	24.53	14.29

Note: The SDQ values in the parent columns refer to the SDQ parent version. PTSD, posttraumatic stress disorder; SDQ, Strengths and Difficulties Questionnaire; BSI-18, Brief Symptom Inventory-18; SDQ cut-off scores are based on Goodman et al. (2000); BSI-18 cut-off scores are based on Derogatis (2000); Median scores of PTSD measures were 13.00 (children), 38.00 (mothers) and 33.00 (fathers).

^aAssessed with the University of California at Los Angeles Child/Adolescent PTSD Reaction Index for DSM-5. ^b Prevalence of Dissociative Subtype.

^cAssessed with the PTSD Check List for DSM-5; ^d Cut-off ≥ 18; ^e Cut-off ≥ 17; ^f Cut-off ≥ 13; ^g Cut-off ≥ 10

Table 3. Fit indices for latent class models.

Model	Log-likelihood	Resid. df	BIC	aBIC	AIC	cAIC	Entropy
2 class	−886.40	50	1843.20	1802.00	1798.79	1856.20	0.67
3 class	−863.27	43	1834.87	1771.49	1766.55	1854.87	0.77
4 class	−852.56	36	1851.36	1765.79	1759.13	1878.36	0.78
5 class	−846.19	29	1876.53	1768.78	1760.38	1910.53	0.77
5 class	−842.98	22	1908.01	1778.08	1767.95	1949.01	0.85
7 class	−839.51	15	1939.00	1786.88	1775.03	1987.00	0.67

Fit indices of the preferred 4-class model are highlighted in bold. Resid. df, Residual degrees of freedom; BIC, Bayesian Information Criterion; aBIC, adjusted Bayesian Information Criterion; AIC, Akaike Information Criterion; cAIC, Bozdogan’s consistent Akaike Information Criterion.

Figure 1. Latent classes of families based on family members’ PTSD symptom severity and impairment. Y-axis indicates the average probability of having a PTSD symptom score above the median and meeting the impairment criterion for PTSD diagnosis.

Table 4. Descriptive statistics and comparisons between latent classes.

	Latent Classes % (N)				ANOVA		Post hoc test (Games-Howell)
	Traumatized families (TF)34.4 (80)	Traumatized mothers (TM)23.5 (47)	Traumatized fathers (TFa)13.8 (37)	Non-traumatized families (NF)28.3 (62)	F	η^2	TF NF	TF TM	TF TFa	TM TFa	TM NF	TFa NF
Child maltreatment, M (SD)	102.38 (91.74)	72.77 (90.44)	76.76 (71.49)	56.89 (54.76)	3.99^†	0.05	**	ns	ns	ns	ns	ns
Traumatic events, M (SD)
Children	10.91 (6.26)	5.09 (2.91)	6.05 (4.24)	5.84 (3.31)	23.53^†	0.24	***	***	***	ns	ns	ns
Mothers	18.41 (5.61)	17.91 (6.28)	17.05 (7.05)	14.16 (5.49)	6.27^†	0.08	***	ns	ns	ns	*	ns
Fathers	22.37 (4.86)	19.06 (4.82)	22.54 (6.74)	19.05 (5.94)	7.43^†	0.09	**	***	ns	*	ns	***
PTSD Diagnosis, % (n)
Children	13.7 (11)	0	0	1.6 (1)	p = 0.001 (Fisher-Freeman-Halton exact test)
Mothers	45.0 (36)	51.1 (24)	40.5 (15)	0	χ^2 = 43.51 (3, N=226), p < 0.001
Fathers	40.0 (32)	8.5 (4)	75.7 (28)	1.6 (1)	χ^2 = 76.39 (3, N=226), p < 0.001

Note: All analyses are based on n=226. There was a large significant multivariate effect of class membership on dependent variables, Pillai’s trace = 0.44, F (15, 660) = 7.46, p <0.001, η²=0.15. M, mean; SD, standard deviation; F, test statistic of ANOVA; η², effect size eta squared; ns, not significant. *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001, ^†Significant after Holm-Bonferroni correction.

Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2000). Using the strengths and difficulties questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. British Journal of Psychiatry, 177(06), 534–539.

 Google Scholar

Derogatis, L. R. (2000). BSI-18: Brief symptom inventory 18 – Administration, scoring, and procedures manual. Minneapolis, MN: NCS Pearson.

 Google Scholar