Domain-specific discrepancies between self- and caseworkers’ proxy- reports of emotional and behavioral difficulties in unaccompanied refugees

ABSTRACT

The aim of this study is to assess adolescent refugees’ psychological distress and examine how reliably caseworkers can assess distress through a proxy-report instrument. The distress of 102 unaccompanied refugees between 16 and 21 years of age housed in youth welfare accommodations in Germany was assessed by self-report using the Brief Symptom Checklist and by proxy-report through the Child Behavior Checklist. Independent of residence status, the self and proxy ratings reveal that more than half of the refugees suffer from increased levels of psychological distress, particularly from anxiety and somatisation. There was a moderate positive correlation between the total scales of the two instruments. The high number of clinically meaningful distress poses a great challenge to caseworkers in facilities for unaccompanied refugees. The Child Behavior Checklist can be a suitable measure to detect clinically meaningful problems, but its validity seems to depend on a good relationship between caseworker and refugee.

KEYWORDS:

• Unaccompanied refugees
• trauma-induced disorders
• psychological distress
• Brief Symptom Checklist
• Child Behavior Checklist

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Notes on contributors

Marco Walg

Dr Marco Walg is a psychologist and psychotherapist working in an outpatient department for child and adolescent psychiatry with a research focus on mental health in adolescent refugees.

Florentine Löwer

Florentine Löwer is a medical student researching in the field of child and adolescent psychiatry as a part of her doctoral thesis.

Stephan Bender

Dr Stephan Bender is professor of child and adolescent psychiatry and psychotherapy at the University of Cologne and director of the department for child and adolescent psychiatry, psychosomatic medicine and psychotherapy of the University Hospital Cologne.

Gerhard Hapfelmeier

Dr Gerhard Hapfelmeier is a child and adolescent psychiatrist and chief doctor of the department for child and adolescent psychiatry of the Sana-Klinikum Remscheid.