Examining the psychological well-being of refugee children and the role of friendship and bullying

TLDR: While refugee children were found to be at risk on various levels, the findings also point to the fact that social relationships including friendship quality and number of friends played an essential protective role.

Abstract: Background. Refugee children might have experienced violent and traumatic events before settling into a new country. In the United Kingdom, the number of refugee children is increasing; however, little is known about their psycho-social and physical well-being. Aim. This study aims to investigate the psychological well-being and behaviour of refugee children compared to British-born children on a number of psychological, social, behavioural, and health-related issues and to investigate the role of friendship as a protective factor. Samples. This study utilized a sample of 149 refugee children recruited from two charities, 79 of which are children aged 6–10 years and 70 older refugee children aged 11– 16 years. The study also included 120 non-refugee children recruited from primary schools aged 6–10 years. Methods. This is a cross-sectional study that investigates the psycho-social well-being of refugee children compared to non-refugee British-born children. The study explored symptoms of post traumatic stress disorder, emotional and behavioural problems (Strengths and Difficulties Questionnaire), self-esteem, friendships and popularity, bullying and victimization, physical health, and psychosomatic problems. Results. Young refugee children reported more peer problems, functional impairment, physical health, and psychosomatic problems compared to the control children and older refugee children groups. On the other hand, older refugee children had lower self-esteem (academic and social self-peers) compared to the younger refugee children group. The differences between the groups were explained by friendship quality, number of friends, peer bullying/victimization, or sibling bullying/victimization except for physical health and psychosomatic problems. Conclusions. While refugee children were found to be at risk on various levels, the findings also point to the fact that social relationships including friendship quality and number of friends played an essential protective role. Conversely, bullying was a risk factor that explained many of the refugees’ problems. These findings pave the way for future research to further probe into the well-being of refugee children in the United Kingdom while also targeting relevant intervention schemes specifically tailored to address their needs.

Figures

Table 2. Frequency and percentage (%) according to the types and subgroups of bullying by peers and siblings by groups (younger and older refugee groups and control group).

Table 1: Mean and Standard Deviation (SD) across groups and differences using Analysis of Variance (F) and the Effect Size (η²)

Table 3. A series of linear regression analyses predicting behavioural and health problems outcomes by group type before and after adjusting for friendship quality, number of friends, peer bullying/victimisation or sibling bullying/victimisation (bold results became non-significant after adjustment) *.

Full text

"This is the peer reviewed version of the following article: Samara, Muthanna, El Asam, Aiman, Khadaroo,
Ameerah and Hammuda, Sara (2020) Examining the psychological wellbeing of refugee children and the role of
friendship and bullying. British Journal of Educational Psychology, 90(2), pp. 301-329., which has been
published in final form at https://doi.org/10.1111/bjep.12282. This article may be used for non-commercial
purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Title:
Examining the psychological wellbeing of refugee children and the role of
friendship and bullying
Running Title: Psycho-social Wellbeing of Refugee Children
Muthanna Samara*, Aiman El Asam, Ameerah Khadaroo & Sara Hammuda
*Professor Muthanna Samara (correspondence author)
Department of Psychology, Kingston University London, Penrhyn Road, Kingston upon
Thames KT1 2EE, United Kingdom
Email: M.Samara@Kingston.ac.uk
Tel: +44 (0) 20 8417 2533
Dr. Aiman El Asam
Department of Psychology, Kingston University London, Penrhyn Road, Kingston upon
Thames KT1 2EE, United Kingdom
Email: A.Elasam@Kingston.ac.uk
Mrs. Ameerah Khadaroo
Department of Psychology, Warwick University, Coventry, CV4 7AL, United Kingdom
Email: A.khadaroo@warwick.ac.uk
Mrs. Sara Hammuda
Department of Psychology, Kingston University London, Penrhyn Road, Kingston upon
Thames KT1 2EE, United Kingdom
Email: Sarahammuda@hotmail.com
Acknowledgements:
This work was supported by the Qatar National Research Fund (QNRF) a member of Qatar
Foundation Doha, Qatar, National Priority Research Programs (NPRP) under Grant (NPRP 7
- 154 - 3 - 034). The authors would like to thank QNRF for their support. We would like also
to thank all the schools, teachers, parents and children for their time and willingness to
participate in this research study.

1
Examining the psychological wellbeing of refugee children and the role of
friendship and bullying
Abstract
Background: Refugee children might have experienced violent and traumatic events before
settling into a new country. In the UK, the number of refugee children is increasing however
little is known about their psycho-social and physical wellbeing.
Aim: This study aims to investigate the psychological wellbeing and behaviour of refugee
children compared to British born children on a number of psychological, social, behavioural
and health related issues and to investigate the role of friendship as a protective factor.
Samples: This study utilised a sample of 149 refugee children recruited from two charities,
79 of which are children aged 6 to 10 years and 70 older refugee children aged 11 to 16 years.
The study also included 120 non-refugee children recruited from primary schools aged 6 to
10 years.
Methods: This is a cross-sectional study that investigates the psycho-social wellbeing of
refugee children compared to non-refugee British born children. In doing so this study
explored symptoms of PTSD, Emotional and Behavioural Problems (SDQ), Self-Esteem,
Friendships and Popularity, Bullying and Victimisation, Physical Health and Psychosomatic
Problems.
Results: Young refugee children reported more peer problems, functional impairment,
physical and psychosomatic problems compared to the control children and older refugee
children groups. On the other hand, older refugee children had lower self-esteem (academic
and social self-peers) compared to the younger refugee children group. The differences
between the groups were explained by friendship quality, number of friends, peer bullying or
victimisation, or sibling bullying or victimisation except for physical and psychosomatic
problems.

2
Conclusions: While refugee children were found to be at risk on various levels, the findings
also point to the fact that social relationships including friendship quality and number of
friends played an essential protective role. Conversely, bullying was a risk factor that
explained many of the refugees’ problems. These findings pave the way for future research to
further probe into the wellbeing of refugee children in the UK while also targeting relevant
intervention schemes specifically tailored to address their needs.
Keywords: Refugee children; psychological wellbeing; social wellbeing; mental health;
friendship; bullying; victimisation; sibling relationships; peer relationships; health

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Introduction
People flee their homes as a result of persecution, war and political violence. The number of
displaced people worldwide is currently estimated at an unprecedented 68.5 million. Nearly
25.4 million of these are considered to be refugees and more than half are children (United
Nations High Commissioner for Refugees [UNHCR], 2018).
Refugee children compared to other groups of vulnerable and at-risk children are more prone
to develop psychological disturbances (Bronstein & Montgomery, 2011; Fazel, Reed, Panter-
Brick & Stein, 2012). Some studies have found that at the onset of migration, refugee children
exhibit conduct problems and several social and behavioural problems which may worsen
during the process of migration (Hodes, 1998a, 2000, 2002b; Hodes & Tolmac, 2005). The loss
of their native land can create a deep grievance, which could affect their mental health and their
functioning (Worthington, 2001; Betancourt et al., 2015), while relocation to a new unfamiliar
environment can trigger a loss of self-identification, sense of security and well-being (Mann,
2010; Worthington, 2001). The experience of a myriad of stressors from both their past and
new life leads refugee children to exhibit more behavioural difficulties than non-refugee
children (Ehntholt & Yule, 2006; Derluyn & Broekaert, 2007). Psychological disturbances
experienced by the children include posttraumatic stress disorder (PTSD: ranging between 19-
54%) anxiety disorders, depression, psychosomatic symptoms and physical illnesses
(Ugwuegbu & Temowo, 1995; Montgomery & Foldspang, 2005; Bronstein & Mongomery,
2011; Bronstein, Montgomery & Dobrowolski, 2012; Dimitry, 2012). The experience of war-
related traumatic events was also associated with intense rivalry in sibling relations and low
friendship quality among young children (Peltonen, Qouta, El Sarraj, & Punamäki, 2010).
UK-based studies found that more than a quarter of refugee children had at least one
psychological disorder and were three times more likely to be affected compared to British

Frequently asked questions

Q1. What have the authors contributed in "Examining the psychological wellbeing of refugee children and the role of friendship and bullying running title: psycho-social wellbeing of refugee children" ?

This study aims to investigate the psychological wellbeing and behaviour of refugee children compared to British born children on a number of psychological, social, behavioural and health related issues and to investigate the role of friendship as a protective factor. This study utilised a sample of 149 refugee children recruited from two charities, 79 of which are children aged 6 to 10 years and 70 older refugee children aged 11 to 16 years. The study also included 120 non-refugee children recruited from primary schools aged 6 to 10 years. This is a cross-sectional study that investigates the psycho-social wellbeing of refugee children compared to non-refugee British born children. In doing so this study explored symptoms of PTSD, Emotional and Behavioural Problems ( SDQ ), Self-Esteem, Friendships and Popularity, Bullying and Victimisation, Physical Health and Psychosomatic Problems. 

Q2. What have the authors stated for future works in "Examining the psychological wellbeing of refugee children and the role of friendship and bullying running title: psycho-social wellbeing of refugee children" ?

Future studies may also include data from refugee children who do not have access to afterschool clubs to examine differences. Children and war: Current understandings and future directions. This suggests that positive peer relationships can explain these difficulties and could better promote the wellbeing of refugee children. 

Q3. What is the importance of promoting a collaborative relationship between schools and families?

In order to boost school-academic self-esteem, it is of utmost importance to promote a collaborative relationship between schools and families. 

Q4. What is the value of socialising and friendship in refugee children?

The value of socialising and friendship is huge in the life of refugee children (Dunkerley, Scourfield, Maegusuku-Hewett & Smalley, 2006) and helps to buffer the exhibition of externalising problems such as bullying (Hodges, Boivin, Vitaro & Bukowski, 1999: Bollmer, Milich, Harris, & Maras, 2005), conduct problems (Hartup, 1995) as well as suppress the feeling of anxiety (Fordham & Stevenson-Hinde, 1999) and loneliness (Parker & Asher, 1993). 

Q5. What is the key role of teachers in supporting young refugees to cope with trauma?

The key role played by teachers in supporting young refugees to cope with trauma and providing them with a positive environment is important for nurturing their wellbeing both at school and outside (Szente, Hoot, & Taylor, 2006). 

Q6. Why did the older refugee children have lower self-esteem?

This may be due to psychosocial crises occurring as part of normal adolescent development or may be due to these normal crises being exacerbated due to the children’s difficult past experiences as refugees (Lustig et al., 2004). 

Q7. How many refugee children were recruited from two charities?

This study utilised a sample of 149 refugee children recruited from two charities, 79 of which are children aged 6 to 10 years and 70 older refugee children aged 11 to 16 years. 

Q8. What could have prevented the likelihood of being bullied?

Since the refugees in the current study actively participated in afterschool activities revealing a willingness to integrate in their new educational setting, this could have significantly limited the likelihood of being peer bullied or at least prevented the likelihood of it from being significantly different from British children. 

Q9. What is the role of friendship in the wellbeing of refugee children?

Examining the psychological wellbeing of refugee children and the role offriendship and bullyingAbstractBackground: Refugee children might have experienced violent and traumatic events before settling into a new country.