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Background During recent years, Europe has faced the arrival of migrants whereof a considerable group of youth present mental health problems, such as symptoms of post-traumatic stress disorder (PTSD). Schools offer a safe environment for mental health interventions to these groups, yet there is limited research on the impact of school-based interventions addressing mental health problems in newcomer youths, especially in the Swedish context. This cluster randomized controlled trial (RCT) aimed to explore the effectiveness of the Teaching Recovery Techniques (TRT) intervention among newcomer students with PTSD symptoms in Swedish secondary schools. Methods Nine schools were randomly assigned to TRT or a wait list control group prior to the baseline assessment. Follow-up data were collected immediately following the intervention and three months post-intervention. In total, 531 students were approached, of which 61 gave consent and were eligible to be included in the study: 55 in TRT and 6 in the control condition. Given the low number of participants in the control condition, we merely analyzed students who had received TRT. Results We report on feasibility of recruitment, data collection, intervention delivery and intervention effectiveness. In terms of intervention effectiveness, within subjects ANOVAs revealed significant reductions in PTSD symptoms and general mental health problems from baseline to the three months-follow-up (p < 0.001). Conclusions Our results indicate that TRT is a promising school-based intervention for newcomer students with PTSD symptoms. For a successful implementation of TRT in the school context, schools need to be engaged and the implementation should be managed by a local coordinator. Trial registration ISRCTN, ISRCTN48178969, Retrospectively registered 20/12/2019.

The value of taking advantage of the participants’ interactions when analyzing focus group data is often stressed. However, there is a lack of detailed descriptions of how focus group data can be merged with interview data, and considered throughout a thematic analysis process. This article describes a systematic way to include focus group interactions in data analysis, using a coding scheme. The aim was threefold: to develop a coding scheme for focus group interactions; to test and describe a process for interaction analysis, merged into the thematic data analysis process, and to test the coding scheme on another dataset. Based on focus group literature a comprehensive coding scheme for analyzing focus group interactions, was developed, including symbols for these interactions. Data from five focus group interviews involving adolescents were subsequently coded using this scheme. Further analysis of the identified interactions was conducted simultaneously with thematic data analysis, using Systematic Text Condensation (STC) as an illustrative method. The coding scheme was then tested on data from a different focus group involving adolescents in another setting. A comparison between the two coders was made, leading to a slight modification of the coding scheme. The resulting coding scheme is a practical tool adding to the previous knowledge on focus group interaction analysis. More specifically, the scheme facilitates focus group interactions to be visible and accounted for thought the thematic analysis process.

Scholars draw increasing attention to the importance of belonging for young refugees' and migrants' well-being, indicating the need to develop an in-depth understanding of their experiences seeking to belong in resettlement. For refugee and migrant newcomers, schools might constitute particularly significant spaces in their negotiation of belonging, due to being a central developmental and acculturative context in resettlement, and a context where newcomers are situated within interpersonal and cultural positions of their families, home, and host society. Rooted in a conceptualization of belonging as a dynamic, plural, and relationally negotiated experience, this study explores how young newcomers' negotiation of belonging takes shape within the school context and how their experiences seeking to belong relate to their well-being. To that, the study engages with the qualitative inquiry of 163 newcomers' (age 11-24) experiences through focus groups conducted in Belgium, Denmark, Norway, and Sweden. Cross-national, joint thematic analysis resulted in two themes: 1. Ambivalences shaping belonging; and 2. Challenging barriers to belonging. Our findings suggest that, in school, newcomers meet opportunities and barriers in their negotiation of belonging that takes shape at the intersection of family, transnational, and host society relations. Schools furthermore seem central spaces for newcomers to exercise agency and creativity in their search for belonging in resettlement. Our findings spark thought on belonging as a reconstructive process in coping with migration and have implications for how schools can support belonging and well-being, through engaging with life stories of migration and the plurality of meanings encroaching upon newcomers' school trajectories.

Background: High levels of post-traumatic stress are well documented among refugees. Yet, refugee adolescents display high heterogeneity in their type of trauma and symptom levels.

Objective: Following the recurrent plea for validated trauma screening tools, this study investigated the psychometric properties of the Children’s Revised Impact of Event Scale (CRIES-8) among refugee adolescents from Afghanistan (n = 148), Syria (n = 234), and Somalia (n = 175) living in Europe.

Method: The model fit for the confirmatory factor structures was tested, as well as measurement invariance between the three groups. The robustness of results was evaluated by testing measurement invariance between recently arrived and settled adolescents, and between different response labelling options. Reliability (α, ω, and ordinal α), criterion validity, and prevalence estimates were calculated.

Results: The intrusion subscale showed a better stable model fit than the avoidance subscale, but the two-factor structure was mainly supported. Configural measurement invariance was achieved between Afghan and Somali adolescents, and strong measurement invariance between Syrian and Somali adolescents. The results were robust considering the time living in the host country and response labelling styles. Reliability was low among Afghan and Syrian adolescents (.717−.856), whereas it was higher among Somali adolescents (.831−.887). The total score had medium-sized correlations with emotional problems (.303−.418) and low correlations with hyperactivity (.077−.155). There were statistically significant differences in symptom prevalence: Afghan adolescents had higher prevalence (55.5%) than Syrian (42.8%) and Somali (37%) adolescents, and unaccompanied refugee minors had higher symptom prevalence (63.5%) than accompanied adolescents (40.7%).

Conclusions: This study mostly supports the use of the CRIES-8 among adolescents from Afghanistan, Syria, and Somalia, and even comparative analyses of group means. Variation in reliability estimates, however, makes diagnostic predictions difficult, as the risk of misclassification is high.

Antecedentes: Niveles altos de estrés postraumático en refugiados están bien documentados. Sin embargo, los adolescentes refugiados muestran una alta heterogeneidad en el tipo de trauma y sus niveles de sintomatología.

Objetivo: Siguiendo la petición recurrente de herramientas validadas para pesquisa de trauma, este estudio investigó las propiedades psicométricas de la Escala Revisada del Impacto de Eventos en Niños (CRIES-8 por sus siglas en inglés) en adolescentes refugiados de Afganistán (n = 148), Siria (n = 234) y Somalia (n = 175) que viven en Europa.

Método: Se probó el ajuste del modelo para las estructuras factoriales confirmatorias, así como la invarianza de medición entre los tres grupos. La solidez de los resultados también se evaluó probando la invarianza de medición entre adolescentes recién llegados y los ya establecidos, y entre las diferentes opciones de respuestas etiquetadas. Se calculó la confiabilidad (α, ω y α ordinal), la validez de criterio y las estimaciones de prevalencia.

Resultados: La subescala de intrusión mostró un mejor ajuste estable del modelo que la subescala de evitación, pero la estructura de dos factores fue principalmente respaldada. Se logró una invarianza de medición configural entre adolescentes afganos y somalíes, y una fuerte invarianza de medición entre adolescentes sirios y somalíes. Los resultados fueron robustos considerando el tiempo vivido en el país anfitrión y los estilos de respuestas etiquetadas. La confiabilidad fue baja entre los adolescentes afganos y sirios (.717–.856), mientras que fue mayor entre los adolescentes somalíes (.831–.887). La puntuación total tuvo correlaciones de tamaño mediano con problemas emocionales (.303–.418) y correlaciones bajas con hiperactividad (.077–.155). Hubo diferencias estadísticamente significativas en la prevalencia de los síntomas: los adolescentes afganos tuvieron una alta prevalencia (55.5%) en comparación con los adolescentes sirios (42.8%) y somalíes (37%), y los refugiados menores de edad no acompañados (URMs por sus siglas en inglés) (63.5%) en comparación con los adolescentes acompañados (40.7%).

Conclusiones: Este estudio respaldó mayoritariamente el uso de la CRIES-8 en adolescentes de Afganistán, Siria y Somalia, e incluso el análisis comparativo de medias grupales. Sin embargo, la variación en las estimaciones de confiabilidad dificulta las predicciones diagnósticas, ya que el riesgo de clasificación errónea es alto.

Teachers are pivotal in creating safe and efficacious learning environments for ethnic minority students. Research suggests that teachers’ multicultural attitudes, self-efficacy, and wellbeing at work may all play important roles in this endeavor. Using survey data on 433 teachers in Belgium, Denmark, Finland, Norway, Sweden, and the United Kingdom, the present study used structural equation models to analyze the paths between teachers’ multicultural attitudes and work-related wellbeing (work dedication and exhaustion), and whether self-efficacy mediates these paths. We further investigated how these associations differ between teachers of reception classes for migrant and refugee students versus teachers of multi-ethnic mainstream classes. The results show that positive multicultural attitudes were directly associated with high level of work dedication, but not with work exhaustion. Self-efficacy mediated the association between multicultural attitudes and work-related wellbeing, indicated by both higher work dedication and lower work exhaustion. Concerning the role of teacher’s class type, self-efficacy mediated the association between positive multicultural attitudes and work dedication for both types of teachers, whereas the mediation to low work exhaustion was only evident in mainstream class teachers. To conclude, teachers’ multicultural attitudes and work-related wellbeing are mediated by self-efficacy and this important link should be acknowledged when designing professional development programs in order to create supportive and competent learning environments for all students.

Feeling a sense of belonging at school is associated with important positive outcomes for youth and requires youth to engage in positive social relationships. Yet there is a limited understanding of the social factors most associated with youths' school belonging and limited evidence about whether correlates of school belonging vary for marginalized groups like newcomers compared to majority groups. Sweden provides an important context for investigation of these issues because, over the past two decades, the country has experienced an influx of asylum seekers and educational reforms that have altered the composition and functioning of Swedish secondary schools. This study addresses these gaps by (1) investigating which of eight social factors are associated with school belonging among diverse Swedish youth, and (2) examining whether newcomer status moderates the relationship between social factors and school belonging. Hierarchical regression and moderation analyses were used to analyze data from 14 to 19 year-old (n = 233) newcomers and non-newcomers in Sweden. An exploratory factor analysis revealed that the school belonging measure contained two factors: positive perceptions and negative perceptions (reverse coded). For both, stronger school belonging was associated with lower perceived ethnic discrimination. Positive perceptions of school belonging were also associated with more prosocial behaviours and lower emotional problems. Negative perceptions of school belonging were associated with more peer problems. Notably, quantity and quality of peer relationships were not associated with school belonging. There was no consistent evidence of newcomer status moderating the relationship between social factors and school belonging. These results highlight factors associated with school belonging which are modifiable and amenable to intervention or impact by policy-ethnic discrimination, prosocial behaviour, and emotional and peer problems. The absence of moderation by newcomer status suggests that school belonging interventions or related policies are likely to affect newcomer and non-newcomer students similarly.

Parenthood can be defined by the contradiction that it is one of the most satisfying yet stressful experiences in life. Many parents experience stress during parenthood, and some to the extent that they display symptoms of parental burnout. Nevertheless, research on parental burnout is scant and many studies have only examined the condition in Western settings. The aim of this study was to examine parental burnout among Somali mothers in Mogadishu, Somalia, and its association with certain psychological, psychosocial, and sociodemographic factors. In this cross-sectional study, questionnaire data were collected through the measurements Parental Burnout Assessment and Patient Health Questionnaire 9, as well as through social and demographic questions. A total of 882 Somali mothers in Mogadishu participated. The analysis methods used were univariate, bivariate, and multiple linear regression analysis. The results revealed that the mean parental burnout score was low in the sample. Additionally, a significant association was found between higher levels of parental burnout and higher levels of depression, perceived lack of social support, being unmarried, having a low monthly household income, and when the youngest child was of school-age.

Background: Children with disabilities have an increased risk of mental health problems. Patterns of mental health problems and well-being may vary. AimsTo identify patterns of mental health problems and well-being in children with disabilities in Sweden, and investigate the influence of parental background (migration, education), and child cognitive level.

Method: In this cross-sectional study, cluster analysis was used to analyse parents' ratings of conduct problems, emotional symptoms, and prosocial behaviour on the Strengths and Difficulties Questionnaire (SDQ) in children with disabilities (n = 136). The influence of parental background (migration, education) and child cognitive level on cluster membership was explored through multinomial logistic regression.

Results: Five clusters of mental health patterns emerged. Three clusters had mean ratings near or past clinical cut-off for one each of the SDQ-subscales. One cluster had difficulties on all three subscales. Greater child cognitive difficulties increased the likelihood of low prosocial behaviour (OR 2.501, p < .001) and of difficulties on all three subscales (OR 2.155, p = .006). Parental background did not influence cluster membership.

Conclusion: Children with disabilities display varying mental health patterns. Awareness of the complexity of mental health patterns among children with disabilities is important. Screening and support for emotional symptoms and prosocial behaviour deficits should be considered for children with conduct problems.

Purpose: The reasons for and experiences during migration, as well as additional stressors in the new host country, may give rise to mental health problems and additional need for public services. The purpose of the study was to investigate factors related to service utilization among newly arrived refugee youth.

Design/methodology/approach: Cross-sectional data were gathered in Sweden where 37 youth aged between 19 and 23 reported on factors related to service utilization, encompassing health-care and support services in school. These factors included predisposition (demographic), need (migration status and mental wellbeing) and enablement (living situation). Service utilization was estimated using multiple logistic regression analysis.

Findings: About a fourth of the sample used psychosocial services. Use of general support was more common. Neither predisposing, need nor enabling factors were associated with the use of psychosocial or general health-related services.

Originality/value: Self-reported factors related to use of health-related services have previously not been investigated for refugee youth, which is important in assuring access to appropriate services for this exposed youth population.

Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020).

Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2.

Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection.

Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.