Assessing trauma and related distress in refugee youth and their caregivers: should we be concerned about iatrogenic effects?

M. Claire Greene, Jeremy C Kane, Paul Bolton, Laura K. Murray, Milton L. Wainberg, Grace Yi, Amanda Sim, Eve Puffer, Abdulkadir Ismael, Brian J. Hall

Research output: Contribution to journalArticlepeer-review


Assessment of potentially traumatic events and related psychological symptoms in refugee youth is common in epidemiological and intervention research. The objective of this study is to characterize reactions to assessments of trauma exposure and psychological symptoms, including traumatic stress, in refugee youth and their caregivers. Eighty-eight Somali youth and their caregivers participated in a screening and baseline interview for a psychological intervention in three refugee camps in Ethiopia. Participants were asked about their levels of distress prior to, immediately after, and approximately two weeks after completing the interview. Other quantitative and qualitative questions inquired about specific reactions to interview questions and procedures. Children and caregivers became increasingly relaxed over the course of the interview, on average. Few children (5.3%) or caregivers (6.5%) who reported being relaxed at the beginning of the interview became upset by the end of the interview. Some children and caregivers reported that certain assessment questions were upsetting and that feeling upset interfered with their activities. Despite some participants reporting persistent negative reactions, most reported liking and benefitting from the interview. While the majority of refugee youth and their caregivers reported positive experiences associated with completing trauma-related assessments, some reported negative reactions. Researchers and practitioners must consider the necessity, risks, and benefits of including questions about potentially traumatic events and related symptoms that are particularly upsetting in screening, survey research, and clinical assessment. When included, it is important that researchers and practitioners monitor negative reactions to these assessments and connect participants who become distressed with appropriate services.

Original languageEnglish (US)
Pages (from-to)1437-1447
Number of pages11
JournalEuropean Child and Adolescent Psychiatry
Issue number9
StatePublished - Sep 2021


  • Adolescent
  • Caregivers
  • Child
  • Refugees
  • Survey and questionnaires
  • Trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Assessing trauma and related distress in refugee youth and their caregivers: should we be concerned about iatrogenic effects?'. Together they form a unique fingerprint.

Cite this