Risk and resilience in Syrian refugee children: A multisystem analysis

Exploratory study of salivary cortisol levels among Syrian refugee children

Refugees from wars often endure exceptionally traumatic experiences. Recovery may be difficult and dependent on supportive conditions in the new residence situations.Here we report an exploratory comparative study of Syrian refugee children (ages 8-12) residing either in the Al-Zaatari refugee camp (n = 39) or in a village in the neighboring city of Irbid, Jordan (n = 27). The Al-Zaatari camp was established in 2012 and is the largest residence site for Syrian refugees, with over 75,000 people. Our study is unique in having salivary cortisol data from Syrian refugee children residing in Jordan. We analyze cortisol levels from saliva samples collected in the morning (08:00-9:00) and later in the afternoon (13:00-14:00) on the same day. Cortisol is a key diagnostic biomarker for physical and mental health conditions. Results indicate exceptionally low cortisol levels for all children, and an unusual diurnal pattern of lower morning than afternoon cortisol among children residing in the camp. Inferences from these results are limited by the sample size, but are consistent with several other studies of cortisol patterns among refugees. We discuss several possible explanations for these findings: recovery to restore physical and mental resources, trauma-modified early childhood development, disrupted circadian schedules, technical issues, and current living conditions.

Hair hormone data from Syrian refugee children: Perspectives from a two-year longitudinal study

For numerous issues of convenience and acceptability, hair hormone data have been increasingly incorporated in the field of war trauma and forced displacement, allowing retrospective examination of several biological metrics thought to covary with refugees' mental health. As a relatively new research method, however, there remain several complexities and uncertainties surrounding the use of hair hormones, from initial hair sampling to final statistical analysis, many of which are underappreciated in the extant literature, and restrict the potential utility of hair hormones. To promote awareness, we provide a narrative overview of our experiences collecting and analyzing hair hormone data in a large cohort of Syrian refugee children (n = 1594), across two sampling waves spaced 12 months apart. We highlight both the challenges faced, and the promising results obtained thus far, and draw comparisons to other prominent studies in this field. Recommendations are provided to future researchers, with emphasis on longitudinal study designs, thorough collection and reporting of hair-related variables, and careful adherence to current laboratory guidelines and practices.