background In unaccompanied refugee minors following resettlement in Western countries, posttraumatic stress disorder (ptsd) appears to be the most prevalent serious mental disorder. It is unclear to what extent ptsd in this group may manifest at later stages following arrival in the host country and which factors may contribute to late onset.
aim To estimate the prevalence of late-onset ptsd in unaccompanied refugee minors and to explore associated factors, including preexistent demographic factors, traumatic eventrelated variables, and posttraumatic factors.
method We used mental health data from unaccompanied refugee minors in the Netherlands collected approximately one (T1) and two years (T2) following resettlement. We created a structural equation model and examined differences between groups with ptsd and late-onset ptsd using multiple group analysis.
results Of the final sample completing both assessments (N=554), 223 (40%) minors met criteria for ptsd at T1, and an additional 88 (16%) met these criteria only at T2 and were thus considered to endorse late-onset ptsd. Late-onset ptsd was not associated with new traumatic events or not obtaining a residence permit. A model including effects of traumatic event exposure, (older) age, (lack of) supervision, and depression and anxiety symptoms explained 65% of the variance in number of ptsd symptoms at T2. In the ptsd group, predictor effects were mainly direct or mediated by ptsd symptoms at T1. In contrast, in the group with late-onset ptsd, effects of traumatic event exposure, age and supervision on number of ptsd symptoms at T2 were fully mediated by depression and anxiety symptoms.
conclusion These results suggest, that late-onset ptsd is an important problem among unaccompanied refugee minors and that depression and anxiety symptoms play a cardinal role in its development.