This study compares clinician appraisal of Bosnian refugee children with independent parent, child and teacher reports. From whom and by what means can children "at risk" be reasonably identified? Forty-eight Bosnian refugee children (aged 7-20), resettled in Sweden 1994-95, were assessed clinically by means of a semi-structured interview. Thereafter, standardized mental health questionnaires were administered to parents (Achenbach's Child Behavior Checklist), children (Achenbach's Youth Self-Report and Macksoud's Posttraumatic Stress Reaction Checklist) and teachers (clinician designed School Competence Scale and Achenbach's Teacher's Report Form). On clinician interview, nearly half of the children (48%) were identified with one or more mental health problem "demanding further attention". Depressiveness was the single most prevalent symptom (31%); followed by post-traumatic stress (23%), and anxiety-regressiveness (15%). At the same time, 75% of the children were rated by teachers as "quite competent" in school. Parent, child and clinician appraisals of primary school children showed broad similarities. Teachers reported a similar prevalence of child distress, but identified different symptoms and different children demanding attention. Evaluation of teenage youths showed greater disparity: teenagers labeled their own symptoms more often as post-traumatic stress reactions and teachers identified few youths in need of attention. Inter-relatedness among parent, child and clinician appraisals supports the robustness of our semi-structured interview. At the same time, apartness of teacher report underscores the need to incorporate an outside-world vantage point in the process of risk assessment. Also, a more concrete presentation of post-traumatic stress reactions and a higher "further attention" threshold for inward emotional problems seem called for.

Multiple informants Mental health Refugees PTSD Children and adolescents

teacher depression refugee anxiety disorder Child Reactive Disorders risk human sex difference Refugees Self Report risk assessment Interview, Psychological controlled study Bosnia and Herzegovina Depressive Disorder Anxiety Disorders child behavior Mental Disorders academic achievement mental disease Bosnia-Herzegovina Sweden school child Humans Adolescent parent male semi structured interview female Reproducibility of Results questionnaire high risk population clinical article emotional disorder prevalence child psychiatry Article adult defense mechanism age posttraumatic stress disorder Observer Variation distress syndrome Stress Disorders, Post-Traumatic Child Behavior Checklist personality assessment Child