Poverty, not war trauma, harms cognition in child refugees

A young boy hangs on a fence with clothing hung from it, as Syrian refugees go about their daily business in the Za'atari refugee camp on February 1, 2013 in Za'atari, Jordan. (Credit: Jeff J Mitchell/Getty Images)

Poverty, not war-related trauma, drives cognitive deficits in child refugees displaced by conflict, according to a new study of adolescents affected by the crisis in Syria.

While somewhat unexpected, given the high levels of war exposure in Syrian refugees, the findings align with recent studies of US children living in adversity, researchers say.

The study published in Child Development, is the first to test executive function—a set of higher-order cognitive skills required for abstract thinking, decision making, and executing complex plans—in displaced Syrian youth and their Jordanian peers.

Displaced and non-displaced youth did not significantly differ in their working memory (the ability to keep goals in mind) or their inhibitory control (the capacity to resist impulses), suggesting that war-related trauma itself may not negatively impact people’s executive function.

However, the study did find evidence that the burden of household poverty, rather than trauma and violence, affect displaced adolescents’ working memory—which, by extension, can harm their ability to succeed in school or the labor market.

Child refugees living under adversity

The finding is consistent with recent studies of children living under adversity in the United States that found a disassociation between poverty and violence in predicting executive function, the researchers note.

“It’s striking that poverty alone influenced working memory, given the multiple war-related trauma the Syrian youth in our study had experienced,” says Catherine Panter-Brick, professor of anthropology at Yale University and the study’s principal investigator.

“Our study is the first to test cognitive skills in real-life settings and to disentangle the impacts of poverty, violence, levels of insecurity, and symptoms of post-traumatic disorder for both refugee and non-refugee populations. It offers important insights into links between childhood adversity and cognitive function.”

Researchers looked at 240 Syrian refugee and 210 Jordanian non-refugee adolescents between the ages of 12 and 18. The participants lived in four cities in northern Jordan—Irbid, Jarash, Mafraq, and Zarqa—that the Syrian crisis has heavily affected. Researchers assigned the youth tasks on tablet devices to assess skills related to working memory and inhibitory control.

The researchers used survey measures to assess poverty, levels of trauma exposure, post-traumatic stress disorder (PTSD), and insecurity. They conducted analyses to learn whether any of those factors predicted the youths’ performance on tasks involving inhibitory control and working memory.

The only association they observed was between poverty and working memory in the displaced youth. They did not see the association among the Jordanian youth, potentially because not enough variation in household wealth existed in this sample, the researchers say.

5.7 million displaced people

Since hostilities began in 2011, the Syrian crisis has forced nearly 5.7 million people to flee the country while another 6.5 million Syrians are internally displaced, creating the world’s largest refugee crisis since World War II, according to the Office of the United Nations High Commissioner for Refugees. Currently, there are currently, 28 million displaced children worldwide.

“Humanitarian agencies working with war-affected populations often hope to boost the ‘soft skills’ of socioemotional learning as well as educational achievement in childhood and adolescence,” says Panter-Brick.

“Working memory matters for learning outcomes, and what matters for working memory is the ongoing burden of poverty, more so than past exposure to violence.”

Panter-Brick’s research team, working with the same cohort of Syrian youth, has developed and tested a tool for measuring resilience in Syrian refugee youth; evaluated the effectiveness of a humanitarian intervention meant to improve the mental health of youth affected by the Syrian crisis; and showed that a humanitarian program reduced levels of cortisol, a hormone associated with stress.

Additional coauthors are from Harvard University, Queen Mary University of London, Hashemite University and the University of Richmond, the University of Wisconsin Madison, and the University of North Carolina at Chapel Hill.

Funding for the research, conducted in collaboration with Mercy Corps, a global non-governmental, humanitarian aid organization, came from Elrha’s Research for Health in Humanitarian Crises (R2HC), which in turn receives funding from the Wellcome Trust and the government of the United Kingdom.

Source: Yale University