The STRESSFUL EVENTS AND PSYCHOLOGICAL IMPACT OF HIDDEN TRAUMA AMONG REFUGEE CHILDREN AGED 3–6 YEARS IN GERMANY: A QUALITATIVE STUDY

Authors

  • Zeina Tuffaha Community Medicine, Faculty of Medicine, University of Cyberjaya
  • Alabed Ali A. Alabed Community Medicine, Faculty of Medicine, University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000 Cyberjaya, Selangor Darul Ehsan, Malaysia.
  • Mohammed A. Abdalqader Community Medicine, Faculty of Medicine, University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000 Cyberjaya, Selangor Darul Ehsan, Malaysia.
  • Mohammad Saffree Jeffree Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu Sabah
  • Mohd Rohaizat Hassan Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
  • Nimetcan Mehmet Orhun Public Health Department, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Türkiye

DOI:

https://doi.org/10.37268/mjphm/vol.26/no.2/art.4048

Keywords:

Refugee children, early childhood, psychological distress, forced displacement, hidden trauma.

Abstract

Refugee children face multiple traumas before, during and after forced displacement. In early childhood, these experiences can include masked trauma, which are emotional, behavioral and developmental adaptations that are not obvious to the naked eye, as children do not have the capacity to talk about their internal feelings of distress. This study aimed to investigate the perceptions of caregivers about stressful experiences and the psychological consequences of invisible trauma in refugee children (ages 3–6) in Berlin, Germany. The study was a qualitative descriptive study that employed purposive sampling with six parents/primary carers of refugee children. The information was gathered by means of semi-structured interviews with twelve open-ended questions at refugee centers in Berlin. Thematic analysis was used to identify common themes in the interview data concerning the emotional, behavioral and developmental outcomes of displacement among children. Six themes were identified: disrupted communication and emotional expression, emotional distress and dysregulation, emotional withdrawal and social isolation, structural barriers to psychological support, disrupted sleep patterns and family stress, developmental regression and increased dependence. Persistent fear, emotional insecurity, communication difficulties, behavioral changes, sleep disturbances, and social adaptation difficulties in children consistently appeared in the reports of caregivers regarding the impact of forced migration.  The impact of forced migration was consistently reported by caregivers in terms of persistent fear, emotional insecurity, communication difficulties, behavioral changes, sleep disturbances and difficulties in social adaptation of children. Children from refugee backgrounds have experienced trauma that is hidden and can be seen in the way they behave, in their emotions and in how they learn, think and act. To ensure refugee children are resilient and healthy, early signs of trauma, trauma-informed mental health services, culturally appropriate services and support, and early childhood education services are all important.

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Published

2026-08-28

How to Cite

Tuffaha, Z., Alabed, A. A. A., Mohammed A. Abdalqader, Jeffree, M. S., Mohd Rohaizat Hassan, & Nimetcan Mehmet Orhun. (2026). The STRESSFUL EVENTS AND PSYCHOLOGICAL IMPACT OF HIDDEN TRAUMA AMONG REFUGEE CHILDREN AGED 3–6 YEARS IN GERMANY: A QUALITATIVE STUDY. Malaysian Journal of Public Health Medicine, 26(2), 120–125. https://doi.org/10.37268/mjphm/vol.26/no.2/art.4048