The Children's Hospital of Michigan Foundation granted $75,000 to the Wayne State University School of Medicine to support a cohort study into post-traumatic stress disorder, anxiety and depression in refugee children from Syria and Iraq.

This is the first external funding for the study, which principal investigator WSU Assistant Professor of Psychiatry and Behavioral Neurosciences Arash Javanbakht, M.D., launched a year ago. The research was previously supported by departmental funds from the state of Michigan in collaboration with the Detroit Wayne Mental Health Authority and Behavioral Health Professionals Inc.

Recent combat in Syria and Iraq have forced millions of civilians to flee those countries. Many of these refugees have settled in southeast Michigan. The stress of the migration has the potential to produce extreme mental and emotional impact, in addition to the trauma of exposure to war, Dr. Javanbakht said.

"I am very excited that it will be the first step to establishing a cohort, where we can follow the cohort through young adult age. I am happy that people appreciate the importance of this unique work and the data that can very much help our understanding of trauma and stress," Dr. Javanbakht said. "The Children's Hospital of Michigan Foundation plays such a vital role in providing the startup funds to research such important programs such as the mental health of refugee children."

Preliminary study data released earlier this year suggested that more than half of refugee children suffer from anxiety, and 80 percent have separation anxiety. Thirty percent of refugee adults have PTSD,a rate higher than that of returning veterans. "Now, we have the data on more than 300 adults and children that show the same rate of stress, depression and trauma as the initial pilot data. We also have data on nearly 200 Iraqi refugees that is in the analysis pipeline," Dr. Javanbakht added.

They will use the new funding to follow their cohort and examine changes in epidemiological and biological correlates of trauma, and the role of environmental factors in these changes among children. From other sources, they will collect similar data on parents to examine the impact of stress and trauma within the family structure. Dr. Javanbakht and a team plan to collect epidemiological, PTSD, anxiety and depression prevalence data, saliva samples for genetics and inflammation markers, and hair samples to measure cortisol levels in 100 Syrian and Iraqi refugee children at the one- and two-year mark following the initial data collection.

The results may help determine the longitudinal impact of trauma in Syrian and Iraqi refugee children in southeast Michigan, determine the environmental factors moderating the impact of trauma in children, advance knowledge of the biomarkers of trauma in children and provide pilot data to apply for larger grants from the National Institutes of Health grants to follow the population for several years, possibly leading to a multifaceted study of the longitudinal interaction of trauma, culture, environment and neurobiology, he said.

While research on psychobiological components of resilience and vulnerability to development of PTSD and other consequences of trauma is rapidly developing, very little is known about the effects of war trauma on civilians from the Middle East. Environmental factors after resettlement, such as cultural and language familiarity, finances, housing, employment, access to resources and new family dynamics, can play a role in stress levels affecting PTSD and depression symptoms severity above or below diagnostic thresholds. Additionally, data is very limited in child refugees, Dr. Javanbakht said.

Of the 2017 grants funded to date by the Children's Hospital of Michigan Foundation, 17 percent have funded programs and research at WSU.

(August 23, 2017)