Psychotic-like experiences, which are subclinical and not necessarily indicative of full-blown psychotic disorders, serve as crucial markers of mental health vulnerability. The high prevalence of PLEs reported in this study underscores a silent crisis faced by Afghan migrant children and adolescents living in Mashhad, Iran. With 94% of the 770 participants admitting to experiencing at least one psychotic-like symptom, the data signals an alarming mental health burden that has largely gone unaddressed in this demographic.

The study’s authors employed the Prodromal Questionnaire-Brief Child Version (PQ-BC), a validated tool designed to screen psychotic-like experiences among young populations. This approach allowed for a nuanced identification not just of the presence of PLEs but also the distress associated with these symptoms. Notably, around 34% of the sample surpassed the clinical cutoff point — indicating they experienced significant distress related to their psychotic-like symptoms — which highlights the urgent need for targeted mental health interventions.

A notable facet of this research is its differentiation between children and adolescents within the migrant cohort. Adolescents were found to be nearly twice as likely as younger children to report PLEs, a finding that aligns with developmental psychology frameworks suggesting heightened vulnerability during adolescence due to emotional, neurological, and social transitions. This age-related trend offers critical implications for designing age-appropriate and developmentally sensitive mental health services.

Central to the study’s inquiry was the examination of childhood trauma, particularly emotional abuse, as a predictor of PLEs. Emotional abuse, often elusive and underreported compared to physical or sexual abuse, emerged as a significant contributing factor. The study quantified this relationship, revealing that higher degrees of reported emotional abuse were associated with increased odds of experiencing psychotic-like symptoms. This finding resonates with a broader body of psychiatric literature that links early traumatic experiences with long-term alterations in cognitive and emotional processing.

Beyond trauma, the researchers explored two psychological constructs known to influence resilience and mental health outcomes: mindfulness and cognitive flexibility. Mindfulness, defined as the ability to maintain non-judgmental awareness of the present moment, was inversely correlated with the occurrence of PLEs, suggesting that higher mindfulness may serve as a protective factor amidst the mental health challenges posed by displacement and trauma. Conversely, higher cognitive flexibility — the capacity to adapt one’s thinking and behavior in response to changing environments and demands — was unexpectedly associated with increased PLEs, posing intriguing questions about how adaptability interacts with vulnerability in stress-exposed populations.

A comprehensive multivariate analysis integrating these variables confirmed their collective explanatory power for PLEs, accounting for 22% of variance in children and 29% in adolescents. While these figures indicate substantial unexplained variance remains, they firmly establish the interrelation between traumatic experiences and cognitive-emotional processes in shaping psychotic-like experiences. This multifaceted insight emphasizes the necessity of holistic mental health strategies that address not only trauma but also enhance adaptive cognitive skills and mindfulness.

The implications of these findings stretch beyond academic interest. Afghan migrant children and adolescents embody a distinctly vulnerable group, navigating the complexities of displacement, socio-economic marginalization, and cultural dislocation. This study elevates their mental health needs to the forefront, challenging policymakers, clinicians, and educators to rethink and strengthen support systems in host countries, particularly those bordering conflict zones like Iran.

Importantly, this research does not merely diagnose problems but gestures toward pathways of resilience and hope. The protective role of mindfulness interventions, widely accessible through schools and community programs, opens avenues for scalable mental health promotive practices. Simultaneously, the nuanced findings on cognitive flexibility invite renewed investigation into how adaptive cognitive traits can be harnessed or potentially moderated to mitigate psychological distress.

These results add a crucial new layer to the global psychiatric understanding of how migration-related adversity manifests in the mental health profiles of youth. They spotlight the subtleties of psychotic-like experiences — often hidden and misunderstood — as significant indicators of distress, underscoring the urgency for early detection and culturally congruent therapeutic approaches.

Moreover, the authors advocate for future longitudinal and intervention studies, encouraging a dynamic exploration of how these psychological factors evolve over time and how targeted therapies might recalibrate the mental health trajectories of young migrants. Such efforts align with contemporary agendas in psychiatry aimed at precision medicine and individualized care.

In conclusion, this pioneering study amplifies the voices of Afghan migrant children and adolescents, weaving a complex narrative that intertwines trauma, mindfulness, cognition, and psychotic-like experiences. It challenges prevailing stigmas around mental health in migrant populations and calls for science-informed, compassionate responses. As global displacement and migration trends persist, the insights gleaned here will be vital for informing mental health policies and services that are equitable, effective, and sensitive to the lived realities of migrant youth worldwide.

Subject of Research: Psychotic-like experiences among Afghan migrant children and adolescents, with predictive roles of childhood trauma, mindfulness, and cognitive flexibility.

Article Title: Prevalence of psychotic-like experiences among Afghan migrant children and adolescents: examining the predictive role of childhood trauma, mindfulness, and cognitive flexibility

Article References:
Rezaee, A.R., Hosseini, S.R. & Firoozabadi, A. Prevalence of psychotic-like experiences among Afghan migrant children and adolescents: examining the predictive role of childhood trauma, mindfulness, and cognitive flexibility. BMC Psychiatry 25, 678 (2025). https://doi.org/10.1186/s12888-025-06979-x

Image Credits: AI Generated

DOI: https://doi.org/10.1186/s12888-025-06979-x

The psychosocial ramifications of forced migration represent a multifaceted challenge that encompasses not only mental health but also profound social disruptions. Forced migrants frequently endure a gamut of stressors including trauma, social displacement, loss of community ties, and chronic uncertainty about their future. These factors cultivate a fertile ground for psychological distress, which in turn manifests as anxiety, depression, and an array of psychosomatic symptoms. The foundational role of psychosocial support in mitigating these symptoms has been well documented; however, the nuances of how such interventions impact the broader social ecology of refugees remain less understood. Ubels’ findings illuminate the interplay between mental health services and social connectedness, revealing that an individual’s network of social relationships significantly influences the efficacy of psychological treatments.

Central to this body of research is the recognition that psychological support often becomes a surrogate for social contact in the lives of refugees and undocumented migrants. Ubels notes the phenomenon where individuals rely heavily on their psychologists not only as mental health professionals but also as primary, and sometimes sole, sources of social interaction. This dynamic, while understandable, signals a concerning void in the social networks of these vulnerable individuals. When an individual lacks diverse social contacts and depends predominantly on therapeutic relationships, the broader psychosocial rehabilitation process can be compromised. This observation highlights the critical need for enabling conditions that foster social engagement beyond clinical settings.

To investigate these patterns, Ubels employed a mixed-methods approach involving quantitative surveys and qualitative interviews with undocumented migrants in the Netherlands and refugees residing in a protracted settlement in Uganda. These populations represent two distinct yet comparable contexts: one characterized by relative access to healthcare yet limited social participation, and the other marked by secure refugee status but constrained infrastructural resources. In the Netherlands, undocumented migrants face legal invisibility and barriers to employment and education, exacerbating isolation and economic precarity. Conversely, the Ugandan settlement, despite its long-standing refugee presence and clearer legal frameworks, struggles with insufficient facilities and livelihood opportunities, limiting the refugees’ self-sufficiency and social mobility.

The dichotomy between these contexts surfaces critical insights into the structural determinants of psychosocial well-being. In the Netherlands, undocumented migrants’ marginalization restricts their ability to build meaningful social ties, as many live under the radar to avoid detection and deportation. This invisibility renders targeted outreach and engagement inherently challenging. The lack of legal work and formal education opportunities traps many in cycles of poverty and social exclusion, thereby attenuating the potential gains from psychosocial programs. In contrast, Ugandan refugees, while unable to fully access resources, benefit from semi-organized community structures that facilitate mutual assistance and shared coping mechanisms, indicating that community-based support systems enhance psychosocial resilience.

Analyzing varied aid programs offers further elucidation. Ubels documented that in the Netherlands, psychological services included individual therapy sessions and group workshops aimed at stress management and healthcare navigation. Yet, the effectiveness of these programs correlated strongly with participants’ ability to engage socially outside of therapeutic interactions. Those who maintained informal connections—whether through voluntary work or community activities—exhibited better psychosocial outcomes than those isolated from such engagement. This finding aligns with psychological theories emphasizing social capital’s role in mental health, suggesting that social integration functions as a buffer against psychological distress.

In Uganda, the research focused on a participatory program where refugees actively supported one another in facing everyday adversities. This peer-led approach not only fostered social cohesion but also stimulated entrepreneurial initiatives such as small-scale businesses and agricultural projects, thereby contributing to economic self-reliance. The linkage between economic empowerment and mental health is well substantiated in migratory contexts, where financial stability alleviates stress while enhancing individual agency. Ubels poignantly asserts that psychosocial support must be complemented with tangible improvements in refugees’ material conditions to achieve sustainable impact; psychological interventions devoid of economic and social context risk falling short.

Moreover, the study brings attention to how funding cuts and tightening migration policies increasingly threaten the foundational elements of refugee support systems. Reduced investment in development cooperation and restrictive regulatory frameworks hinder access to basic needs like food security and housing stability. Consequently, refugees and undocumented migrants encounter aggravated stressors that exacerbate mental health problems and undermine aid programs’ effectiveness. This predicament calls for multisectoral policy responses that integrate mental health care with social protection and inclusion strategies.

Beyond targeted interventions, Ubels advocates for inclusive programs that engage refugees and undocumented migrants within broader societal frameworks. Given that many challenges faced by these groups—such as poverty and social isolation—are not exclusively migratory issues but broader social problems, creating inclusive communal spaces fosters diverse networks. Such integration diminishes the dependency on specialized aid organizations by embedding vulnerable individuals within mainstream social fabrics. The expansion of neighborhood-level initiatives that bring together people from diverse backgrounds emerges as a promising avenue for reinforcing social capital and enhancing collective well-being.

Ubels’ discourse emphasizes the necessity for a paradigm shift in refugee support paradigms, moving from isolated psychological treatments to holistic models that encompass social and economic dimensions. The integration of mental health services with community development, economic empowerment, and legal inclusion is pivotal. Such comprehensive frameworks acknowledge the interconnectedness of mental health and the socio-political realities migrants face, thereby offering more enabling environments for recovery and flourishing.

The methodological rigor in Ubels’ work, combining ethnographic depth with quantitative data, strengthens the credibility of these findings. By situating psychosocial support within lived realities across continents and socio-political contexts, her research foregrounds the diverse manifestations of vulnerability and resilience. This comparative lens enriches our understanding of how policy environments, community structures, and individual agency converge to shape mental health trajectories in forcibly displaced populations.

In light of these insights, stakeholders including mental health practitioners, policymakers, and humanitarian organizations must reconsider intervention designs. Strategies that facilitate legal pathways to work and education not only enhance psychosocial outcomes but also contribute to broader social stability. Encouraging voluntary engagement in community life, alongside maintaining professional psychological services, constitutes a balanced approach that can mitigate social isolation and promote sustainable integration.

Ultimately, Ubels’ research advocates for a nuanced appreciation of the social determinants of mental health within migratory contexts, challenging conventional reliance solely on psychosocial support. By highlighting the complementary roles of community integration and economic empowerment, her work sets a precedent for developing intervention models resilient to the evolving challenges of forced migration. These findings have profound implications for the design of inclusive, effective, and humane migration policies worldwide.

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Subject of Research: The interplay between psychosocial support and social integration among refugees and undocumented migrants in the Netherlands and Uganda.

Article Title: Beyond Therapy: The Social Dimensions of Psychosocial Support for Refugees and Undocumented Migrants

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Keywords: refugees, undocumented migrants, psychosocial support, mental health, social integration, forced migration, Netherlands, Uganda, social networks, economic empowerment, community resilience, migration policy