Comparing Family Drawing Test Indices and Behavioral Problems between Iranian and Afghan Emigrant Children, Isfahan Province, Iran

The outcomes of immigration on behavioral problems have shown a risk perspective. This risk perspective focuses on the psychological problems of migration and the need to adapt to a new cultural environment (1). learning language, occupational, and social stressors set the stage for intergenerational conflict and stress in these families (2). These perspectives also emphasize that migrant families are frequently confronted with discrimination (3) which may negatively affect psychological status (4).

Children in migrant families are thought at increased risk for child maltreatment due to struggles related to difficult economic status; adverse interactions with law enforcement, and poor supportive network (5-7). In the case of comparison between groups, according to their risk profile, children in immigrant families significantly differ from children with US-born parents in unpleasant maltreatment and relational experiences (6, 8). Migrant children confronted with challenges of living in a new social and cultural environment in cities, although their family structure and values may not have changed (9). Almost 20% of emigrant parents left their children in their hometown when they were less than one year old (10). In addition, these children's long-term separation from parent(s), as well as unhealthy family and emotional caring, greatly impacts their life quality and their physical and psychological function as they grow-up (10, 11). Due to emigrant parents’ high work hours and relatively low level of education, emigrant parents often lack the time and skills to supervise their children’s educational status; this inadequate parent–child communication makes emigrant children more likely to have negative feelings, especially loneliness than urban children (12). interethnic and intercultural challenges are an urgent object of the scientific and practical research, today (13).

One of the commonly used methods for evaluating the psychological status of children, has been an analysis of their drawings. Children’s drawings can give clues about their previous and current lives. The child’s personality characteristics can be revealed through their drawings (14, 15). Clinicians and researchers believe that analytic interpretation of drawing indexes reveals negative affects (16) and traits, giving insight about who a person is (17). Drawing can fulfill different functions of children such as helping them recognize ideas about their selves, world and enable them to create visual representations of their thoughts and feelings (18). Drawing skills emerge during the second year of life and grow significantly through childhood (19-21). Drawings have also been used to identify attachment patterns in non‐abused children (22, 23). Despite some criticism about the validity of drawings as a projective test, practitioners with different theoretical approaches consider drawings as instruments that allow the child to express his/her negative affects (21).

Children with behavioral problems have inappropriate severe and inevitable reactions which are not individually and socially acceptable (24). Childhood behavioral problems are usually classified in two broad areas: internalizing and externalizing disorders. Externalizing disorders are identified with behaviors such as aggression, disobedience, hyperactivity, and impulsiveness; while, internalizing disorders are identified with experiences and behaviors such as depression, social isolation and anxiety (25). Children with behavioral problems are prone to depression (26) and the risk of having high-risk behaviors is more likely to threaten their health (27).

Afghans’ immigration has been the greatest movement in the last three decades of modern world history and more than 96% of it has been directed toward Iran and Pakistan (28, 29). Given the history of Afghans’ immigration to Iran, which has been started seriously and extensively from 1979 (30), it can be said that Afghans have been interacting with Iranians at least for 36 years, in the “immigrant” position. During this time, their relationship has always been affected as an “alien” minority with the host community by two facts: on the one hand, it is influenced by the fact that the host community has not accepted them as “Iranians” and on the other hand, it is affected by their own characteristics as marginal people (28). Despite the large number of Afghan refugees in Iran, few researches have been carried out on the emigrant children’s problems.

This research aimed to compare the family drawing test indices and behavioral problems in both concrete (Achenbach questionnaire) and projective (family draw test) measures among Iranian and Afghan emigrant children

The mean age and standard deviation for the Iranian group were equal to 9.3 (0.97) while they were obtained 9.65 (1.33) for the Afghan refugee group. Other demographic characteristics of research samples are presented in Table 1. Moreover, descriptive findings and final analysis are shown in Tables 2 and 3.

The results in Table 2 indicate that the difference between two groups of Iranian and emigrant students in the indicators of size, rhythm, drawing location, valuation, deletion of person and distance is significant (P < 0.05). Other indicators were not significantly different. After testing normal distribution by Kolmogorov-Smirnov test and equality of variances with the Levene test, the behavioral problems were analyzed by analysis of variances. The results presented in Table 3.

Based on the findings in Table 3, the difference between mean scores in overall behavioral problems, dimensions of somatization, problems of thinking and anti-social problem was significant in two groups (P < 0.05) but no significant difference was observed between the scores of depression-anxiety, depression-depression, social problems, attention and aggression of the two groups.

This research aimed to compare family drawing test and behavioral problems between Iranian and emigrant primary school children. The obtained results are discussed in the following.

There is a significant difference in the frequency of family drawing test indices in two groups of Iranian and non-Iranian primary school children. It was indicated that the drawing indices of Afghan refugee children are different from Iranian kids. That is, the abundance of some of the DAF test indices such as drawing size, rhythm of drawing, drawing location, valuation, removing a person and having distance with family members in emigrant children is more than Iranian children (19). Indicator of drawing size had three large, medium and small items; although the size of drawing of most Iranian and emigrant children was their average, the size of the drawing in about 26% of emigrant students was small. When the size of the drawing is small, It can mean depression, shyness and fear. On the contrary, when the child draws his painting to a large scale which exceeds the limit of paper, it can be a sign of convenience in self-expression (21). Indulgence in such feelings represents imbalance. Index of drawing rhythm included 2 states of with and without interruption; about 17 percent of emigrant students in this index draw their paintings with interruptions. It is often observed that a child repeats lines of symmetry in drawing a person or from person to another. This tendency to repeat the rhythm, which is sometimes followed up to real stereotypic behavior, is contrary to the free drawing that is the function of imagination and it means exactly that the subject has lost part of their temperament and normal state or lives under the influence of the imposed rules which can be related to strict restrictions and rules that the parents of Afghan children are likely to consider for the country in another country (19). The area of the page that is occupied by the painting can have a graphical meaning (21). In fact, along with children who use the entire page, there are subjects who limit their drawing to a small part of the page. In this index, about 29% of emigrant children had drawn their paintings at the bottom of the page which is more seen in depressed children. Depressed and incapable subjects who just draw at the bottom of the page, may be the children who are forbidden to have any sort of mutation toward the higher position and any kind of imagination (due to external or internal censorship). In the valuation index, emigrant children have acquired higher scores compared with Iranian children, in removing a person and also distance with family members. When a participant does not draw himself, it can be said that he does not feel comfortable in his current position in terms of age and sex. In addition, he wants to be someone else. Actually, it cannot be imagined that a child can remove himself from his family system. Therefore, it should be accepted that he has drawn himself in the form of someone else except in special cases who wants to occupy his place (20). In this case, it must be discovered that who his desire is matching. Also the matter that the child assumes themselves to be removed from the family means that may have difficulty to establish relationships with other members of the family. These results can be explained with feelings of rejection and being different which may have been created in the interactions of emigrant children with Iranian kids and can cause negative self-esteem.

The results of this study indicate that immigrant elementary school students gained a higher score than Iranian students in some behavioral problems like somatization, problems of thinking, anti-social harms as well as the total score of behavioral problems. According to the findings, the prevalence of some behavioral problems (subscales of checklist of Achenbach child behavioral problems) among emigrant children is higher than Iranian children. An interesting point in the results is that both somatization problems (as one of the intrinsic problems) and also anti-social complications (as one of the exogenous problems) is higher in Afghan children (Table 3) which indicates that negative coping strategies to overcome or existing problems are different and it is not merely show itself in the form of internalizing behaviors. This should be considered by countries which accept the immigrants. Perhaps the cultural adjustment level of families with the new society (especially given the religious difference), social rejection of immigrants (which could be due to the negative stereotypic impressions of Iranian citizens), separation from relatives (which can make feeling of loneliness and being different) (35) can be known as reasons of higher levels of behavioral problems in the studied population. Aggression is one of the most common externalizing behavior problems in childhood and adolescence. Many environmental factors in the life of Afghan children such as feeling of rejection in the interpersonal relationships, family problems, unwanted behavioral and emotional misconducts in the family environment, and patterning of aggression (25) in peer groups can explain the higher scores of this group compared to the Iranian students. Of course, it should be noted that this behavior is a kind of defensive response that helps the child and adolescent to reduce the emotional threats in the family environment and relationships with peers (25). Based on the results, the somatization subscale scores of the behavioral disorders in Afghan students are significantly higher than those of Iranian students. The interesting point in the results is that the aggression scores as the externalized behavior disorders are higher in these children, as well as the subscales scores of somatization as an internalized behavior disorder. An explanation can be that these children act on the basis of the learned pattern of emotional expression, due to a basic and underlying feeling of anxiety resulting from leaving the home country and problems of adaptation to the new environment (26). In the sense that if family and environmental conditions give these children the possibility of aggression, they will defend from their anxiety and worry, and if they are not able of the self-externalization through aggression, they will show their physical symptoms.