Exploratory study of salivary cortisol levels among Syrian refugee children

Refugees from wars often endure exceptionally traumatic experiences. Recovery may be difficult and dependent on supportive conditions in the new residence situations.Here we report an exploratory comparative study of Syrian refugee children (ages 8-12) residing either in the Al-Zaatari refugee camp (n = 39) or in a village in the neighboring city of Irbid, Jordan (n = 27). The Al-Zaatari camp was established in 2012 and is the largest residence site for Syrian refugees, with over 75,000 people. Our study is unique in having salivary cortisol data from Syrian refugee children residing in Jordan. We analyze cortisol levels from saliva samples collected in the morning (08:00-9:00) and later in the afternoon (13:00-14:00) on the same day. Cortisol is a key diagnostic biomarker for physical and mental health conditions. Results indicate exceptionally low cortisol levels for all children, and an unusual diurnal pattern of lower morning than afternoon cortisol among children residing in the camp. Inferences from these results are limited by the sample size, but are consistent with several other studies of cortisol patterns among refugees. We discuss several possible explanations for these findings: recovery to restore physical and mental resources, trauma-modified early childhood development, disrupted circadian schedules, technical issues, and current living conditions.