Medicine:Asylum seekers with apathetic refugee children

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Asylum seekers with apathetic refugee children was a medical and political debate in Sweden in 2006 concerning asylum seekers who came to Sweden with apathetic children.[1] The period was a subject of media coverage starting in 2002, with 55 cases[2] and in 2005, it escalated to 424 cases. The refugees were mostly from Kazakhstan, Kyrgyzstan, Uzbekistan, Armenia, Azerbaijan, and former Yugoslavia.[3][4] After a long heated debate, psychiatrist Thomas Jackson, the state investigation expert who held the controversial idea that the children were being abused and should be separated from their parents, was shut out of the debate.[5] [6] The debate ended with a more generous refugee policy that formulated a new condition for the apathetic children titled "resignation syndrome" (uppgivenhetssyndrom in Swedish).[7][8] Jackson vehemently opposed this diagnosis insisting on calling it coerced child abuse.[9] Jackson also criticized Swedish doctors and the healthcare system for indirectly contributing to child abuse.[10] When suspicions of manipulation or abuse were uncovered, News24 published an article in 2005 of a "child-abuse scam being uncovered in Sweden".[11]

Resignation syndrome

Resignation syndrome is characterized by depression, apathy, non-communication, and loss of bodily functions. There are also signs of severe long-term stress which are worsened by asylum processes, waiting times, and rejection by the home country.[12] It is also followed by a gradual behavioral withdrawal into an unconscious and severely handicapping state that requires tube feeding.[13]

The children are unable to move, eat, drink, or respond even to painful stimuli and can be in this state for months or years.[citation needed] When the refugee families' social situation improved, most children recovered.[14] In other medical professions, the condition is seen as a hoax or child abuse with the goal of being granted permanent residence.[15]

Debate

The debate involved several doctors, reporters, and activists who all engaged with the goal of understanding whether the children were simulating or if they were victims of severe abuse.[16] According to an article published in Svenska Dagbladet by chief physician Hans Bendz, simulation is a known phenomena and it is not impossible in the case of the apathetic children.[17] A study conducted in 2016 stated that the children were either catatonic[18] as a result of psychogenic stress due to waiting for asylum or that they were a victims of malingering by proxy,[19] rendering them unable to eat, drink or talk.

The hypothesis was that the children had become severely catatonic once they had found out that they were being deported as families lacked asylum. The Swedish Social and Health Authority, in its Guidelines on Uppgivenhets Syndrome published in 2013, writes that a patient is not completely healthy until the family has received a permanent residence permit.[20]

However, the debate continued over the origin of the phenomena. Swedish doctor Henry Ascher, together with Anders Hjern, claimed that it was due to trauma related to being refugees.[21][22] This thesis was supported by Gellert Tamas.[23] The phenomena was titled as an epidemic.[24] In an open letter signed by 42 psychiatrists, they demanded that the government stop promoting child abuse by not granting permanent residence.[25] In 2004, the government initiated a state investigation with the goal of analyzing and surveying the prevalence of the condition[26] but reporters from Sveriges Radio accused the state investigators of lying.[27]

Criticism against Tamas

Gellert Tamas, author and lecturer, published a book titled De Apatiska (lit. The Apathetic) criticizing Swedish doctors and politicians who suspected that the children were simulating or were being manipulated. The book was criticized by Swedish doctor and associate professor, Tomas J Eriksson, stating that Tamas had failed to discuss why there was an increase from zero to 400 cases within a few years and why it decreased again.[28] He also stated that Tamas had failed to explain why the condition only affected children awaiting asylum and who were accompanied by family members. Tamas also never discussed why the phenomena only occurred among children from former Yugoslav and Soviet republics. Eriksson also questions why Tamas does not explain how this never happens among Swedish children who are under severe pressure.

Eriksson had stated in a debate on SVT[clarification needed] that he had treated many refugee children and stated that the children were either poisoned or manipulated.[29] Peter Engelsöy, deputy head and chief physician, stated in an article published by Aftonbladet that Tamas' book was full of incorrect statements and that Tamas had used character assassination on Engelsöy.[30] The heads of the Swedish agency for child and youth psychiatry (Barn- och ungdomspsykiatrin) criticized Tamas in an article published by Aftonbladet stating that Tamas was spreading rumors about the psychiatrists' alleged incompetence in treating apathetic children.[31] The criticism was that the psychiatrists could not solely base their clinical diagnosis on Tamas publications without the risk of encouraging child abuse.

An article in Dagens Nyheter stated that Tamas' credibility can be questioned.[32] Tamas was reported by the governments' state experts Marie Hessler and Nader Ahmadi to the Granskningsnämnden för radio och TV (the investigation committee for radio and TV) for having intentionally distorted the commentary of several participants in the Swedish television program Uppdrag Granskning's episode of "The Toying of the Apathetic".[33] Thomas Jackson stated in lectures for healthcare staff and in his publications that Tamas' book was dangerous for apathetic refugee children as he spread rumors that the national agencies had, in turn, spread rumors that the children were simulating.[34] According to an article published by DTMedia, reporters Gellert Tamas and Janne Josefsson did not listen to the criteria for forced simulation which Jackson presented in his participation on Uppdrag Granskning.[35]

Government investigation

According to Nader Ahmadi, the research leader of the state investigation SOU:2006, in some cultures, children could be used "holistically" for the survival of the family.[36][37][38] Ahmadi has also stated in an article by Gefle Blad that "manipulation, simulation and poisoning of the children is not impossible".[39] Most children were from former Soviet republics and former Yugoslavia.[40] Marie Hessler, head of the Stockholm County Council's child psychiatry unit, stated that she had never witnessed any similar cases in the neighboring Nordic countries.[41] Hessler was heavily criticized in the fevered debate for her neutrality by the Liberals, the Center Party and the Christian Democrats.[42]

In 2005, there was a case of a severely depressed boy who faced deportation and the Swedish humanitarian organizations demanded he be granted permanent residence. However, the proposal was voted against by the Moderate Party. At the time, migration minister, Barbro Holmberg, said that giving special treatment could increase the risk for even more asylum children to become apathetic.[43] The Green Party's leader, Gustav Fridolin, accused her of being racist stating that asylum families would never manipulate their children.[44] Holmberg was also criticized in chronicles published in Barometern and Gefle Blad for having stated that "refugee parents drugged and abused their own children".[45][46]

Annica Ring, an executive official in the Migration Board office in Solna, Stockholm, was interviewed by Svenska Dagbladet. In this interview, she stated that the board had been investigating some "irregularities" among the refugee families indicating that the parents were in some way responsible for the condition of the children, either through psychological manipulation or medication. The board reported this to the social authorities and when nothing happened, they turned the report to the police who suspected that the children had been poisoned.[47] The board was heavily criticized by the Swedish media.[48] Björn Sundin, a reporter stated that he did not believe in the state investigation expert Thomas Jackson's theory after he, as a symbolic protest, joined Svenskarnas Parti, but Sundin noted that Jackson's argumentation had validity and credibility, and that the critique of Jackson was not met objectively.[49] Swedish author, Lars Ulwencreutz, praised Jackson in his book for "having the bravery of calling the phenomena child abuse".[50]

Child abuse

However, Thomas Jackson, psychiatrist, doctor and the elected expert of the state investigation during the Labour Party at the time concluded that the children were under severe abuse being tube fed by parents or guardians intending to weaken the child to gain wealth from the Swedish welfare system.[51][52] This led to a large controversy and Jackson was labeled as an "incompetent Nazi" by author Gellert Tamas[53] and by reporters Malena Rydell and Jenny Wennberg of Arbetarbladet.[54][55]

According to Jackson, the abuse has continued and he proposed the term, "commando syndrome".[56] Jackson has reported that after his investigation, he was contacted by trafficking gangs from Eastern European countries who threatened him. After having contacted the police, they stated that the threats were due to the unveiling of criminal networks. Jackson published an article in Dagens Medicin but it was removed as Jackson's standpoint was too controversial.[57] Jackson's thesis is supported by Marc Feldman, an expert on Munchausen by proxy.[58] Tomas Eriksson, an elected expert of the state investigation, has stated that the children might be manipulated or poisoned.[59] Lise Tamm, the state prosecutor, began an investigation based on reports that refugee parents were criminally abusing their children, but Socialtjänsten, the Swedish social service, had "conflicting interests" with the authorities which made an investigation impossible.[60]

Tamm stated in 2006 that the Migration Board had reported nine parents in Stockholm who were suspected of abusing their children.[61][62] Tamm concluded that Tamas had intentionally distorted her commentary of the situation.[63] In 2011, child right experts, Laila Lindberg and Sara Damber, stated in an article published by Svenska Dagbladet that apathetic children were denied help as health care personnel often lacked courage and knowledge in their diagnosis of the potential abuse of the children.[64] In another article by Svenska Dagbladet, the National Board of Health and Welfare had failed in reporting the suspected abuse of children by refusing to cooperate with the authorities.[65] Some healthcare personnel had witnessed how parents in secret emptied the nourishing drop from the children's tubes.[66]

In some cases, there were reports of families hating their children who were not always sick.[67] According to an article published by Aftonbladet in 2005, Janna Valik, the general director of the Migration Agency, failed to investigate reports of abuse among apathetic children and was displaced by the government.[68] The Chancellor of Justice started an investigation of the Migration Agency to determine if the correct procedure had been followed.[69]

Sweden

In a study conducted in September 2011 by Henry Ascher from the University of Gothenburg, the refugee children were caught in an ambiguous debate: on one side, it was Sweden's humane migration policy following the UN Convention on the Rights of the Child and on the other hand, the suspicion of guardians abusing their children after receiving the decision of deportation.[70] According to an article by the BBC, the phenomenon occurs only in Sweden and is labeled as "resignation syndrome".[71] Jackson has commentated on this stating that the correct term for this phenomenon should be "commando syndrome".[72]

In an article by Melissa Sartore of the Ranker, the children became ill after the parents were denied asylum. She described it as a "mysterious disease".[73] Göran Bodegård wrote in his commentary on the paper "Pervasive Refusal Syndrome (PRS) 21 years on—a reconceptualization and renaming" that after the families were denied residency, 400 children fell ill.[74] In 2016, Dagens Medicin published an article about the increasing numbers of apathetic refugee children.[75] BMJ published an article about the Karolinska Institutes controversy whether or not the children were simulating or being abused.[76]

According to an article by Professor Karl Lofgren from the Victoria University of Wellington, he discussed how the children could be traumatized by war despite not having lived in a war zone since the majority came from former Yugoslavia and the Soviet Union.[77] Lofgren also stated that there was no psychiatrist involved in the state investigation. This is incorrect as Thomas Jackson is mentioned as the licensed psychiatrist.[78] Lofgren also wrote that when all refugee children were granted general amnesty in 2005, there was a decrease in cases in 2007.[79] Thomas Jackson has stated that there are over 2000 children possibly being abused since many of the guardians now are paid by the state to provide care for the children.

Bill Schiller from the BBC aired a radio episode stating that this phenomenon did not exist in other countries which led to a savage debate as to whether or not the children were faking.[80] According to an article by Svenska Dagbladet, the number of apathetic refugee children has decreased ever since financed care was provided for the guardians at home.[81] Migrationsverket, Sweden's Migration Agency, suspected 13 cases of malingering by proxy where parents were found abusing their children.[82][83] Several doctors and nurses stated in an interview that the parents used physical violence on the doctors if they did not immediately recommend asylum. Many doctors provided the guardians with tubes in to nurture them; thereby, furthering the abuse. Some children were also isolated with windows and curtains closed.

Karl Sallin, a pediatrician at Karolinska University Hospital, told the New Yorker that "another way to give the children hope would be to treat them properly and not leave them lying on a bed with a nasal tube for nine months".[84] In the spring of 2005, the debate about the apathetic refugee children had grown stronger mobilizing asylum rights movements with organizations, individuals, political parties, and religious communities who all campaigned for a general amnesty. Apathetic refugee children and their parents were subjects of skepticism as an increasing suspicion of forced manipulated coercing was a possible risk. Gellert Tamas claimed these statements were not true.[85]

Björn Lundin, the head physician at the child and youth psychiatric clinic and Stefan Croner, the head physician at the child and youth medicine clinic, presented munchhausen-by-proxy as a theory in an article explaining that in some cases the children are victims of severe abuse. The doctors stated that in these cases one of the parents, usually the mother, is the perpetrator.[86]

Nocebo effect

According to an article by Hannah Bradby in 2017, there was a risk of the "nocebo effect", the "evil twin" of the placebo effect, where a doctor, through a supposedly neutral medical intervention, brings about unwanted side effects. Well-meaning doctors reinforce the necessity for refugee children's extreme suffering in to persuade the Migration Board to grant residency permits which leads to a self-fulfilling prophecy where the parents decide that only granted residency will make the child healthy again. The idea was criticized as it prevented a proper medical investigation of the child's condition.[87] Bradby also stated that within days, after the child is separated from the parents, regardless of the previous condition of the child, the child becomes healthy eating and drinking like normal.[88] Jackson has stated that this type of phenomenon does not exist in Norway as the children who fall victim to this are separated from the parents to see if they recover.

Culture

In 2011, the Stockholm State Theater, having drawn inspiration from Gellert Tamas book "De Apatiska" (lit. The Apathetic), hosted a play mocking politicians and medical personnel who suspected malingering by proxy and who disagreed with the idea that the children were traumatized from war.[89] There is also an Australian group who performs, named "Apathy for Beginners"[90]

See also

  • Psychosomatic illness

References

  1. ↑ Brink, Susan. "In Sweden, Hundreds Of Refugee Children Gave Up On Life" (in en). NPR.org. NPR (Swedish refugee children). https://www.npr.org/sections/goatsandsoda/2017/03/30/521958505/only-in-sweden-hundreds-of-refugee-children-gave-up-on-life. Retrieved 15 July 2019. 
  2. ↑ Graham, Mark (2018) (in en). Bureaucracy, Integration and Suspicion in the Welfare State. Routledge. ISBN 9781317299646. https://books.google.com/books?id=X6txDwAAQBAJ&q=apathetic+refugee+children+debate&pg=PT264. Retrieved 22 July 2019. 
  3. ↑ Jacobsen, Stine Lindahl; Thompson, Grace (2016) (in en). Music Therapy with Families: Therapeutic Approaches and Theoretical Perspectives. Jessica Kingsley Publishers. p. 249. ISBN 9781784501051. https://books.google.com/books?id=EebiDAAAQBAJ&q=apathetic+children+resignation&pg=PA249. Retrieved 22 July 2019. 
  4. ↑ Radio, Sveriges. "Apathetic Children "In The Risk Zone" - Radio Sweden" (in en). sverigesradio.se. https://sverigesradio.se/sida/artikel.aspx?programid=2054&artikel=3423106. 
  5. ↑ (Swedens State Television), SVT (26 March 2012). "Läkaren Thomas Jackson går med i ett högerextremt parti (Dr. Thomas Jackson joins right wing extreme party)" (in sv). SVT Nyheter. SVT (News). https://www.svt.se/kultur/lakaren-thomas-jackson-gar-med-i-ett-hogerextremt-parti. Retrieved 16 July 2019. 
  6. ↑ läkare, Thomas Jackson, licensed psychiatrist and doctor; Psykiatri, Specialist I. Allmän; Psychiatry, Director European College of (22 April 2012). "Nej, jag är inte nazist (No, i am no nazi)" (in sv). na.se. https://www.na.se/artikel/nej-jag-ar-inte-nazist. 
  7. ↑ Leasa, Stacey (29 March 2017). "Hundreds Of Kids Are Falling Into Comas In Sweden And Nobody Knows Why" (in en). GOOD. Good Health. https://health.good.is/articles/refugee-children-sweden. Retrieved 15 July 2019. 
  8. ↑ Svenska Akademiens ordlista, 14th ed. (2015)
  9. ↑ Borders, Psychiatry Without (2019) (in en). Review of the psychiatric and criminal phenomena "Malingering by Proxy" or "Commando Syndrome" occurring amongst Apathetic Refugee Children in Sweden.. https://www.academia.edu/39151112. 
  10. ↑ Jackson, Thomas (in sv-SE). Jackson Jagar Journalister: (Image 12: Article from 2006 in Dagens Medicin where Jackson criticized Swedish healthcare and doctors of contributing to child abuse). http://jajj.se/artikel-i-dagens-medicin-ar-2006-raddade-100-tals-apatiska-barn-men-censurerades/bild-12-5/. Retrieved 16 July 2019. 
  11. ↑ Ryznar, Margaret (2005). "Family Law Prof: Child-Abuse Scam Uncovered in Sweden" (in en). lawprofessors.typepad.com. Indiana University (Robert H. McKinney School of Law) (Child abuse scam uncovered in Sweden. Originally published by News24). https://lawprofessors.typepad.com/family_law/2005/11/childabuse_scam.html. Retrieved 16 July 2019. 
  12. ↑ Oliver Razum, Yudit Namer. Settling Ulysses: An Adapted Research Agenda for Refugee Mental Health (http://ijhpm.com Int J Health Policy Manag 2018, 7(4), 294–296. Article History: Received: 25 July 2017 Accepted: 31 October 2017 Published online: 8 November 2017 ed.). Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.. p. 295. http://www.ijhpm.com/article_3436_36c373fb49d295b2ee74739a2804ade0.pdf. 
  13. ↑ Gómez-Carrillo, Ana; Kirmayer, Laurence J. (2019) (in en). Agency, embodiment and enactment in psychosomatic theory and practice. pp. 169–182. https://mh.bmj.com/content/45/2/169#ref-2. Retrieved 15 July 2019. 
  14. ↑ Lundberg, Ulf; Cooper, Cary (2010) (in en). The Science of Occupational Health: Stress, Psychobiology, and the New World of Work. John Wiley & Sons. ISBN 9781444391114. https://books.google.com/books?id=jUZ201FykkMC&q=apathetic+children+epidemic+sweden&pg=PT105. 
  15. ↑ (in en) BMJ: British Medical Journal. University of California: British Medical Association. 2008. p. 1317. https://books.google.com/books?id=QItOAQAAIAAJ&q=hoax. Retrieved 22 July 2019. 
  16. ↑ Hedlund, Daniel (2016). Drawing the limits unaccompanied minors in Swedish asylum policy and procedure (Printed in Sweden by Holmbergs, Malmö 2016 Distributor: Department of Child and Youth Studies ed.). Department of Child and Youth Studies. Stockholm University. p. 22. ISBN 978-91-7649-335-9. https://www.diva-portal.org/smash/get/diva2:906409/FULLTEXT01.pdf. Retrieved 15 July 2019. 
  17. ↑ Bendz, Hans (13 December 2005). "Apatisk epidemi obegriplig (Apathetic epidemic not incomprehensible)" (in sv). Svenska Dagbladet. Svd (Svenska dagbladet) (SVD) ((Translation: The fact that many pediatricians reject and conceal simulated illness as a diagnostic alternative is a professional mistake. Simulation is not an unknown phenomenon in science, writes head physician Hans Bendz)). https://www.svd.se/apatisk-epidemi-obegriplig. Retrieved 16 July 2019. 
  18. ↑ Hedström, Sofie (2017). The Mental health of Asylum-seeking Children in the Nordic Countries (Signe Smith Jervelund ed.). University of Copenhagen. p. 15. https://cage.ku.dk/publications/related-publications/Sofie_Viktoria_Hedstr_m_404062_247382_Hovedopgave_Kandidatopgave-SofieHedstrom.pdf. Retrieved 15 July 2019. 
  19. ↑ Petrovic, Predrag; Hjern, Anders; Engström, Ingemar; Evers, Kathinka; Lagercrantz, Hugo; Sallin, Karl (2016). "Resignation Syndrome: Catatonia? Culture-Bound?" (in English). Frontiers in Behavioral Neuroscience 10: 7. doi:10.3389/fnbeh.2016.00007. PMID 26858615. 
  20. ↑ Klatzer, Jürgen (2017). "Sweden: Refugee children fall into a coma". Kurier.at. Kurier.at. https://www.escap.eu/bestanden/Care%20(38)/Refugees/REFUGEE%20CRISIS/Background%20articles/refugee_children_sweden_03_04_2017.pdf. Retrieved 15 July 2019. 
  21. ↑ Birgit Lie, Gwynyth Overland, Eugene Guribye and (2014). Nordic Work with Traumatised Refugees (British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ed.). Cambridge Scholars Publishing. p. 6. https://www.cambridgescholars.com/download/sample/61859. Retrieved 15 July 2019. 
  22. ↑ LUNDGREN, Elin Lindström Claessen, EVA. "Henry Ascher – With compassion for those in need". www.akademiliv.se. Akademiliv. http://www.akademiliv.se/en/2018/05/49559/. Retrieved 15 July 2019. 
  23. ↑ Tamas, Gellert. "The Apathetic - (Without doubt, this is a disgrace to Sweden on a par with the extradition of the Balts or the forcible sterilisation of the mentally impaired. And Tamas should obviously be given great recognition for having uncovered this matter.")" (in sv-SE). http://tamas.se/the-apathetic/. Retrieved 15 July 2019. 
  24. ↑ Sejersen, Thomas; Wang, Ching H. (2013) (in en). Acute Pediatric Neurology. Springer Science & Business Media. p. 119. ISBN 9780857294913. https://books.google.com/books?id=5y-3BAAAQBAJ&q=apathetic&pg=PA119. Retrieved 22 July 2019. 
  25. ↑ Pinkston, Pinkston. "The apathetic children began showing up in Swedish emergency rooms in the early" (in en). www.coursehero.com (University of North Carolina Wilmington (UNCW)). https://www.coursehero.com/file/p7r09h3/The-apathetic-children-began-showing-up-in-Swedish-emergency-rooms-in-the-early/. Retrieved 16 July 2019. 
  26. ↑ Regeringskansliet, Government offices of Sweden (2005). Sweden's Fourth Periodic Report to the UN Committee on the Rights of the Child 2002–2007 (Swedish Code of Statutes - SFS 2006:67: Act Prohibiting Discrimination and Other Degrading Treatment of Children and School Students ed.). p. 19. https://www.government.se/49b757/contentassets/aa0d552fb1ef4c31a54e6e2c22126777/swedens-fourth-periodic-report-to-the-un-committee-on-the-rights-of-the-child-2002-2007. Retrieved 16 July 2019. 
  27. ↑ Radio, Sveriges. "Experter har lurats om apatiska flyktingbarn - Klartext (Experts have been lying about the apathetic refugee children)" (in sv). sverigesradio.se. https://sverigesradio.se/sida/artikel.aspx?artikel=947169&programid=493. Retrieved 16 July 2019. 
  28. ↑ J. Eriksson, Swedish doctor and associate professor, Tomas. ""Gellert Tamas har fel om de apatiska barnen" | Nyheter | Expressen (Tamas is wrong about the apathetic refugee children)" (in sv). www.expressen.se. Expressen (Debate: Gellert Tamas is wrong). https://www.expressen.se/nyheter/gellert-tamas-har-fel-om-de-apatiska-barnen/. Retrieved 16 July 2019. 
  29. ↑ Radio, Sveriges. "Ilska mot läkaren som gav klartecken till utvisning - P4 Sjuhärad (Anger against doctor who gave permission to deport)" (in sv). sverigesradio.se. P4 Sjuhärad (P4 Sjuhärad) (Debate: Tomas Eriksson is angry for not being allowed to reply to Gellert Tamas commentary that Eriksson. had actively participated in deporting a young boy. (Eriksson: I have treated many children)). https://sverigesradio.se/sida/artikel.aspx?programid=95&artikel=5510039. Retrieved 16 July 2019. 
  30. ↑ Engelsöy, deputy head and chief doctor, Peter. "DEBATT: "Allvarliga brister i Gellert Tamas bok" (Severe incorrect statements in Tamas book)" (in sv). Aftonbladet. Aftonbladet (Aftonbladet) (Criticism on Tamas book). https://www.aftonbladet.se/debatt/a/Rx1eR2/overlakare-gellert-tamas-bok-innehaller-allvarliga-brister. Retrieved 16 July 2019. 
  31. ↑ Sten Lundqvist, verksamhetschef för BUP:s specialenheter, bland andra det mobila asylteamet MaST och flyktingenheten., Olav Bengtsson, divisionschef för barn- och ungdomspsykiatrin i Stockholm.. "DEBATT: "Tamas sprider grundlösa rykten" (Debate: Tamas is spreading rumors)" (in sv). Aftonbladet. Aftonbladet (Debate: Tamas publication of the book "The Apathetic" where he criticizes the credibility of Swedish psychiatrists). https://www.aftonbladet.se/debatt/a/l1MyG7/bup-cheferna-tamas-sprider-grundlosa-rykten. Retrieved 16 July 2019. 
  32. ↑ Nyheter, Dagens (2 November 2009). "Gellert Tamas trovärdighet kan ifrågasättas. (Gellert Tamas credibility can be questioned)" (in sv). DN.SE. Dagens nyheter (Tamas is not credible). https://www.dn.se/kultur-noje/kulturdebatt/gellert-tamas-trovardighet-kan-ifragasattas/. Retrieved 16 July 2019. 
  33. ↑ Nader Ahmadi, research leader, Marie Hessler, national coordinator (2006) (in sv). SOU 2006:114 Asylsökande barn med uppgivenhetssymtom - ett svenskt fenomen åren 2001-2006 (Swedish National Coordinator for Children in the Asylum Process ed.). Sweden: Norstedts Juridik AB. p. 111. ISBN 9789138226773. https://books.google.com/books?id=DXH0Igxl5P8C&q=dagens+medicin+thomas+jackson&pg=PA114. 
  34. ↑ Suk, Vavra. "Svenska medier skapar apatiska barn (Swedish media creates apathetic children)". Vavra Suk. http://www.eaec-se.org/articles/Jackson/svenska-medier-skapar-apatiska-barn.htm. Retrieved 17 July 2019. 
  35. ↑ Larsen, Christian (11 July 2007). "Läkare till attack mot svensk media (Doctor attacks Swedish media)" (in sv). dt.se. DT (MittMedia) (Forced simulation). https://www.dt.se/artikel/lakare-till-attack-mot-svensk-media. Retrieved 17 July 2019. 
  36. ↑ Smith, Linda Varsell (2017) (in en). Mirabilia. p. 75. ISBN 9780988855489. https://books.google.com/books?id=K1eSDwAAQBAJ&q=apathetic+children+resignation&pg=PA75. Retrieved 22 July 2019. 
  37. ↑ Aviv, Rachel (27 March 2017). "The Trauma of Facing Deportation" (in en). The New Yorker. https://www.newyorker.com/magazine/2017/04/03/the-trauma-of-facing-deportation. Retrieved 15 July 2019. 
  38. ↑ Ahmadi N (2006). Asylsökande barn med uppgivenhetssymtom – trauma, kultur, asylprocess [Asylum-seeking children with symptoms of resignation – trauma, culture, asylum process]. Statens offentliga utredningar SOU 2006:49. Edita, Stockholm
  39. ↑ Wikström, Erik (11 October 2006). "Ett svårlöst mysterium (A difficult mysterium to solve)" (in sv). gd.se. Gefle Blad (GD) (GD) (Nader Ahmadi, research leader of the apathetic refugee children epidemic in the state investigation, commentating on the risk of manipulation and poisoning of the children). https://www.gd.se/artikel/ett-svarlost-mysterium. Retrieved 16 July 2019. 
  40. ↑ Björn Axel, Forslund, Carl-Magnus; Johansson. "(Ahmadi (2006) argued that people from these countries, e.g. Azerbaijan, have a "holistic approach" where children in some cases could act as patrons for the collective, i.e. the family, and use the resources available for collective survival)". European Child & Adolescent Psychiatry. https://portal.research.lu.se/portal/files/1815560/3878944.pdf. Retrieved 15 July 2019. 
  41. ↑ Sizoo, Lysanne (23 January 2005). "Apathetic refugee children: a Swedish phenomenon". www.thelocal.se. The Local (The Local). https://www.thelocal.se/20050123/878. Retrieved 15 July 2019. 
  42. ↑ "Many fewer 'apathetic' refugee children". www.thelocal.se. 30 December 2006. https://www.thelocal.se/20061230/5944. 
  43. ↑ Overland, Gwynyth; Guribye, Eugene; Lie, Birgit (2014) (in en). Nordic Work with Traumatised Refugees: Do We Really Care. Cambridge Scholars Publishing. p. 105. ISBN 9781443867771. https://books.google.com/books?id=zCNQBwAAQBAJ&q=apathetic+refugee+children+debate&pg=PA106. Retrieved 22 July 2019. 
  44. ↑ "Apathetic refugee children could stay in Sweden". www.thelocal.se. 8 June 2005. https://www.thelocal.se/20050608/1561. 
  45. ↑ Blad, Gefle (31 March 2012). "Apatiska – inte "apatiska" (Apathetic - not apathetic)" (in sv). gd.se. GD (Debate). https://www.gd.se/artikel/apatiska-inte-apatiska. Retrieved 16 July 2019. 
  46. ↑ (chronicle), Barometer (2 April 2012). ""Tomhylsan" fällde sig själv (The empty shell fell in its own trap)" (in sv-SE). Barometern. Barometern (Debate: Thomas Jackson). http://www.barometern.se/kronika/tomhylsan-fallde-sig-sjalv/. Retrieved 16 July 2019. 
  47. ↑ Peterson, Åsa (2006). "LEDARE: En riktigt smutsig flyktingskandal (A really filthy refugee scandal)" (in sv). Aftonbladet. Expressen (Debate: Government experts lie about the apathetic refugee children). https://www.aftonbladet.se/ledare/a/qn66X1/en-riktigt-smutsig-flyktingskandal. Retrieved 16 July 2019. 
  48. ↑ Coombs, W. Timothy; Holladay, Sherry J. (2012) (in en). The Handbook of Crisis Communication. John Wiley & Sons. p. 491. ISBN 9781444361902. https://books.google.com/books?id=mt0F2LBNPa8C&q=apathetic+refugee+children+debate&pg=PA494. Retrieved 22 July 2019. 
  49. ↑ Sundin, Björn. "Att ge näring åt obehagliga frön – apatiska flyktingbarn, nazistpartier och ineffektiva svar – Björn Sundin (Feeding uncomfortable seeds - apathetic refugee children, nazi parties and ineffective answers)" (in sv-SE). Björnsundin.se. Björn Sundin. http://bjornsundin.se/2012/04/22/att-ge-naring-at-obehagliga-fron-apatiska-flyktingbarn-nazistpartier-och-ineffektiva-svar-fb/. Retrieved 16 July 2019. 
  50. ↑ Ulwencreutz, Lars (2015) (in sv). Redaktor'n Faktar Vidare (The editorial keeps fact-checking on). Lulu.com. p. 55. ISBN 9781329373990. https://books.google.com/books?id=OBcsCgAAQBAJ&q=Thomas+jackson+svenskarnas+parti&pg=PA55. 
  51. ↑ Jackson, psychiatrist, Thomas (2017). "BioEdge: Only in Sweden? But why?". BioEdge. Bioedge (Bioedge). https://www.bioedge.org/indepth/view/only-in-sweden-but-why/12361. Retrieved 15 July 2019. 
  52. ↑ Offentliga Utredningar, Statens. "Asylum seeking children with resignation syndrome - Trauma, culture and asylum process". Rapport från den nationella samordnaren för barn i asylprocessen med uppgivenhetssymtom Stockholm 2006. https://www.regeringen.se/contentassets/46c4732d9b6440a087102b9b43ebf5c9/asylsokande-barn-med-uppgivenhetssymtom-sou-200649. Retrieved 15 July 2019. 
  53. ↑ Malmqvist, Dan (17 November 2017). "Thomas Jackson har fått rätt om de apatiska barnen (Thomas Jackson was right about the apathetic refugee children)" (in sv-SE). Nya Tider. Nya Tider (Nya Tider). https://www.nyatider.nu/thomas-jackson-har-fatt-ratt-om-de-apatiska-barnen/. Retrieved 15 July 2019. 
  54. ↑ Wennberg, Jenny (27 March 2012). "Om titelns betydelse (the essence of the title)" (in sv). arbetarbladet.se. Arbetarbladet (Debate: Thomas Jackson is a nazi). https://www.arbetarbladet.se/artikel/om-titelns-betydelse. Retrieved 16 July 2019. 
  55. ↑ Rydell, Malena (2016). "Malena Rydell: Ensamkommande är 2010-talets apatiska flyktingbarn (unaccompanied refugee children is the 2010 apathetic refugee children)" (in sv-SE). Dagens Arena. Arbetarbladet (Debate: The apathetic refugee children and Thomas Jackson being a nazi). https://www.dagensarena.se/opinion/malena-rydell-ensamkommande-ar-2010-talets-apatiska-flyktingbarn/. Retrieved 16 July 2019. 
  56. ↑ Borders, Psychiatry Without, Psychiatry (2019) (in en). Review of the psychiatric and criminal phenomena 'Malingering by Proxy' or 'Commando Syndrome' (suggested by Dr. Thomas Jackson) amongst Apathetic Refugee Children in Sweden.. Sweden: Psychiatry Without Borders. https://www.researchgate.net/publication/333907059. 
  57. ↑ Without Borders, Psychiatry (2019) (in en). Swedens biggest Medical Paper Dagens Medicins and Swedish doctors cover up of the psychiatric and criminal phenomena 'Group Malingering by Proxy' occurring amongst apathetic refugee children in Sweden between 2006 to present day anno 2019. Psychiatry Without Borders. https://www.researchgate.net/publication/333902816. Retrieved 15 July 2019. 
  58. ↑ "Swedens Apathetic Children Problems – Interview professor Thomas Jackson MD. PhD at E.C.P. and professor Marc Feldman MD PhD, USA | Jackson Jagar Journalister" (in sv-SE). http://jajj.se/swedens-apathetic-children-problems-interview-professor-thomas-jackson-md-phd-at-e-c-p-and-professor-marc-feldman-md-phd-usa/. 
  59. ↑ Tamas, Gellert. Apatiska barn hotade igen (Apathetic refugee children threatened again). Sweden: Arena Gruppen. http://tamas.se/00/wp-content/uploads/2013/02/Apatiska-barn-hotade-igen.Arkiv_.pdf. Retrieved 16 July 2019. 
  60. ↑ Wahldén, Christina (20 September 2006). "Omöjligt utreda apatiska barn (Lise Tamm: Impossible to investigate apathetic refugee children)" (in sv). Svenska Dagbladet. Svd (Svenska Dagbladet) (SVD) (Impossible to investigate apathetic refugee children). https://www.svd.se/omojligt-utreda-apatiska-barn. Retrieved 16 July 2019. 
  61. ↑ SVT, SVT (8 July 2006). "Utredningar om apatiska barn läggs ned (Investigations of child abuse amongst apathetic refugee children is dropped)" (in sv). SVT Nyheter. SVT. https://www.svt.se/nyheter/inrikes/utredningar-om-apatiska-barn-laggs-ned. Retrieved 16 July 2019. 
  62. ↑ (Swedish State Television), SVT (17 August 2006). "Inga åtal om vanvård av apatiska barn (No charges against mistreatment of apathetic refugee children)" (in sv). SVT Nyheter. SVT (SVT) (Lise Tamm: We cant prove crime). https://www.svt.se/nyheter/inrikes/inga-atal-om-vanvard-av-apatiska-barn. Retrieved 16 July 2019. 
  63. ↑ Tamm, Lise. "(The Apathetic)". Gellert Tamas. http://deapatiska.se/lise-tamm/. 
  64. ↑ Sara Damber, Laila Lindberg (29 May 2011). "Apatiska barn nekas rätt hjälp (Apathetic refugee children are denied help)" (in sv). Svenska Dagbladet. Svenska dagbladet (Svenska dagbladet). https://www.svd.se/apatiska-barn-nekas-ratt-hjalp. Retrieved 16 July 2019. 
  65. ↑ Wahldén, Christina (23 November 2005). "Vanvården granskas av länsstyrelsen (Mistreatment of children is examined by the county)" (in sv). Svenska Dagbladet. Svd (Svenska dagbladet). https://www.svd.se/vanvarden-granskas-av-lansstyrelsen. Retrieved 16 July 2019. 
  66. ↑ Wahldén, Christina (22 November 2005). "Larm om vanvård av apatiska barn (Reports of mistreatment of apathetic refugee children)" (in sv). Svenska Dagbladet. SvD (Svenska dagbladet). https://www.svd.se/larm-om-vanvard-av-apatiska-barn. Retrieved 16 July 2019. 
  67. ↑ Wahldén, Christina (15 December 2005). "Apatiska barn ofta inte sjuka (Apathetic children not always sick)" (in sv). Svenska Dagbladet. SvD (svenska dagbladet) (Debate). https://www.svd.se/apatiska-barn-ofta-inte-sjuka. Retrieved 16 July 2019. 
  68. ↑ Simone Söderhjelm, Mira Micic. "Miljöpartiet: Direktören måste avgå (Green party: The director general must be displaced)" (in sv). Aftonbladet. Aftonbladet (Critique of Valiks actions in not reporting potential abuse of children). https://www.aftonbladet.se/nyheter/a/qnPE6m/mpdirektoren-maste-avga. Retrieved 16 July 2019. 
  69. ↑ Nyheter, Dagens (18 January 2006). "JO granskar Migrationsverket (Chancellor of Justice investigates the Migration agency)" (in sv). DN.SE. DN (Investigation of the Migration agency). https://www.dn.se/nyheter/sverige/jo-granskar-migrationsverket/. Retrieved 16 July 2019. 
  70. ↑ Henry Ascher, Marita Eastmond and (2014) (in en). In the Best Interest of the Child? The Politics of Vulnerability and Negotiations for Asylum in Sweden (Informa Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK ed.). Routledge, Journal of Ethnic and Migration StudiesVol. 37, No. 8, September 2011, pp. 1185. p. 4. https://www.researchgate.net/publication/233302013. Retrieved 15 July 2019. 
  71. ↑ Pressley, Linda (2017). "only in sweden but why - Google Search". www.google.se. BBC (BBC) (Swedens resignated children). https://www.google.se/search?client=safari&ei=hlksXajLOIHamwXH6pGoCQ&q=only+in+sweden+but+why&oq=only+in+sweden+but+why&gs_l=psy-ab.3..0.1279.3955..4049...0.0..0.174.2115.15j6......0....1..gws-wiz.......0i71j35i39j35i39i19j0i131j0i67j0i203j0i22i30.wIynuwpEW4g. Retrieved 15 July 2019. 
  72. ↑ Jackson, Thomas. "Jackson-Mal-BP-Syndrom | Jackson Jagar Journalister (Jackson hunts reporters)" (in sv-SE). http://jajj.se/jackson-mp-syndrom/. Retrieved 15 July 2019. 
  73. ↑ Sartore, Melissa. "Syrian Refugees Are "Falling Asleep Until They Die" And Nobody Knows Why" (in en). Ranker. Ranker (Ranker) (Swedens Mysterious Disease). https://www.ranker.com/list/what-is-syrian-resignation-syndrome/melissa-sartore?page=3. Retrieved 15 July 2019. 
  74. ↑ Nunn, Kenneth P.; Lask, Bryan; Owen, Isabel (2013). "Pervasive refusal syndrome (PRS) 21 years on: a re-conceptualisation and a renaming". European Child & Adolescent Psychiatry 23 (3): 163–172. doi:10.1007/s00787-013-0435-5. PMID 23793560. 
  75. ↑ Krey, Jens (2016). "Antalet apatiska barn ökar (The number of apathetic refugee children is increasing)" (in sv). Dagens Medicin. Dagens Medicin (Dagens Medicin) (Apathetic Refugee Children). https://www.dagensmedicin.se/artiklar/2016/02/24/antalet-apatiska-barn-okar/. Retrieved 15 July 2019. 
  76. ↑ McColl, Karen (1 December 2008). "Report sparks controversy over cause of children's psychiatric symptoms" (in en). BMJ (Karen McColl) 337: a2818. doi:10.1136/bmj.a2818. PMID 19047188. https://www.bmj.com/content/337/bmj.a2818.full. Retrieved 15 July 2019. 
  77. ↑ Löfgren, Karl. "Sweden's apathetic refugee children (A)". CASE PROGRAM. https://www.anzsog.edu.au. 
  78. ↑ Without Borders, Psychiatry (2019) (in en). Review of the psychiatric and criminal phenomena "Malingering by Proxy" or "Commando Syndrome" (suggested by Dr. Thomas Jackson) amongst Apathetic Refugee Children in Sweden. (DOI: 10.13140/RG.2.2.28490.82887 ed.). Sweden. https://www.researchgate.net/publication/333907059. Retrieved 17 July 2019. 
  79. ↑ Löfgren, Karl (2013). "Sweden's apathetic refugee children". School of Thought, the Australia and New Zealand. CASE PROGRAM. https://www.anzsog.edu.au/preview-documents/case-study-level-3/874-sweden-s-apathetic-refugee-children-b-2013-151-2/file. Retrieved 15 July 2019. 
  80. ↑ Radio, Sveriges (Bill Schiler). "Apathetic Children's Syndrome On The Rise - Radio Sweden" (in en). sverigesradio.se. Sveriges Radio (Swedens Radio) (SR) (The apathetic refugee children). https://sverigesradio.se/sida/artikel.aspx?programid=2054&artikel=3017530. Retrieved 15 July 2019. 
  81. ↑ Wahldén, Christina (18 December 2005). "Färre fall av apatiska barn efter aktiv vård (Fewer cases of apathetic refugee children after active care)" (in sv). Svenska Dagbladet. Svenska Dagbladet. https://www.svd.se/farre-fall-av-apatiska-barn-efter-aktiv-vard. Retrieved 15 July 2019. 
  82. ↑ "Child abuse scam in Sweden" (in en). News24. 22 November 2005. https://www.news24.com/World/News/Child-abuse-scam-in-Sweden-20051122. 
  83. ↑ Wahldén, Markus Lutteman, Christina (15 December 2005). "Apatiska barn ofta inte sjuka (Apathetic refugee children not always sick)" (in sv). Svenska Dagbladet. SVD (SVD) (Debate). https://www.svd.se/apatiska-barn-ofta-inte-sjuka. Retrieved 15 July 2019. 
  84. ↑ Zoe Apostolides, Zoe (15 April 2018). "Real life 'Sleeping Beauty' photo captures heartbreaking story". NewsComAu. News.com.au (News.com.au). https://www.news.com.au/lifestyle/health/world-press-photographer-captures-the-intriguing-resignation-syndrome/news-story/4d8c775eba189b3630471a120e6e49e6. Retrieved 15 July 2019. 
  85. ↑ Sager, Maja (2011). Everyday Clandestinity: Experiences on the Margins of Citizenship and Migration Policies. University of Lund. p. 37. https://lup.lub.lu.se/search/ws/files/6179754/1770358.pdf. Retrieved 15 July 2019. 
  86. ↑ Olsson, Tatjana Larina (2006). Apatiska flyktingbarn - ur behandlarens perspektiv (Apathetic refugee children - from the therapists perspective). Stockholm: University of Stockholm. pp. 9, 31. http://www.diva-portal.se/smash/get/diva2:189784/FULLTEXT01.pdf. Retrieved 14 August 2019. 
  87. ↑ "Hundreds of refugee children in Sweden slipping into coma-like state in rare phenomenon" (in en). The Independent. 1 April 2017. https://www.independent.co.uk/news/world/europe/refugee-children-sweden-coma-like-states-families-deported-uppgivenhetssyndrom-resignation-syndrome-a7662126.html. 
  88. ↑ Bradby, Hannah. "Deportation and despair in context". Cost of Living. All content © 2015 Cost Of Living. All Rights Reserved. https://uu.diva-portal.org/smash/get/diva2:1176002/FULLTEXT01.pdf. Retrieved 15 July 2019. 
  89. ↑ Khemiri, Jonas Hassen (14 August 2011). "Apatiska för nybörjare (Apathetic children for beginners)" (in sv-SE). Jonas Hassen Khemiri. http://www.khemiri.se/pjaser/apatiska-for-nyborjare/. Retrieved 15 July 2019. 
  90. ↑ "Apathy for Beginners". https://visitwagga.com/calendar/event?productId=5cf31f00421ae9f7138a4ef8. 




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