Empirical data on psychological symptoms were collected during the diagnostic process of the Outpatient Health-Care Center for Refugee Children and Adolescents (OCR) of the University Medical Center Hamburg-Eppendorf. The diagnostic process and the data-collection procedure were approved by the ethics committee of the Chamber of Psychotherapists, Hamburg (05/2017-PTK-HH), and have been described in detail elsewhere (Barthel, Ravens-Sieberer, Schulte-Markwort, Zindler, & Klasen, 2019). All refugee children and adolescents who sought treatment in the OCR took part in the standard diagnostic process which was conducted by psychologists, often with the help of interpreters. Their diagnostic data were used for the present study if patients gave their informed consent, if they were at least eleven years old and had experienced at least one interpersonal trauma. The exclusion criteria for the diagnostic process were severe psychological instability (being in acute risk of harming themselves or others or being in direct need of inpatient treatment), alcohol or drug intoxication or acute symptoms of psychosis or suicidality as established by an initial medical consultation.

For collecting information on symptom relations as perceived by clinicians, all four clinicians (psychotherapist or psychiatrists) of the OCR who provided psychotherapy to refugee youth were asked to participate in the study.1 Clinicians were instructed about the procedure over the phone and entered their Perceived Symptom Relations (PSR) via a newly developed online tool on their computer.

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