1
|
Jabali O, Ayyoub AA, Jabali S. Navigating health challenges: the interplay between occupation-imposed movement restrictions, healthcare access, and community resilience. BMC Public Health 2024; 24:1297. [PMID: 38741152 DOI: 10.1186/s12889-024-18817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/09/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Transportation plays a significant role in health, community resilience, and access to basic needs such as healthcare, social services, education, and job opportunities. Health and community resilience are, however, impacted by a multitude of complex and unequal factors, such as transportation restrictions exacerbated by the Israeli occupation. The goal of the research was to examine the intricate relationships that exist in Palestine between movement restrictions imposed by occupation, health outcomes, and community resilience. METHOD A self-structured questionnaire, devised based on expert conversations and previous literature, was used in this descriptive, quantitative study to explore health and resilience outcomes. Age, gender, marital status, place of residence, and means of transportation were among the various factors that were utilized to describe the socio-demographics of the study sample (n = 202). The researchers employed stepwise multiple regression and descriptive statistics for the data analysis. RESULTS Study findings indicated that transportation restrictions have significant direct and indirect health consequences. A significant direct effect is observed, signifying a negative correlation between restrictions and health; increased transportation restrictions are consistently correlated with a decline in health. The study emphasized how place of residence affects health outcomes, with higher scores for campers and people living in green line areas. It also underscores that public means of transportation are found to be better for health outcomes than private cars. CONCLUSION This study emphasized that roadblocks, checkpoints, and military incursions make it difficult for Palestinians to receive medical care, which has a detrimental impact on their health and well-being. It also underscores the need for significant reforms in Palestinian health and transportation systems to enhance infrastructure and healthcare access. The Palestinian Authority should invest in public transportation and community resilience programs to address transportation-related health issues, especially in villages, due to frequent settler attacks.
Collapse
Affiliation(s)
- Oqab Jabali
- Language Center, Faculty of Humanities and Education Sciences, An-Najah National University, Nablus, Palestine.
| | - Abed Alkarim Ayyoub
- Psychology and Counseling Department, Faculty of Humanities and Educational Sciences, An Najah National University, Nablus, Palestine
| | | |
Collapse
|
2
|
Allchin B, Albermann K, Blake-Holmes K, Gatsou L, Hine R, van Doesum K, Nicholson J. Sustaining efforts to improve family well-being with parents with mental ill health and substance (mis)use. Front Psychiatry 2024; 15:1376409. [PMID: 38596628 PMCID: PMC11003303 DOI: 10.3389/fpsyt.2024.1376409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
Research conducted over the past 30 years has developed an extensive body of knowledge on families where parents experience mental ill health and/or substance (mis)use, and interventions that are effective in improving their outcomes. A more recent focus has also explored the importance and nuance of implementation. This perspective article reflects on the concept and practice of sustainability within this body of work and considers underlying assumptions in the field about the goal and direction of interventions that make clarity about sustainability difficult. We identify challenges for understanding sustainability, relating to how and who defines it, what is measured and the impact of context. We conclude by considering how we might be better able to plan and design for sustainability within this field.
Collapse
Affiliation(s)
- Becca Allchin
- Mental Health Program, Eastern Health, Melbourne, VIC, Australia
- School of Rural Health, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, VIC, Australia
| | - Kurt Albermann
- Social Pediatric Center, Cantonal Hospital, Winterthur, Switzerland
| | - Kate Blake-Holmes
- School of Social Work, Faculty of Social Sciences, University of East Anglia, Norwich, United Kingdom
| | - Lina Gatsou
- Institute of Health, Health Policy and Social Care Research, De Montfort University, Leicester, United Kingdom
- Child and Adolescent Mental Health Services, Leicestershire Partnership NHS (National Health Service) Trust, Leicester, United Kingdom
| | - Rochelle Hine
- Monash Rural Health, Monash University, Warragul, VIC, Australia
| | - Karin van Doesum
- Department of Clinical Psychology, Radboud University Nijmegen, Nijmegen, Netherlands
- Community Mental Health Service, Department Impluz Prevention, Dimence-groep, Deventer, Netherlands
| | - Joanne Nicholson
- The Heller School, Institute for Behavioral Health, Brandeis University, Waltham, MA, United States
| |
Collapse
|
3
|
Bangpan M, Felix L, Soliman F, D’Souza P, Jieman AT, Dickson K. The impact of mental health and psychosocial support programmes on children and young people's mental health in the context of humanitarian emergencies in low- and middle-income countries: A systematic review and meta-analysis. Glob Ment Health (Camb) 2024; 11:e21. [PMID: 38572260 PMCID: PMC10988149 DOI: 10.1017/gmh.2024.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/20/2023] [Accepted: 01/30/2024] [Indexed: 04/05/2024] Open
Abstract
Humanitarian emergencies pose a significant global health challenge for children and young people's mental and psychological health. This systematic review investigates the effectiveness of mental health and psychosocial support (MHPSS) programmes delivered to children and young people affected by humanitarian emergencies in low- and middle-income countries (LMICs). Twelve electronic databases, key websites and citation checking were undertaken. Forty-three randomised controlled trials (RCTs) published in English between January 1980 and May 2023 were included in the review. Overall, the findings suggest that cognitive behavioural therapy may improve depression symptoms in children and young people affected by humanitarian emergencies. Narrative exposure therapy may reduce feelings of guilt. However, the impact of the other MHPSS modalities across outcomes is inconsistent. In some contexts, providing psychosocial programmes involving creative activities may increase the symptoms of depression in children and young people. These findings emphasise the need for the development of MHPSS programmes that can safely and effectively address the diverse needs of children and young people living in adversarial environments.
Collapse
Affiliation(s)
- Mukdarut Bangpan
- The Evidence for Policy and Practice information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, University College London, London, United Kingdom
| | - Lambert Felix
- School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, United Kingdom
| | - Farida Soliman
- Linguistics Department, Queen Mary University of London, London, United Kingdom
| | - Preethy D’Souza
- The Evidence for Policy and Practice information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, University College London, London, United Kingdom
| | - Anna-Theresa Jieman
- Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, United Kingdom
| | - Kelly Dickson
- The Evidence for Policy and Practice information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, University College London, London, United Kingdom
| |
Collapse
|
4
|
Hudson CC, Traynor J, Björgvinsson T, Beard C, Forgeard M, Hsu KJ. Performance-based attentional control, but not self-reported attentional control, predicts changes in depressive symptoms in short-term psychotherapy. Behav Res Ther 2024; 173:104476. [PMID: 38199180 DOI: 10.1016/j.brat.2024.104476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 12/18/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Although impairments in attentional control are pervasive across psychopathology, there is substantial individual differences. In the current study, we examined whether individual differences in self-reported and performance-based measures of attentional control predict changes in depressive symptoms and well-being in a diagnostically diverse sample of patients attending a CBT-based partial hospital program. METHOD Participants were 89 patients (56.2% men, 75.3% non-Hispanic White). At baseline, patients completed the self-reported Attentional Control Scale and the Rapid Serial Visual Presentation task (RSVP), a behavioral measure of attentional control. Depressive symptoms were assessed daily using the Patient Health Questionnaire and well-being was assessed using the Mental Health Continuum Short Form. RESULTS On average, greater self-reported attentional control was significantly associated with lower depressive symptoms, β = -0.49, t(52) = 4.84, p < .001, 95% CIs [-0.69, -0.29], and greater well-being, β = 0.45, t(53) = 3.90, p < .001, 95% CIs [0.22, 0.67]. More accurate task-based performance was associated with a decline in depressive symptoms over time, β = -0.02, t(32) = 2.50, p = .02, 95% CIs [-0.04, -0.01]. Neither self-reported nor performance-based measures of attentional control predicted changes in well-being. Finally, exploratory analyses suggest that depressive symptoms also improved over time for individuals who underestimated self-reported attentional control abilities relative to task-based performance, β = -0.19, t(32) = 2.23, p = .03, 95% CIs [-0.36, -0.02]. CONCLUSIONS Results suggest that performance-based attentional control may be an important target for assessment and intervention, as well as a potential mechanism underlying risk and recovery.
Collapse
Affiliation(s)
- Chloe C Hudson
- McLean Hospital, USA; Harvard Medical School, USA; Virginia Polytechnic Institute and State University, USA.
| | | | | | | | | | - Kean J Hsu
- Georgetown University, USA; National University of Singapore, Singapore
| |
Collapse
|
5
|
Heltne UM, Sarkadi A, Lien L, Dybdahl R. Training non-specialists in teaching recovery techniques (TRT) to help traumatised children in humanitarian settings: a qualitative analysis of experiences gained from 20 years of practice. Int J Equity Health 2023; 22:187. [PMID: 37697272 PMCID: PMC10494337 DOI: 10.1186/s12939-023-01999-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Although several manuals and guidelines have been developed to enhance the quality of task-sharing interventions, it remains challenging to train non-professional personnel in mental health and psychosocial support. Practitioners must translate general recommendations into practical applications to make them relevant in demanding contexts. However, limited research exists on practical experiences with standardised programmes in the field. AIM To explore how experiences gained from the training of first-line health providers in a low-threshold intervention for children with trauma symptoms may guide implementation of such interventions in local communities in low-income countries. METHOD We summarise 20 years of experience in the training of first-line health providers, teachers, and school counsellors in providing a low-threshold intervention. The intervention is called teaching recovery techniques (TRT), developed by the Children and War Foundation (CAW). Field notes containing notes from trainings and oral, informal feedback from participants are analysed using thematic analysis, a method well-suited for identifying, analysing, and reporting patterns, or themes, within data in qualitative research. FINDINGS The analysis showed three main themes/ challenges: (1) Who can conduct the TRT intervention? (2) What form and content should the training take? (3) How can the intervention be used in a responsible way to follow the 'do no harm' principle? We discuss the implications of the findings for trainings in scalable interventions and further research.
Collapse
Affiliation(s)
| | | | - Lars Lien
- National Competence Services for Concurrent Addiction and Mental Disorders, Brummundal, Norway
| | - Ragnhild Dybdahl
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
6
|
Pavlova I, Krauss S, McGrath B, Cehajic-Clancy S, Bodnar I, Petrytsa P, Synytsya T, Zhara H. Individual and contextual predictors of young Ukrainian adults' subjective well-being during the Russian-Ukrainian war. Appl Psychol Health Well Being 2023. [PMID: 37652753 DOI: 10.1111/aphw.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 09/02/2023]
Abstract
The Russian invasion of Ukraine is accompanied by horrific losses among civilians. This study investigates various individual (hope, optimism, resilience, post-traumatic growth, and coping strategies) and contextual predictors (experience of life under occupation, actively hostile home environment, and frequent moves) of subjective well-being among the youth living in Ukraine. A total sample of 593 students from several universities participated in the study using surveys that contained questions about sociodemographic characteristics, life satisfaction, hope, optimism, personal post-traumatic growth, resilience, and coping strategies. Data were analyzed using JAMOVI software. The level of dissatisfaction with their own lives was 34.7%; most of the respondents had a higher incidence of minimal/mild hopelessness (88.7%) and high/moderate level of optimism (60.9%). The majority of participants had moderate and high levels of post-traumatic growth (51.9% and 6.7%, respectively) and resilience (46.0% and 14.5%, respectively). Optimism, hope, resilience, post-traumatic growth, using emotional support, and life in occupation predicted life satisfaction among the study sample.
Collapse
Affiliation(s)
- Iuliia Pavlova
- Department of Theory and Methods of Physical Culture, Lviv State University of Physical Culture, Lviv, Ukraine
- Lesya Ukrainka Volyn National University, Lutsk, Ukraine
| | - Steven Krauss
- Institute for Social Science Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Breeda McGrath
- The Chicago School of Professional Psychology, Chicago, Illinois, USA
| | | | - Ivanna Bodnar
- Department of Theory and Methods of Physical Culture, Lviv State University of Physical Culture, Lviv, Ukraine
| | - Petro Petrytsa
- Department of Physical Education and Rehabilitation, Ternopil Volodymyr Hnatiuk National Pedagogical University, Ternopil, Ukraine
| | - Tetiana Synytsya
- Faculty of Physical Culture and Sports, National University "Yuri Kondratyuk Poltava Polytechnic", Poltava, Ukraine
| | - Hanna Zhara
- Department of Biological Bases of Physical Education, Health and Sports, T.H. Shevchenko National University "Chernihiv Colehium", Chernihiv, Ukraine
| |
Collapse
|
7
|
Bosqui T, McEwen FS, Chehade N, Moghames P, Skavenski S, Murray L, Karam E, Weierstall-Pust R, Pluess M. What drives change in children receiving telephone-delivered Common Elements Treatment Approach (t-CETA)? A multiple n = 1 study with Syrian refugee children and adolescents in Lebanon. CHILD ABUSE & NEGLECT 2023:106388. [PMID: 37612204 PMCID: PMC10879464 DOI: 10.1016/j.chiabu.2023.106388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/14/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Although the evidence-base for mental health and psychosocial support (MHPSS) interventions in humanitarian settings is growing rapidly, their mechanisms of change remain poorly understood despite the potential to improve the effectiveness and reach of interventions. OBJECTIVE This study aimed to explore the mechanisms or factors that drive change in a modular transdiagnostic telephone-delivered mental health intervention, Common Elements Treatment Approach (t-CETA). PARTICIPANTS AND SETTING Participants were Syrian refugee children and adolescents living in tented settlements in Lebanon. METHODS We used a multiple n = 1 design, drawing on secondary data from 9 children who completed t-CETA during a pilot randomized controlled trial. RESULTS Children with historical war-related trauma were more likely to show significant improvement across symptom clusters by the end of treatment compared to children presenting with depression related to daily living conditions. Children also showed fluctuating symptoms during the early stages of treatment (engagement and cognitive restructuring) but significant decline in symptoms after the trauma module (prolonged imaginal exposure) and depression module (behavioral activation). Salient external life events identified were starting or dropping out of school, working, change in living conditions, family conflict and the October Revolution; and interpersonal factors of parental engagement (with or without full attendance) and counsellor skills in building rapport were also identified as having an impact on treatment success. CONCLUSIONS Implications of our findings are discussed in terms of integrating active ingredients into MHPSS programming, and building on parental and multi-sector involvement in child and adolescent mental health care in humanitarian settings.
Collapse
Affiliation(s)
| | - Fiona S McEwen
- Department of War Studies, King's College London, London, UK; Queen Mary University of London, London, UK
| | | | | | | | - Laura Murray
- Johns Hopkins Bloomberg School of Public Health, USA
| | - Elie Karam
- Institute for Development, Research, Advocacy and Applied Care, Lebanon
| | | | - Michael Pluess
- Queen Mary University of London, London, UK; School of Psychology, University of Surrey, Guildford, UK
| |
Collapse
|
8
|
Bandeira M, Graham MA, Ebersöhn L. The significance of feeling safe for resilience of adolescents in sub-Saharan Africa. Front Psychol 2023; 14:1183748. [PMID: 37663363 PMCID: PMC10469746 DOI: 10.3389/fpsyg.2023.1183748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents. Methods Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health). Results This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique. Discussion The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.
Collapse
Affiliation(s)
- Monica Bandeira
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - Liesel Ebersöhn
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| |
Collapse
|
9
|
Qasrawi R, Vicuna Polo S, Abu Khader R, Abu Al-Halawa D, Hallaq S, Abu Halaweh N, Abdeen Z. Machine learning techniques for identifying mental health risk factor associated with schoolchildren cognitive ability living in politically violent environments. Front Psychiatry 2023; 14:1071622. [PMID: 37304448 PMCID: PMC10250653 DOI: 10.3389/fpsyt.2023.1071622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Mental health and cognitive development are critical aspects of a child's overall well-being; they can be particularly challenging for children living in politically violent environments. Children in conflict areas face a range of stressors, including exposure to violence, insecurity, and displacement, which can have a profound impact on their mental health and cognitive development. Methods This study examines the impact of living in politically violent environments on the mental health and cognitive development of children. The analysis was conducted using machine learning techniques on the 2014 health behavior school children dataset, consisting of 6373 schoolchildren aged 10-15 from public and United Nations Relief and Works Agency schools in Palestine. The dataset included 31 features related to socioeconomic characteristics, lifestyle, mental health, exposure to political violence, social support, and cognitive ability. The data was balanced and weighted by gender and age. Results This study examines the impact of living in politically violent environments on the mental health and cognitive development of children. The analysis was conducted using machine learning techniques on the 2014 health behavior school children dataset, consisting of 6373 schoolchildren aged 10-15 from public and United Nations Relief and Works Agency schools in Palestine. The dataset included 31 features related to socioeconomic characteristics, lifestyle, mental health, exposure to political violence, social support, and cognitive ability. The data was balanced and weighted by gender and age. Discussion The findings can inform evidence-based strategies for preventing and mitigating the detrimental effects of political violence on individuals and communities, highlighting the importance of addressing the needs of children in conflict-affected areas and the potential of using technology to improve their well-being.
Collapse
Affiliation(s)
- Radwan Qasrawi
- Department of Computer Sciences, Al-Quds University, Jerusalem, Palestine
- Department of Computer Engineering, Istinye University, Istanbul, Türkiye
| | - Stephanny Vicuna Polo
- Al-Quds Center for Business Innovation and Entrepreneurship, Al-Quds University, Jerusalem, Palestine
| | - Rami Abu Khader
- Al-Quds Center for Business Innovation and Entrepreneurship, Al-Quds University, Jerusalem, Palestine
| | | | - Sameh Hallaq
- Al-Quds Bard College for Arts and Sciences, Al-Quds University, Jerusalem, Palestine
| | - Nael Abu Halaweh
- Department of Computer Sciences, Al-Quds University, Jerusalem, Palestine
| | - Ziad Abdeen
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| |
Collapse
|
10
|
Knettel BA, Knippler E, Martinez A, Sardana S, Agor D, Mwobobia J, Ledbetter L, Amiri I, Relf MV, Goldston DB. A scoping review of counseling interventions for suicide prevention in Africa: Few studies address this life-saving aspect of mental health treatment. J Affect Disord 2023; 328:183-190. [PMID: 36806597 PMCID: PMC10068682 DOI: 10.1016/j.jad.2023.02.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/05/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Nearly 800,000 people die by suicide each year, with 77 % occurring in low- and middle-income countries. Suicide is underestimated in many African settings due to challenges in data collection, stigma, and policies that promote silence; nonetheless, rates of suicide in Africa are consistently higher than global averages. METHODS We conducted a scoping review of counseling interventions assessing suicide outcomes among adults in Africa using MEDLINE, Embase, PsycINFO, African Index Medicus, CABI Global Health, and Proquest databases. Study screening and data extraction was informed by the JBI Manual for Evidence Synthesis. RESULTS Of 2438 abstracts reviewed, 33 studies met criteria for full-text review and 13 were included in the analysis. Interventions served several populations, including people living with HIV, out of school youth, university students, and women undergoing obstetric fistula repair. There was a near-equal split in individual versus group counseling modalities and the use of professional versus lay counselors. The majority of interventions had primary outcomes focused on other mental health or social variables with a secondary focus on suicide. Mechanisms of change for suicide prevention were poorly articulated. LIMITATIONS The review was limited to English-language studies conducted after 2001 and excluded qualitative studies and those with fewer than 10 participants. CONCLUSIONS There is a clear paucity of research in this area, particularly in the lack of randomized clinical trials and studies with suicide prevention as their primary outcome. Researchers should seek to develop or adapt evidence-based, culturally-resonant interventions to reduce the burden of suicide on the African continent.
Collapse
Affiliation(s)
- Brandon A Knettel
- Duke University School of Nursing, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Elizabeth Knippler
- Duke University School of Nursing, Durham, NC, USA; Duke Center for AIDS Research, Duke University, Durham, NC, USA
| | - Alyssa Martinez
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Srishti Sardana
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - David Agor
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Judith Mwobobia
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Leila Ledbetter
- Duke University Medical Center Library and Archives, Durham, NC, USA
| | - Ismail Amiri
- Duke Global Health Institute, Duke University, Durham, NC, USA; Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Michael V Relf
- Duke University School of Nursing, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - David B Goldston
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| |
Collapse
|
11
|
Singh NS, DeJong J, Popple K, Undie CC, El Masri R, Bakesiima R, Calderon-Jaramillo M, Peprah E, Naseri S, Cornier N, Blanchet K. Adolescent wellbeing in humanitarian and fragile settings: moving beyond rhetoric. BMJ 2023; 380:e068280. [PMID: 36940938 PMCID: PMC10019456 DOI: 10.1136/bmj-2021-068280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- Neha S Singh
- Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Jocelyn DeJong
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Kimberley Popple
- Health in Humanitarian Crises Centre, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Ritah Bakesiima
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Lira University, Lira, Uganda
| | - Mariana Calderon-Jaramillo
- Asociación Profamilia, Centre d'Estudis Demografics, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ellen Peprah
- STOP NCDs, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Saha Naseri
- World Health Organization, Kabul, Afghanistan
| | - Nadine Cornier
- Humanitarian Response Division, United Nations Population Fund), Geneva, Switzerland
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva
| |
Collapse
|
12
|
Shabnam J, Timm HU, Nielsen DS, Raunkiaer M. Development of a complex intervention (safe and secure) to support non-western migrant patients with palliative care needs and their families. Eur J Oncol Nurs 2023; 62:102238. [PMID: 36459811 DOI: 10.1016/j.ejon.2022.102238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE International evidence supports the benefits of early use of palliative care, although the best use of services is often under-utilised among Danish migrants. The study aims to develop a theoretically informed, evidence-based intervention to increase support in palliative care service provision among non-western migrant patients with a life-threatening disease and their families in Denmark. METHODS The overall approach was guided by the United Kingdom Medical Research Council framework for developing and evaluating complex interventions by involving stakeholders for example patients, family caregivers, and healthcare professionals. The intervention was developed iteratively by incorporating theory and evidence. Evidence was synthesized from a systematic review, semi-structured interviews, and group discussions with patients (n = 8), family caregivers (n = 11), healthcare professionals (n = 10); and three workshops with migrants (n = 5), social and healthcare professionals (n = 6). The study took place in six different settings in two regions across Denmark. RESULTS The safe and secure complex intervention is a healthcare professional (e.g. nurse, physiotherapist, or occupational therapist) led patient-centred palliative care intervention at the basic level. The final intervention consists of three components 1. Education and training sessions, 2. Consultations with the healthcare professional, and 3. Coordination of care. CONCLUSION This study describes the development of a supportive palliative care intervention for non-western migrant patients with palliative care needs and their families, followed by a transparent and systematic reporting process. A palliative care intervention combining multiple components targeting different stakeholders, is expected that safe and secure is more suitable and well customized in increasing access and use of palliative care services for non-western migrant families in Denmark.
Collapse
Affiliation(s)
- Jahan Shabnam
- REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, 5800 Nyborg, Denmark; Department of Clinical Research, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
| | - Helle Ussing Timm
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen, K, Denmark; University Hospitals Center for Health Research (UCSF), Rigshospital, Denmark.
| | - Dorthe Susanne Nielsen
- Geriatric Department G, Odense, Odense University Hospital, Kløvervænget 23, 5000, Odense C, Denmark.
| | - Mette Raunkiaer
- REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, 5800 Nyborg, Denmark; Department of Clinical Research, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
| |
Collapse
|
13
|
Acolin J, Hajat A, Nurius PS, Lengua LJ. Playgrounds are for children: Investigating developmentally-specific "Green Space" and child mental health. SSM - MENTAL HEALTH 2022; 2:100087. [PMID: 38292754 PMCID: PMC10826856 DOI: 10.1016/j.ssmmh.2022.100087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
"Green space" effects on health have been amply demonstrated, but whether specific features of green space exert differential effects remains unknown. Driven by developmental psychology theory highlighting the importance of play for young children, we investigated the association between parks with playgrounds, as a subtype of "green space", and young child mental health. After adjusting for individual race, sex, income, and cumulative risk as well as neighborhood disadvantage, we find that children (N=95) living near parks with playgrounds have better mental health than those near parks without playgrounds (β ˆ = - 1.22 (95% CI: -3.82 - 1.38, p=0.36) Child Behavior Checklist scale). While not statistically significant, the observed difference, which is equivalent to 11% of the baseline mean score, is meaningful. Our results, while only suggestive, indicate that moving beyond "green space" to investigate developmentally-specific features may be worthwhile.
Collapse
Affiliation(s)
- Jessica Acolin
- Department of Health Systems and Population Health, School of Public Health, University of Washington, 3980 15 Ave NE, Seattle WA USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, 3980 15 Ave NE, Seattle WA USA
| | - Paula S. Nurius
- School of Social Work, University of Washington, 4101 15 Ave NE, Seattle WA USA
| | - Liliana J. Lengua
- Department of Psychology, University of Washington, 3751 W. Stevens Way NE, Seattle WA USA
| |
Collapse
|
14
|
Mental health in refugee children. Curr Opin Psychol 2022; 48:101460. [PMID: 36130437 DOI: 10.1016/j.copsyc.2022.101460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 01/28/2023]
Abstract
Almost half of the world's forcibly displaced population are children, most commonly originating from Syria, Iraq, and Afghanistan. Health disparities are well documented, especially for mental health, but not consistent across groups, time or context. Despite high exposure to trauma and stress, refugee children also show remarkable resilience. An ecological model of refugee health including both risk and resilience factors is therefore recommended. The model also includes the dynamic inter-relationship of past traumatic experiences, ongoing daily stressors and the disruptions of basic systems affecting both the individual and families as a whole, offering a framework to better understand the health disparities and appropriate interventions for refugee children.
Collapse
|
15
|
The mental health consequences on children of the war in Ukraine: A commentary. Psychiatry Res 2022; 317:114798. [PMID: 36057188 DOI: 10.1016/j.psychres.2022.114798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022]
Abstract
The news from Ukraine is currently full of heart-wrenching stories accompanied by graphic images of civilian casualties and massacres that are telecast world-wide on a daily basis. It is hard to fathom the magnitude of the devastation and disruption to regular lives and everyday routines that war brings with it, the witnessing of countless deaths, the associated trauma of living in perpetual fear, and the daily experience of many families and orphans who are crowded into basement bomb shelters now for months on end. These issues make us contemplate the mental health consequences, among other lasting effects, of this costly war in Ukraine, and wars in other countries not so widely featured in Western news. Despite people of all ages being affected by war, children are especially vulnerable. This commentary outlines some of the epidemiology of the consequences of war, the mental health sequelae specifically, and the complexity of providing culturally and contextually relevant interventions that meet the needs of children.
Collapse
|
16
|
Munson MR, Raghavan R, Shimizu R, Rodwin AH, Jaccard J. Methodologies to Advance a "Science of How": Identifying and Engaging Intervention Targets and Outcomes. Psychiatr Serv 2022; 73:1039-1046. [PMID: 35172593 DOI: 10.1176/appi.ps.202100202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although implementation science has taken hold in many areas of psychiatric services research, a need remains for developing effective, low-cost interventions for specific subpopulations with mental health conditions. The experimental therapeutics approach has gained momentum as a framework for developing effective interventions. However, few studies have taken steps to rigorously apply experimental therapeutics. This article provides a blueprint for applying this approach. METHODS A focused literature review was conducted to document the frequency of the application of experimental therapeutics among articles published between 2011 and 2021 in some of the American Psychiatric Association's journals. Independently of the review, the authors delineated a four-component approach for applying experimental therapeutics in research and present practical, innovative strategies to advance psychiatric services research. RESULTS The four-component approach includes outlining prerequisites, identifying target mechanisms, proposing intervention strategies to address target mechanisms, and using advanced analytic methods. The strategies described for each component are not exhaustive; rather, they suggest promising avenues for research that can lead to more effective interventions and deeper understanding of how, and for whom, an intervention works. CONCLUSIONS The application of experimental therapeutics in psychiatric services research can lead to increased development, refinement, and implementation of effective interventions for specific populations or conditions.
Collapse
Affiliation(s)
- Michelle R Munson
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - Ramesh Raghavan
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - Rei Shimizu
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - Aaron H Rodwin
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| | - James Jaccard
- Silver School of Social Work, New York University, New York City (Munson, Raghavan, Rodwin, Jaccard); School of Social Work, University of Alaska, Anchorage (Shimizu)
| |
Collapse
|
17
|
Calam R, El-Khani A, Maalouf W. Editorial Perspective: How can we help the children of Ukraine and others affected by military conflict? Child Adolesc Ment Health 2022; 27:294-296. [PMID: 35892181 DOI: 10.1111/camh.12581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 11/27/2022]
Abstract
Parents and caregivers play a key role in protecting children from the stresses of war. Their own experiences, changes they see in children in their care and the nature of the parenting they provide can have a profound effect on childrens' reactions. The adoption of a pyramid of resources from universally available psychoeducational materials to specialised forms of trauma-informed interventions allows for screening and provision of appropriate levels of assistance. The importance of consideration of the family's context, the evidence base and the capacity of informal and professional networks to support caregiving is discussed. Resources available through the United Nations Office on Drugs and Crime are provided to share experiences of building a pyramid of interlinked, evidence-based, trauma-informed interventions which have been developed in collaboration with families and practitioners experiencing life through the contexts of military conflict, displacement and resettlement.
Collapse
Affiliation(s)
- Rachel Calam
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Aala El-Khani
- United Nations Office on Drugs and Crime and The University of Manchester, Manchester, UK
| | - Wadih Maalouf
- Prevention, Treatment and Rehabilitation Section, United Nations Office on Drugs and Crime, Vienna, Austria
| |
Collapse
|
18
|
Im H, Swan LET. Factors Influencing Improvement of Trauma-Related Symptoms Among Somali Refugee Youth in Urban Kenya. Community Ment Health J 2022; 58:1179-1190. [DOI: https:/doi.org/10.1007/s10597-021-00928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/29/2021] [Indexed: 06/22/2023]
|
19
|
Im H, Swan LET. Factors Influencing Improvement of Trauma-Related Symptoms Among Somali Refugee Youth in Urban Kenya. Community Ment Health J 2022; 58:1179-1190. [PMID: 35013831 DOI: 10.1007/s10597-021-00928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/29/2021] [Indexed: 11/03/2022]
Abstract
Somali refugee youth present with a heightened risk for common mental disorders (CMDs), and yet few studies have discussed factors influencing mental health outcomes after psychosocial interventions. This study aimed to identify key factors that contribute to the improvement of CMD symptoms among Somali youth displaced in urban Kenya. Logistic regression analyses revealed that trauma exposure and emotional coping predict overall symptom improvement, pointing to a differential intervention effect on those with differing levels of religious belief and attitudes toward violence. This study provides insights into how psychosocial factors likely contribute to positive intervention outcomes in Somali refugee youth.
Collapse
Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Ave., 3rd Floor, Richmond, VA, 23284, USA.
| | - Laura E T Swan
- Department of Population Health Sciences, University of Wisconsin - Madison, 610 Walnut St., Madison, WI, 53726, USA
| |
Collapse
|
20
|
The cultural sensitivity continuum of mental health interventions in Sub-Saharan Africa: A systematic review. Soc Sci Med 2022; 306:115124. [PMID: 35751989 DOI: 10.1016/j.socscimed.2022.115124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 11/22/2022]
Abstract
Although there is a small but growing literature examining mental health interventions in Sub-Saharan Africa (SSA), there are very few systematic reviews of mental health interventions in the region. Those that exist primarily examine interventions for specific ailments (e.g., substance use, trauma) or specific modes of treatment (e.g., traditional healers, interpersonal psychotherapy). No systematic review has sought to assess the extent to which interventions used in SSA reflect local cultural context. The current systematic review is unique in that it aims to: quantify the number of published studies examining distinct mental health interventions in SSA that reflect local culture; identify and characterize mental health interventions that can be considered indigenous; identify Western mental health interventions in SSA that have undergone cultural adaptation and characterize the nature and extent of those adaptations; and provide recommendations for researchers and practitioners seeking to develop mental health interventions for African populations. A total of 980 articles were identified across five databases from January 31st to February 1st, 2021, and 29 were included in the study. The Ecological Validity Model (EVM) was used to assess degree of cultural sensitivity of non-indigenous interventions within eight cultural dimensions. Findings indicate that few studies examine mental health interventions in SSA and much of this research is authored by Western rather than local researchers. The most common intervention approaches were cognitive-behavioral therapy and problem-solving therapy. Assessment with the EVM framework demonstrated that concepts and goals of treatment were the cultural dimensions that were most likely to lack culturally sensitive elements. Recommendations are provided regarding achieving cultural sensitivity and collaborations between indigenous practitioners and contemporary healthcare systems. This review is an important step in evaluating progress towards achieving global equity in access to suitable mental health care.
Collapse
|
21
|
Tamimi N, Kienzler H, Hammoudeh W, Giacaman R. Capacity Strengthening: Development and Evaluation of the Training Course “Research Methods for Mental Health in War and Conflict”. INTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT 2022. [DOI: 10.1111/ijtd.12259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy Tamimi
- Department of Global Health & Social Medicine School of Global Affairs/Faculty of Social Science and Public Policy King’s College London London UK
| | - Hanna Kienzler
- Department of Global Health & Social Medicine King's College London London UK
| | | | - Rita Giacaman
- Institute of Community and Public Health Birzeit University Birzeit Palestine
| |
Collapse
|
22
|
Kankaanpää R, Aalto S, Vänskä M, Lepistö R, Punamäki RL, Soye E, Watters C, Andersen A, Hilden PK, Derluyn I, Verelst A, Peltonen K. Effectiveness of psychosocial school interventions in Finnish schools for refugee and immigrant children, "Refugees Well School" in Finland (RWS-FI): a protocol for a cluster randomized controlled trial. Trials 2022; 23:79. [PMID: 35086535 PMCID: PMC8793091 DOI: 10.1186/s13063-021-05715-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools are natural environments in which to enhance young people's social and emotional skills, mental health, and contact between diverse groups, including students from refugee and immigrant backgrounds. A layered or tiered provision of services is recommended as it can be effective to meet the needs of war-affected adolescents who variably show mental health problems (such as posttraumatic stress disorder (PTSD)). The current protocol describes the study design for a multi-layered intervention model. The study will test the effectiveness of two interventions: a teacher-training intervention In-Service Teacher Training (INSETT) combined with targeted cognitive-behavioral treatment-based Teaching Recovery Techniques (TRT) and a classroom-focused preventive intervention Peer Integration and Enhancement Resources (PIER). We analyze, first, whether the interventions are effective in decreasing psychological distress and increasing positive resources, i.e., prosocial behavior and resilience among refugee and immigrant students. Second, we analyze which student-, school-, and parent-related factors mediate the possible beneficial changes. Third, we look at which groups the interventions are most beneficial to. METHODS A three-arm cluster RCT with parallel assignment, with a 1:1:1 allocation ratio, is applied in 16 schools that agreed to participate in the Refugees Well School interventions and effectiveness study. Schools were randomized to three conditions of two active interventions and a waiting list control condition. Students, their parents, and teachers in intervention and control schools participated in the study at baseline before the interventions, after the interventions, and at 6 to 12 months after the interventions. The primary effectiveness criterion variables are psychological distress (SDQ) symptoms, resilience (CYRM-12), and prosocial behavior (SDQ). DISCUSSION The current study presents a recommended universal approach of layered interventions aiming to reduce psychological distress and increase resilience among refugee and immigrant students. A combination of promotive, preventive, and targeted interventions may offer a holistic, ecological intervention package for schools to better address the needs of the whole group. TRIAL REGISTRATION ISRCTN ISRCTN64245549 . Retrospectively registered on 10 June 2020.
Collapse
Affiliation(s)
- Reeta Kankaanpää
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Sanni Aalto
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Riina Lepistö
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | | | - Emma Soye
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Charles Watters
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Arnfinn Andersen
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Per Kristian Hilden
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Ilse Derluyn
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - An Verelst
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - Kirsi Peltonen
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| |
Collapse
|
23
|
Sutomo R, Ramadhani FPR, Hanifa IN. Prevalence and associated factors of psychosocial and behavioral problems in Indonesian adolescent students during the COVID-19 pandemic. Front Pediatr 2022; 10:908384. [PMID: 36090562 PMCID: PMC9460758 DOI: 10.3389/fped.2022.908384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/03/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and the subsequent measures to control it, such as social distancing, school closure, and online learning, put adolescent students at higher risk of psychosocial and behavioral problems (PSBP). The adverse potential is more concerning as the outbreak continues, especially in limited-resource countries, and requires further mitigation. OBJECTIVE To assess the prevalence and factors associated with PSBP in Indonesian adolescent students in the COVID-19 pandemic. SUBJECT/METHODS We conducted a cross-sectional study in Yogyakarta Province, Indonesia, involving junior high school students. An anonymous online questionnaire in google form format was used to collect demographic data and the potential variables and screen the PSBP with the Strengths and Difficulties Questionnaire (SDQ). Logistic regression was applied to determine the independent variables. RESULTS Six hundred seventy-six subjects participated, including 237 males (35.1%) and 439 females (64.9%). There were 34.6% subjects with PSBP, with a peer-relation problem as the most common one. The multivariable logistic regression showed that subjects with longer screen time duration and more family conflicts were more likely to have PSBP, with an adjusted odds ratio (OR) of 1.5 (95% CI: 1.1-2.1, p = 0.025) and 2.4 (95% CI: 1.5-3.8, p < 0.001), respectively, whereas whom with better family cohesion are less likely to have the problem with an adjusted OR of 0.4 (95% CI: 0.3-0.6, p < 0.001). CONCLUSIONS There is a high prevalence of PSBP among Indonesian adolescent students during the COVID-19 pandemic. Longer screen time duration and more family conflict are associated with higher prevalence, whereas better family cohesion with lower prevalence of PSBP.
Collapse
Affiliation(s)
- Retno Sutomo
- Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | | | - Intan Noor Hanifa
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
24
|
The mental health and well-being of internally displaced female Yazidis in the Kurdistan Region of Iraq: a realist review of psychosocial interventions and the impact of COVID-19. Glob Ment Health (Camb) 2022; 9:508-520. [PMID: 36618744 PMCID: PMC9806966 DOI: 10.1017/gmh.2022.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Yazidis in the Kurdistan Region of Iraq have been exposed to recurrent traumatic experiences associated with genocide and gender-based violence (GBV). In 2014, ISIS perpetrated another genocide against the Yazidi community of Sinjar. Women and girls were held captive, raped and beaten. Many have been forced into displacement. Rates of post-traumatic stress disorder (PTSD) and suicide are high. Limited research has evaluated interventions delivered to this population. METHODS This review explores how the global evidence on psychosocial interventions for female survivors of conflict-related sexual violence applies to the context of the female Yazidi population. We used a realist review to explore mechanisms underpinning complex psychosocial interventions delivered to internally displaced, conflict-affected females. Findings were cross-referenced with eight realist, semi-structured interviews with stakeholders who deliver interventions to female Yazidis in the Kurdistan Region of Iraq. Interviews also allowed us to explore the impact of COVID-19 on effectiveness of interventions. RESULTS Seven mechanisms underpinned positive mental health outcomes (reduced PTSD, depression, anxiety, suicidal ideation): safe spaces, a strong therapeutic relationship, social connection, mental health literacy, cultural-competency, gender-matching and empowerment. Interviews confirmed relevance and applicability of mechanisms to the displaced female Yazidi population. Interviews also reported increased PTSD, depression, suicide and flashbacks since the start of the COVID-19 pandemic, with significant disruptions to interventions. CONCLUSION COVID-19 is just one of many challenges in the implementation and delivery of interventions. Responding to the mental health needs of female Yazidis exposed to chronic collective violence requires recognition of their sociocultural context and everyday experiences.
Collapse
|
25
|
War-related quality of life is associated with depressive symptoms and hopelessness among Palestinians: sense of belonging and resilience as mediating variables. Glob Ment Health (Camb) 2022; 9:483-490. [PMID: 36618748 PMCID: PMC9806959 DOI: 10.1017/gmh.2022.52] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/21/2022] [Accepted: 09/12/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The current study was designed to test the correlation between quality of life, depressive symptoms, and hopelessness, and whether sense of belonging and resilience mediating the correlation between quality of life, depressive symptoms, and hopelessness in a society characterized by high level of political violence and prolonged trauma. METHODS Structural equation modeling (SEM) was performed to test the conceptual model, where quality of life was identified as a predictor variable, sense of belonging and resilience as mediating variables, and depressive symptoms and hopelessness as outcome variables. The participants of the study were 437 Palestinian adults: 190 males and 247 females, they were recruited using online methods; emails, Facebook, and Twitter. FINDINGS Results indicated that quality of life negatively correlated with depressive symptoms (r = -0.603; p < 0.01), and hopelessness (r = -0.453; p < 0.01), and positively correlated with resilience (r = 0.534; p < 0.05), and sense of belonging (r = 0.428; p < 0.01). Results of SEM indicated the correlation between quality of life, depressive symptoms, and hopelessness was fully mediated by the sense of belonging and resilience. CONCLUSIONS Our study sheds light on resilience and sense of belonging as protective factors against ongoing traumatic experiences among Palestinians. Future research should be addressed to understand better the features of resilience and sense of belonging that can help maintain psychological functioning in conditions of chronic and ongoing violence, the personal and historical antecedents of such protective factors, and the factors that can directly or indirectly undermine them.
Collapse
|
26
|
Nancy T, Hanna K, Weeam H, Hala K, Mathias R, Rita G. Towards decolonising research methods training: the development of a locally responsive online learning course on research methods for mental health in war and conflict for researchers and practitioners in the Gaza Strip. Glob Ment Health (Camb) 2021; 8:e42. [PMID: 34868612 PMCID: PMC8607309 DOI: 10.1017/gmh.2021.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 09/14/2021] [Accepted: 09/28/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Concerns exist that online learning directed at non-Western settings to strengthen research capacity imposes Western-centric epistemology, provides unidirectional transfer of knowledge, and neglects local paradigms and expertise. We argue that a plurality of voices, histories and epistemologies are essential to strengthen research capacity. We share our experience developing and teaching an online course for mental health professionals and researchers in the Gaza Strip. METHODS Birzeit University and King's College London developed and delivered the course equally, focusing on the intersection between qualitative research methods, mental health and conflict, and addressing local research needs. We incorporated local case studies and expertise, encouraged interaction in English and Arabic, and stimulated critique of Western theories. Seventeen participated, 12 completed the pre-course questionnaire, 15 completed the post-course questionnaire and four undertook semi-structured interviews. RESULTS Our pre-course survey showed participants most needed coding and qualitative data analysis skills. Post-course findings showed improved qualitative research skills. Most agreed the course was comprehensive and well delivered, with relevant case studies. Three themes were identified: (1) the course was locally contextualised and met students' needs; (2) the course fostered dialogic and multi-directional learning and (3) suggestions for improvements. Several participants wanted some topics in greater depth and further specialised training. A few suggested the course be in Arabic. CONCLUSION Fostering multi-directional learning is key for non-Western knowledge, epistemologies, and languages to gain prominence in Western academia. A social transformation would see local researchers and educators engage with and use local methods and paradigms in mental health in war and conflict.
Collapse
Affiliation(s)
- Tamimi Nancy
- King's College London Ringgold Standard Institution – Global Health & Social Medicine, 40 Aldwych, LondonWC2R 2LS, United Kingdom of Great Britain and Northern Ireland
| | - Kienzler Hanna
- King's College London Ringgold Standard Institution – Global Health & Social Medicine, 40 Aldwych, LondonWC2R 2LS, United Kingdom of Great Britain and Northern Ireland
| | - Hammoudeh Weeam
- Birzeit University Institute of Community and Public Health Ringgold Standard Institution, Ramallah, State of Palestine
| | - Khalawi Hala
- Birzeit University Institute of Community and Public Health Ringgold Standard Institution, Ramallah, State of Palestine
| | - Regent Mathias
- King's College London School of Social Science and Public Policy Ringgold Standard Institution – Global Health and Social Medicine London, London, United Kingdom of Great Britain and Northern Ireland
| | - Giacaman Rita
- Birzeit University Institute of Community and Public Health Ringgold Standard Institution, Ramallah, State of Palestine
| |
Collapse
|
27
|
Dangmann C, Solberg Ø, Myhrene Steffenak AK, Høye S, Andersen PN. Syrian Refugee Youth Resettled in Norway: Mechanisms of Resilience Influencing Health-Related Quality of Life and Mental Distress. Front Public Health 2021; 9:711451. [PMID: 34631646 PMCID: PMC8494783 DOI: 10.3389/fpubh.2021.711451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The importance of resilience factors in the positive adaptation of refugee youth is widely recognised. However, their actual mechanism of impact remains under-researched. The aim of this study was therefore to explore protective and promotive resilience mechanisms to inform future interventions and policy. Promotive resilience is seen as a direct main effect and protective resilience as a moderating effect. Methods: This was a cross-sectional study of Syrian youth recently resettled in Norway, aged 13–24 years. Regression and moderation analyses were used to explore different interactions, including moderated mediation using the PROCESS macro for SPSS. Result: A direct main effect of promotive resilience was found for health-related quality of life (HRQoL) and general mental distress, but not for post-traumatic stress disorder (PTSD). No moderating effects of protective resilience were found. Post-migration stressors mediated the effects of potentially traumatic events (PTE) from war and flight, and this indirect effect was present at all levels of resilience. Conclusion: Despite high risk exposure and mental distress, resilience was also high. Broad resilience interventions targeting multiple factors would likely benefit the group, but these should include both individual assets and building supportive environments. Additionally, reducing current stress and providing treatment for those in need could enable recovery and increase the efficacy of resilience factors already present.
Collapse
Affiliation(s)
- Cecilie Dangmann
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Øivind Solberg
- Department of Health Science, Swedish Red Cross University College, Stockholm, Sweden
| | | | - Sevald Høye
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| |
Collapse
|
28
|
Onyishi CN, Ilechukwu LC, Victor-Aigbodion V, Eseadi C. Impact of spiritual beliefs and faith-based interventions on diabetes management. World J Diabetes 2021; 12:630-641. [PMID: 33995850 PMCID: PMC8107980 DOI: 10.4239/wjd.v12.i5.630] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/23/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
Management of diabetes constitutes significant social and economic burdens worldwide. There is a shortage of empirical studies on the management of diabetes and the associated mental health issues through spiritual beliefs and faith-based interventions (FBIs). It is not also clear how spiritual beliefs and FBIs account for the effective management of diabetic conditions. This article discusses the impact of spiritual beliefs and FBIs in the management of diabetes, from relationship and efficacy studies that report outcomes from experimental procedures of related interventions. The majority of the relationship studies showed positive relationships, while efficacy studies showed a high efficacy of interventions in faith-based approaches. However, none of the studies clearly reported the mechanisms of change or modality of operation in a FBI that can serve as a model across culture and context. Possible mechanisms of change were discussed for further development of a standard faith-based model, and finally, suggestions for future research were also highlighted by the authors.
Collapse
Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | | | - Vera Victor-Aigbodion
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| |
Collapse
|
29
|
Avendaño-Vásquez CJ, Reina-Gamba NC, Daza-Castillo LA, Quarantini L. Nursing Interventions in Children Living Under Armed Conflict Situations and Quality of Life: A Scoping Review. J Pediatr Nurs 2021; 58:44-52. [PMID: 33316614 DOI: 10.1016/j.pedn.2020.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/22/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
PROBLEM Today, one in four children in the world lives in an area of conflict or disaster, and more than 30 million have been displaced, enslaved or trafficked, abused, and exploited. However, there is little recognition of nursing interventions in this context and their impact on the quality of life. ELIGIBILITY CRITERIA Studies that (1) Described nursing interventions in children under situations of armed conflict. (2) Identified the impact of the interventions in the Quality of Life. (3) identify research trends in the field by nursing professionals. (4) Summarized concepts associated and nursing interventions proposed in armed conflict to address this problem. SAMPLE From June to November 2019, electronic databases such as Embase, MEDLINE, LILACS, BIREME library, CINAHL, and ProQuest were accessed. Eleven papers were included in the review. RESULTS The studies described the positive effects of nursing interventions on mental health and mortality. No studies were found reporting the impact of the interventions on quality of life. The topics of significant research in nursing focus on mental health. Care practices based on leadership, health management, advocacy, and intermediation in public policies should be a matter of interest for nurses. CONCLUSIONS Future research is required to generate a comprehensive and accurate understanding of the nursing interventions in children under armed conflict situations. IMPLICATIONS Recognizing the applied interventions and proposing a frame of reference justifies present and future research to children's attention under armed conflict situations.
Collapse
Affiliation(s)
| | | | | | - Lucas Quarantini
- Medicine Post-graduated program. (PPgMS), Federal University of Bahia, Brazil; Neurosciences, and the Mental Health Department, School Medicine. The Federal University of Bahia, Brazil
| |
Collapse
|
30
|
Liu G, Li YC, Wang Y, Liu JX, Sang YS, Zhang W, Zhang L. Research on Psychological Scales Based on the Multitheory Fusion. Curr Bioinform 2020. [DOI: 10.2174/1574893615666191227091641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective:
This study proposed an innovative approach to simplify the multiple
psychological scales for children and adolescents by integrating statistical methods and item
reflection theory into a structural equation model.
Methods:
First, a psychological scale for adolescents to replace the existing scales optimized for
adults with the Delphi method has been developed. Second, the number of items in the current
group of scales has been reduced.
Result and Conclusion:
A psychological scale for adolescents has been built up that
comprehensively reflects their psychological characteristics in terms of mental state, behavioral
status, emotion & feeling, relationship, and environmental adaptation. This psychological scale has
been simplified and improved its reliability and validity.
Collapse
Affiliation(s)
- Guangdi Liu
- College of Computer and Information Science, Southwest University, Chongqing 400715, China
| | - Yu Chen Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yue Wang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Jing Xiang Liu
- College of Computer Science, Sichuan University, Chengdu 610065, China
| | - Yong Sheng Sang
- College of Computer Science, Sichuan University, Chengdu 610065, China
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Le Zhang
- College of Computer and Information Science, Southwest University, Chongqing 400715, China
| |
Collapse
|
31
|
Bosqui T, Mayya A, Younes L, Baker MC, Annan IM. Disseminating evidence-based research on mental health and coping to adolescents facing adversity in Lebanon: a pilot of a psychoeducational comic book 'Somoud'. Confl Health 2020; 14:78. [PMID: 33292348 PMCID: PMC7672177 DOI: 10.1186/s13031-020-00324-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/05/2020] [Indexed: 11/21/2022] Open
Abstract
Background Despite advances in the evidence base and scaling up of mental health and psychosocial interventions for children and adolescents affected by conflict and adversity, a theory-practice gap remains, with limited translation of research findings to affected communities. Methods In order to disseminate findings from a review on mental health and coping for children and adolescents, a psychoeducational comic book ‘Somoud’ was developed and piloted with adolescents and their caregivers in Lebanon, using a qualitative Grounded Theory approach. Results In total, 10 participants (5 adolescents, 5 parents), took part in the study. Using Thematic Content Analysis, 6 themes were identified; 1) psychoeducation versus misinterpretation, 2) balancing depth with accessibility, 3) aesthetic appeal, 4) contextual relevance and realism, 5) daily stressors, and 6) parental and social relationships. Conclusions The findings demonstrate the importance of cultural and contextual piloting of psychoeducational content, and the potential usefulness and accessibility of a comic book format to disseminate information to adolescents. Data from the pilot was used to inform the development of a new version of ‘Somoud’ for sharing with adolescents in Lebanon. Further research is required to establish the effectiveness of the psychoeducational book as a ‘self-help’ tool, and to further improve knowledge exchange between researchers and communities.
Collapse
Affiliation(s)
- Tania Bosqui
- Department of Psychology, American University of Beirut, Beirut, 1007202, Lebanon.
| | - Anas Mayya
- Department of Psychology, American University of Beirut, Beirut, 1007202, Lebanon
| | - Liliane Younes
- Beit Atfal Assamoud Family Guidance Centre, Beirut, Lebanon
| | - Myriam Claire Baker
- Department of Psychology, American University of Beirut, Beirut, 1007202, Lebanon
| | - Ismat Maktabi Annan
- Department of Psychology, American University of Beirut, Beirut, 1007202, Lebanon
| |
Collapse
|
32
|
Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228479. [PMID: 33207689 PMCID: PMC7698263 DOI: 10.3390/ijerph17228479] [Citation(s) in RCA: 284] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 02/07/2023]
Abstract
The psychological impact of the COVID-19 pandemic has been widely discussed during the past few months, with scholars expressing concern about its potential debilitating consequences on youth mental health. Hence, this research aimed to provide a systematic review of the evidence on the COVID-19 pandemic’s impact on youth mental health. We conducted a mixed methods integrated review to identify any empirical study that focused on young people ≤ 18 years old. Eight databases were systematically searched to identify studies of any type of research design. The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD4202019375). Twelve studies deemed eligible for data extraction (n = 12,262). The findings show that COVID-19 has an impact on youth mental health and is particularly associated with depression and anxiety in adolescent cohorts. The quality appraisal indicated that all studies were of low or moderate methodological quality. The COVID-19 pandemic is affecting young people’s lives, and thus generating robust research evidence to inform policy decisions is essential. Hence, the methodological quality of future research should be drastically improved.
Collapse
|
33
|
van der Boor CF, Amos R, Nevitt S, Dowrick C, White RG. Systematic review of factors associated with quality of life of asylum seekers and refugees in high-income countries. Confl Health 2020; 14:48. [PMID: 32699551 PMCID: PMC7370437 DOI: 10.1186/s13031-020-00292-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/30/2020] [Indexed: 11/10/2022] Open
Abstract
The stressful experiences that many asylum seekers and refugees (AS&R) are exposed to during forced migration, and during resettlement in host countries, can have a profound impact on their mental health. Comparatively less research attention has been allocated to exploring other indices of quality of life (QoL) in AS&R populations. This review aimed to (i) synthesize the predictors and correlates of QoL of AS&R populations in high-income countries, and (ii) to identify the methodological strengths and weaknesses of this body of research. Fourteen databases were systematically searched (Medline, PsychINFO, CINAHL, Cochrane Library, Health Technology Assessment, National Health Service Economic Evaluation, Educational Resource Index and Abstracts, BiblioMap, Scopus, Social Sciences Citation Index, Evidence Aid, DARE, Web of Science and PubMed). Eligibility criteria included: adults seeking asylum or refuge in a high-income country, primary quantitative data, the use of a measure based on the WHO's definition of QoL, published in a peer-reviewed journal. A narrative synthesis approach was used, and the quality was assessed using the AXIS tool for cross-sectional studies and the CASP tool for longitudinal studies. Of the 13.656 papers identified, 23 met the eligibility criteria. A wide range of factors were found to have significant associations with QoL. Both positive and negative correlates of QoL were largely dominated by social (e.g. social networks) and mental health factors (e.g. depression). Although all of the cross-sectional studies met over half of the quality criteria, only 12 met 75% or more of these criteria. For the longitudinal studies, for all but one study lacked statistical precision and the results cannot be applied to the local population. Key findings across the various forms of QoL (overall, physical, psychological, social and environmental) were that having established social networks and social integration were associated with higher QoL, whereas having mental disorders (i.e. PTSD or depression) was strongly associated with reduced QoL. More research is needed into physical and environmental predictors and correlates of QoL. The findings of the review can be used to inform policies and interventions aimed at supporting AS&R and promoting the integration and wellbeing of these populations.
Collapse
Affiliation(s)
- Catharina F van der Boor
- Institute of Life and Human Sciences, University of Liverpool, Brownlow Hill, Liverpool, L69 3BX UK
| | - Rebekah Amos
- Institute of Life and Human Sciences, University of Liverpool, Brownlow Hill, Liverpool, L69 3BX UK
| | - Sarah Nevitt
- Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool, L69 3BX UK
| | - Christopher Dowrick
- Institute of Life and Human Sciences, University of Liverpool, Brownlow Hill, Liverpool, L69 3BX UK
| | - Ross G White
- Institute of Life and Human Sciences, University of Liverpool, Brownlow Hill, Liverpool, L69 3BX UK.,University of Liverpool, G.10, Ground floor, Whelan Building, Quadrangle, Brownlow Hill, Liverpool, L69 3GB UK
| |
Collapse
|
34
|
Purgato M, Tedeschi F, Betancourt TS, Bolton P, Bonetto C, Gastaldon C, Gordon J, O'Callaghan P, Papola D, Peltonen K, Punamaki RL, Richards J, Staples JK, Unterhitzenberger J, de Jong J, Jordans MJD, Gross AL, Tol WA, Barbui C. Mediators of focused psychosocial support interventions for children in low-resource humanitarian settings: analysis from an Individual Participant Dataset with 3,143 participants. J Child Psychol Psychiatry 2020; 61:584-593. [PMID: 31701533 DOI: 10.1111/jcpp.13151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Research on psychosocial interventions has been focused on the effectiveness of psychosocial interventions on mental health outcomes, without exploring how interventions achieve beneficial effects. Identifying the potential pathways through which interventions work would potentially allow further strengthening of interventions by emphasizing specific components connected with such pathways. METHODS We conducted a preplanned mediation analysis using individual participant data from a dataset of 11 randomized controlled trials (RCTs) which compared focused psychosocial support interventions versus control conditions for children living in low- and middle-income countries (LMICs) affected by humanitarian crises. Based on an ecological resilience framework, we hypothesized that (a) coping, (b) hope, (c) social support, and (d) functional impairment mediate the relationship between intervention and outcome PTSD symptoms. A systematic search on the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed, PyscARTICLES, Web of Science, and the main local LMICs databases was conducted up to August 2018. The hypotheses were tested by using individual participant data obtained from study authors of all the studies included in the systematic review. RESULTS We included 3,143 children from 11 studies (100% of data from included studies), of which 1,877 from six studies contributed to the mediation analysis. Functional impairment was the strongest mediator for focused psychosocial interventions on PTSD (mediation coefficient -0.087, standard error 0.040). The estimated proportion of effect mediated by functional impairment, and adjusted for confounders, was 31%. CONCLUSIONS Findings did not support the proposed mediation hypotheses for coping, hope, and social support. The mediation through functional impairment may represent unmeasured proxy measures or point to a broader mechanism that impacts self-efficacy and agency.
Collapse
Affiliation(s)
- Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, University of Verona, Verona, Italy.,Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, University of Verona, Verona, Italy
| | - Theresa S Betancourt
- Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA, USA
| | - Paul Bolton
- Center for Humanitarian Health, Department of International Health and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chiara Bonetto
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, University of Verona, Verona, Italy
| | - Chiara Gastaldon
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, University of Verona, Verona, Italy.,Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - James Gordon
- The Center for Mind-Body Medicine, Washington, D.C, USA
| | | | - Davide Papola
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, University of Verona, Verona, Italy
| | - Kirsi Peltonen
- Department of Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Raija-Leena Punamaki
- Department of Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Justin Richards
- School of Public Health & Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | | | | | - Joop de Jong
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Mark J D Jordans
- Center for Global Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wietse A Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,HealthRight International, New York, NY, USA
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Section of Psychiatry, University of Verona, Verona, Italy.,Cochrane Global Mental Health, University of Verona, Verona, Italy
| |
Collapse
|
35
|
The need to shift to a contextualized and collective mental health paradigm: learning from crisis-hit Lebanon. Glob Ment Health (Camb) 2020; 7:e26. [PMID: 34191996 PMCID: PMC7533479 DOI: 10.1017/gmh.2020.20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/18/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022] Open
|
36
|
Pedersen GA, Zajkowska Z, Kieling C, Gautam K, Mondelli V, Fisher HL, Swartz JR, Adewuya A, Karmacharya R, Kohrt BA. Protocol for a systematic review of the development of depression among adolescents and young adults: psychological, biological, and contextual perspectives around the world. Syst Rev 2019; 8:179. [PMID: 31325965 PMCID: PMC6642734 DOI: 10.1186/s13643-019-1104-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 07/12/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Depression is a leading contributor to disability-adjusted life-years because of early onset and chronicity throughout the lifecycle. It is crucial to identify early predictors of depression among adolescents and young people to effectively target prevention. A gap in the literature is a comprehensive systematic review of predictors of depression among adolescents around the globe, especially in low- and middle-income countries LMICs. This review aims to identify evidence for biological, psychological, and contextual risk factors for the development of depression among adolescents and young adults (10-24 years of age) in high-income countries (HICs) and LMICs, ultimately contributing to (a) identification of potential mechanisms underlying depression development, (b) selection of common risk and protective factors as targets for detection, and (c) refinement of risk models that can be evaluated through existing cohorts in HICs and LMICs. METHODS This review will follow the Population, Exposure, Comparison, Outcome (PI(E)CO) model and adheres to the PRISMA-P guidelines. A search strategy was developed by a multidisciplinary research consortium. Seven databases (MEDLINE via Ovid, PsycINFO, Cochrane Database of Systematic Reviews, Web of Science, Lilacs, African Journals Online, Global Health) will be searched to identify articles. Independent raters will screen and retrieve articles for inclusion, conduct quality ratings, and extract data. The Systematic Assessment of Quality in Observational Research adapted for Cultural Psychiatry Epidemiology (SAQOR-CPE) will be used to assess quality of observational studies. We will assess for publication bias using funnel plots and statistical methods. We will use narrative synthesis to present results, addressing the study's objectives following the Cochrane Handbook guidelines. Meta-analyses will be used to report summary statistics for association of risk factors with development of depression. DISCUSSION This systematic review will summarize evidence-based research that examines the psychological, biological, and contextual factors contributing to the onset of depression in adolescents across the globe. Results will support the development of a model that can be evaluated in existing cohorts around the world. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration CRD42018103973 .
Collapse
Affiliation(s)
- Gloria A Pedersen
- School of Medicine and Health Sciences, Division of Global Mental Health, 2120 L St NW, Ste 600, Washington DC, 20037, USA
| | - Zuzanna Zajkowska
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Christian Kieling
- Department of Psychiatry and Child & Adolescent Psychiatry Division, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 - 400N, Porto Alegre, RS, 90035-903, Brazil
| | - Kamal Gautam
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Anek Marga, Baluwatar, G.P.O. Box 8974/CPC 612, Kathmandu, Nepal.
| | - Valeria Mondelli
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Helen L Fisher
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Johnna R Swartz
- Department of Human Ecology, University of California Davis, One Shields Ave, Davis, CA, 95616, USA
| | - Abiodun Adewuya
- Department of Behavioral Medicine, Lagos State University College of Medicine, 1-5 Oba Akinjobi Way, G.R.A., Ikeja P.M.B, Lagos, 21266, Nigeria
| | - Rakesh Karmacharya
- Center for Human Genetic Research, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA
| | - Brandon A Kohrt
- School of Medicine and Health Sciences, Division of Global Mental Health, 2120 L St NW, Ste 600, Washington DC, 20037, USA
| |
Collapse
|
37
|
Pettoello-Mantovani M, Pop TL, Mestrovic J, Ferrara P, Giardino I, Carrasco-Sanz A, Nigri L, Namazova-Baranova L, Vural M, Çokuğraş FÇ. Fostering Resilience in Children: The Essential Role of Healthcare Professionals and Families. J Pediatr 2019; 205:298-299.e1. [PMID: 30684982 DOI: 10.1016/j.jpeds.2018.10.069] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza," University of Foggia, Foggia, Italy.
| | - Tudor Lucian Pop
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; 2nd Pediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Julije Mestrovic
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; University Hospital of Split, Medical School of Split, Split, Croatia
| | - Pietro Ferrara
- Italian Society of Pediatrics (SIP), Rome, Italy; Institute of Pediatrics, Catholic University Medical School, Rome, Italy
| | - Ida Giardino
- Residency Course in Pediatrics, University of Foggia, Foggia, Italy
| | - Angel Carrasco-Sanz
- European Confederation of Primary Care Paediatricians (EPCP), Lyone, France; Primary Care Health Center Potosi, Madrid, Spain
| | - Luigi Nigri
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Italian Federation of Pediatricians, Rome, Italy
| | - Leyla Namazova-Baranova
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Russian Medical Research and Scientific Medical University, Moscow, Russia
| | - Mehmet Vural
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Istanbul, Turkey
| | - Fügen Çullu Çokuğraş
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Istanbul, Turkey
| |
Collapse
|