Prevalence and factors related to dating violence victimization and perpetration among a representative sample of adolescents and young adults in Haiti

BACKGROUND

Studies examining both victimization and perpetration of dating violence among both women and men are virtually non-existent in Haiti. This study aimed to document the prevalence and factors associated with victimization and perpetration of dating violence (DV) among adolescents and young adults aged 15-24 years in Haiti.

PARTICIPANTS AND SETTING

A total of 3586 participants (47.6% women; mean age = 19.37; SD = 2.71) were sampled in the 10 geographical departments according to residence areas (urban/rural), age group (15-19/20-24 years old), and gender (men/women).

METHOD

Participants completed questionnaires assessing DV victimization and perpetration, witnessing interparental violence, parental violence, violence acceptance, social desirability, and self-esteem.

RESULTS

Overall, 1538 participants (56% women) were in a romantic relationship in the past year. Results showed that men were more likely to experience both psychological (49.4% of women and 57% of men, X² = 8.17, p = .004), and physical violence (11.1% of women and 18.8% of men, X² = 8.13, p = .004). There were marginally significant differences for sexual violence between gender for adolescents aged 15 to 19 (26.5% of girls and 20.5% of boys, X² = 3.25, p = .07), and not for young adults (21.8% of women and 24.0% of men, X² = 0.49, p = .48). No significant difference was observed for any forms of DV perpetration. DV perpetration was positively associated with victimization (b = 0.5, p = .002), however victimization was not associated with perpetration. Results also showed different associations between violence perpetration and victimization, gender, social desirability, acceptance of violence, parental violence, and witnessing interparental violence.

CONCLUSIONS

This study highlights avenues for prevention and intervention that must begin at an early age, engage teachers, train peer-educators, promote healthy, non-violent and egalitarian romantic relationships.

Ebola virus disease, stigmatization, peritraumatic distress, and posttraumatic stress disorder in the Democratic Republic of the Congo: A moderated mediation model

BACKGROUND

Mechanisms worsening the development of Posttraumatic stress disorder (PTSD) symptoms among individuals affected by high-mortality epidemics are unclear. This study examined the prevalence of PTSD and related risk factors among populations affected by the Ebola virus disease (EVD) outbreak, and investigated whether peritraumatic distress mediates the impact of exposure level to EVD on PTSD symptoms, and the moderation role of stigmatization.

METHODS

The sample included 1614 participants (50% women) affected by EVD in Democratic Republic of the Congo (DRC). Participants completed the PTSD Check-List for DSM-5, Peritraumatic Distress Inventory, and measures evaluating levels of exposure and stigmatization related to EVD. Descriptive analyses and a moderated mediation model were computed.

RESULTS

A total of 58.81% participants (95% CI: 56.41%; 61.21%) met PTSD diagnostic criteria. Participants living in rural areas presented greater risk, while there is no significant difference between men and women. Peritraumatic distress mediated partially the association between exposure to EVD and PTSD symptoms. Moreover, this relationship was moderated by stigmatization related to EVD.

LIMITATIONS

As the design was cross-sectional, this study could not examine the causality of PTSD symptoms among communities affected by EVD.

CONCLUSIONS

This study shows high prevalence rates and important risk factors associated with PTSD in populations affected by EVD. It indicates elements that could help to develop and implement prevention and intervention programs in affected communities.

The global challenge of providing mental health services in poverty: the situation of Northern Haiti

When people living in poverty are asked to describe their living conditions, mental health issues quickly come to mind (grief, sadness, anger, fear, bitterness, frustration, discontent, anxiety, and emotional damage consisting of low mood and depression, fatigue, hypersensitivity, sleep difficulties and physical pain). Although the association between poverty and mental health have been widely demonstrated in the literature, care must be taken to avoid the psychiatrization of poverty. However, how can healthcare be provided to people living in poverty when basic needs are not met? This article explores the global challenge of providing mental health services in impoverished populations, using the example of the poorest country in America: Haiti. It examines the availability of services offered through the Mental Health Centre at Morne Pelé, and the necessity for innovative and comprehensive approaches to provide culturally appropriate care that meets the real needs of populations. It highlights effective measures that policy makers should implement to develop an efficient mental healthcare system based on the lessons of the Mental Health Centre at Morne Pelé.

Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: A systematic review and meta-analysis

OBJECTIVE

We conducted a systematic review and meta-analysis to estimate the pooled prevalence of depression, anxiety, insomnia, PTSD, and Psychological distress (PD) related to COVID-19 among affected populations.

METHODS

We searched articles in Medline, Embase, APA PsycInfo, CINAHL, Scopus, and Web of Science. Random-effects meta-analyses on the proportions of individuals with symptoms of depression, anxiety, insomnia, PTSD, and PD were generated and between-group differences for gender, healthcare workers (HCWs), and regions where studies were conducted.

RESULTS

A total of 2189 articles were screened, 136 full-text articles were assessed for eligibility. Fifty-five peer-reviewed studies met inclusion criteria for the meta-analysis (N=189,159). The prevalence of depression (k=46) was 15.97% (95%CI, 13.24-19.13). The prevalence of anxiety (k=54) was 15.15% (95%CI, 12.29-18.54). The prevalence of insomnia (k=14) was 23.87% (95%CI, 15.74-34.48). The prevalence of PTSD (k=13) was 21.94% (95%CI, 9.37-43.31). Finally, the prevalence of psychological distress (k=19) was 13.29% (95%CI, 8.80-19.57). Between-group differences were only found in HCWs (z=2.69, p < 0.05) who had a higher prevalence of insomnia than others.

CONCLUSIONS

Findings suggest that the short-term mental health consequences of COVID-19 are equally high across affected countries, and across gender. However, reports of insomnia are significantly higher among HCWs than the general population.

Racial disparities in child welfare in Ontario (Canada) and training on ethnocultural diversity: An innovative mixed-methods study

BACKGROUND

Despite continuous reports showing the overrepresentation of Black children in the child welfare system in Ontario, Canada's most populous and ethnically diverse province, knowledge in the factors contributing to this issue remain scarce.

OBJECTIVE

This study aimed to explore questions relating to caseworker's training on ethnocultural diversity in connection with racial disparities and overrepresentation of Black children in child welfare services.

PARTICIPANTS AND SETTINGS

This two-fold mixed-methods study included (1) a qualitative methodology based on four focus groups with child welfare caseworkers from a Children's Aid Society (CAS) in Ontario and community facilitators (N = 24), and (2) an analysis of academic curriculums from all 36 Ontarian colleges and universities offering social work programs.

METHODS

We used an innovative and complementary mixed-method design based on grounded theory.

RESULTS

Results from categorical content analyses with NVivo revealed that community facilitators perceived a lack of ethnocultural competency amongst CAS caseworkers. Similarly, CAS caseworkers reported inadequate training on ethnocultural diversity during and following their post-secondary education (college or university). Corroborating these findings, results from documentary analyses of Ontarian university and college curriculums in social work revealed that barely one in two programs had a mandatory course on cultural issues.

CONCLUSIONS

This study reveals a need for additional efforts to provide adequate training to child welfare caseworkers on ethnocultural diversity, starting with undergraduate training programs, in order to understand and tackle the overrepresentation of Black children in child welfare services. Implications for policy and practice are discussed.

A systematic review of mental health programs among populations affected by the Ebola virus disease

OBJECTIVES

The Ebola virus disease (EVD) is associated with major mental health consequences (e.g., depression, anxiety, PTSD). Studies have shown a need for relevant and effective programs to address mental health consequences associated to EVD. This systematic review aimed to describe programs implemented following EVD outbreaks and to evaluate their effectiveness and relevance in order to provide evidence-based data to improve mental health services.

METHODS

We first searched EMBASE, PubMed, PsycINFO, PILOTS, Cochrane Library and MEDLINE for a systematic review on EVD and on MHPSS programs. Then, we searched the grey literature. The search generated 2827 publications. Eleven studies were retained according to the PRISMA statement.

RESULTS

This systematic review revealed that most programs were implemented by international organizations in collaboration with local partners. Many of them were implemented following WHO mhGAP and Psychological First Aid guidelines. Programs were implemented in hospitals, Ebola treatment centres, communities among different categories of individuals exposed to EVD (survivors, health workers and volunteers, other frontline workers, children, adults, etc.). Only two of the identified programs which integrated cultural factors were empirically evaluated. Results from the evaluations showed mental health improvement for both children and adults.

CONCLUSIONS

This study provides the first systematic review on MHPSS programs among communities affected by EVD. This study shows the need to increase efforts to systematically document and evaluate the implemented programs. Results also provide preliminary evidence about the value of culturally sensitive MHPSS programs and of the implication of local mental health professionals.

The mental health professional at the feet of the Ebola virus: individual treatment and global mental challenges

SummaryMental health professionals form an important component of the response teams currently working in the Democratic Republic of the Congo to treat what is historically the second-largest Ebola outbreak. They provide psychological treatment to patients under extraordinary conditions, helping them cope with anxiety and the daily death of other patients.Declaration of interestNone.