Impact of traumatic events on coping strategies and their effectiveness among Kurdish children

War trauma and strategies for coping with stress among Ukrainian refugees staying in Poland

Objectives

The Russian military aggression against Ukraine resulted in a humanitarian crisis. There was a mass exodus of war refugees. More than 17 million people have left Ukraine since the war broke out. The refugees who came to Poland and other countries have experienced war trauma. The study aims to assess mental health of Ukrainian war refugees in Poland.

Population and methods

At the time of the study, that is, in April and May 2022, between 1,5 million and 2 million Ukrainian refugees were staying in Poland. They were mainly young women with their children. The CAWI (Computer-Assisted Web Interview) technique was used in the study. The research sample was selected using purposive sampling. The invitation to take part in the survey was posted on social media for Ukrainians in Poland, and also sent to the participants of a Polish as a Foreign Language course. The study utilizes the RHS-15 and a nominal scale measuring the strategies for coping with stress.

Results

The research sample consists of 737 respondents. The results of the screening tests indicate that depression, anxiety disorders and PTSD may be observed among 73% of respondents, whereas 66% of the respondents display psychological distress. The analyses have shown that higher levels of mental health disorders were observed among women and refugees who do not speak Polish. Younger respondents experienced a higher psychological distress. The results of the study also indicate that the refugees more often implemented problem-focused strategies. The analysis has shown that the respondents who followed active strategies scored the lowest on RHS-15. The emotion-focused strategies, such as praying, diverting attention by becoming involved in different activities or taking sedatives were not effective. The highest levels of disorders were present among the refugees who indicated resignation.

Conclusions

The collected observations indicate that the main problem which might hinder their adaptation could be mental health issues, which in turn impact the general deterioration of health and the quality of life.

War trauma exposed refugees and posttraumatic stress disorder: The moderating role of trait resilience

OBJECTIVE

Examining how exposure to pre-migration war related trauma and duration of living in refugee camp can impact on PTSD and psychiatric morbidity, while assessing the moderating role of trait resilience and coping style.

METHODS

In a cross-sectional study, exposure to war related trauma and duration of living in refugee camp was evaluated in a sample of 83 asylum seekers and refugees from the Middle East, together with an assessment of PTSD and psychiatric morbidity via self-rating instruments. Trait resilience and coping style were also measured.

RESULTS

Eighty-three participants were included in the analysis, 96.4% reported having experienced more than one war related traumatic event while the mean duration of living in refugee camps was 23.6 (SD = 7.6) years. Of the entire sample, 32.5% reached the threshold for clinical presence of PTSD and 38.8% for psychiatric morbidity. Both pre-migration war related trauma (F(1,82) = 24.118, p < .001) and duration of living in refugee camp (F(2,81) = 2.511, p = .008) were significantly associated with PTSD. Trait resilience moderated effects of high-profile trauma exposure on PTSD severity, R2 = 0.26, MSE = 0.547, F(3,79) = 9.6357, p < .0001, with higher resilience levels weakening the effect of traumatic exposure on PTSD development.

CONCLUSIONS

Our results shed light on the ways that resilience can influence the relationship between war trauma exposure and PTSD symptoms. Findings support the role of resilience-based interventions in order to bolster resilient functioning and optimize treatment of this disadvantaged and highly distressed population.

Profiles of Coping Strategies in Resilient Adolescents

To understand how resilient adolescents adapt to adverse situations, this study examined resilient adolescents and their coping strategies. Resilience is the phenomenon characterized by good outcomes despite serious threats to adaptation and/or development. The current study aimed to identify the coping strategy profiles that distinguish a resilient group from three other groups—struggling, competent, and vulnerable—specifically to differentiate the resilient group from the competent group. Descriptive discriminant analysis results indicated that resilient adolescents simultaneously utilized not only problem-focused but also the emotion-focused coping strategies. The competent group primarily used problem-focused coping, while the struggling group primarily used emotion-focused strategies. Finally, the vulnerable adolescents used neither problem-focused nor emotion-focused strategies. Practical implications of the results were discussed to guide professionals.

Coping responses in the midst of terror: the July 22 terror attack at Utøya Island in Norway

This study examined the peri-trauma coping responses of 325 survivors, mostly youth, after the July 22, 2011 terror attack on Utøya Island in Norway. The aim was to understand peri-trauma coping responses and their relation to subsequent post-traumatic stress (PTS) reactions. Respondents were interviewed face-to-face 4-5 months after the shooting, and most were interviewed at their homes. Peri-trauma coping was assessed using ten selected items from the "How I Cope Under Pressure Scale" (HICUPS), covering the dimensions of problem solving, positive cognitive restructuring, avoidance, support seeking, seeking understanding, and religious coping. PTS reactions were assessed with the UCLA PTSD Reaction Index. The participants reported using a wide variety of coping strategies. Problem solving, positive cognitive restructuring, and seeking understanding strategies were reported most often. Men reported using more problem-solving strategies, whereas women reported more emotion-focused strategies. There were no significant associations between age and the use of coping strategies. Problem solving and positive cognitive restructuring were significantly associated with fewer PTS reactions. The results are discussed in light of previous research and may help to inform early intervention efforts for survivors of traumatic events.

Daily hassles and coping dispositions as predictors of psychological adjustment

This study examined daily hassles and coping dispositions in relation to life satisfaction and depressive symptoms among resettled unaccompanied refugees and other youth in the resettlement country. A total of 223 unaccompanied refugees ( M = 20 years) was compared with 609 ethnic minority and 427 majority youth in Norway. Unaccompanied refugees reported higher levels of depressive symptoms, daily hassles and engagement and disengagement coping than the other two groups, but equal level of life satisfaction. Daily hassles and disengagement coping predicted lower life satisfaction and more depressive symptoms across groups. Engagement coping predicted higher life satisfaction in all groups, but not less depressive symptoms among unaccompanied refugees. Multiple mediation analyses showed that daily hassles and coping dispositions partly explained group differences in depressive symptoms, and that at the same level of hassles and disengagement coping, unaccompanied refugees would be significantly more satisfied with life. Findings suggest that interventions to promote more effective coping strategies to handle the many hassles in their daily lives may improve unaccompanied refugees’ psychological adjustment and chances to succeed in the resettlement country.

Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict--a systematic review of findings in low- and middle-income countries

BACKGROUND

Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions.

METHODS

We performed a systematic review of peer-reviewed qualitative and quantitative studies focused on resilience and mental health in children and adolescents affected by armed conflict in low- and middle-income countries.

RESULTS

Altogether 53 studies were identified: 15 qualitative and mixed methods studies and 38 quantitative, mostly cross-sectional studies focused on school-aged children and adolescents. Qualitative studies identified variation across socio-cultural settings of relevant resilience outcomes, and report contextually unique processes contributing to such outcomes. Quantitative studies focused on promotive and protective factors at different socio-ecological levels (individual, family-, peer-, school-, and community-levels). Generally, promotive and protective factors showed gender-, symptom-, and phase of conflict-specific effects on mental health outcomes.

CONCLUSIONS

Although limited by its predominantly cross-sectional nature and focus on protective outcomes, this body of knowledge supports a perspective of resilience as a complex dynamic process driven by time- and context-dependent variables, rather than the balance between risk- and protective factors with known impacts on mental health. Given the complexity of findings in this population, we conclude that resilience-focused interventions will need to be highly tailored to specific contexts, rather than the application of a universal model that may be expected to have similar effects on mental health across contexts.

Annual Research Review: The experience of youth with political conflict--challenging notions of resilience and encouraging research refinement

AIMS AND METHOD

Drawing on empirical studies and literature reviews, this paper aims to clarify and qualify the relevance of resilience to youth experiencing political conflict. It focuses on the discordance between expectations of widespread dysfunction among conflict-affected youth and a body of empirical evidence that does not confirm these expectations.

FINDINGS

The expectation for widespread dysfunction appears exaggerated, relying as it does on low correlations and on presumptions of universal response to adversity. Such a position ignores cultural differences in understanding and responding to adversity, and in the specific case of political conflict, it does not account for the critical role of ideologies and meaning systems that underlie the political conflict and shape a young people's interpretation of the conflict, and their exposure, participation, and processing of experiences. With respect to empirical evidence, the findings must be viewed as tentative given the primitive nature of research designs: namely, concentration on violence exposure as the primary risk factor, at the expense of recognizing war's impact on the broader ecology of youth's lives, including disruptions to key economic, social, and political resources; priority given to psychopathology in the assessment of youth functioning, rather than holistic assessments that would include social and institutional functioning and fit with cultural and normative expectations and transitions; and heavy reliance on cross-sectional, rather than longitudinal, studies.

CONCLUSIONS

Researchers and practitioners interested in employing resilience as a guiding construct will face such questions: Is resilience predicated on evidence of competent functioning across the breadth of risks associated with political conflict, across most or all domains of functioning, and/or across time? In reality, youth resilience amidst political conflict is likely a complex package of better and poorer functioning that varies over time and in direct relationship to social, economic, and political opportunities. Addressing this complexity will complicate the definition of resilience, but it confronts the ambiguities and limitations of work in cross-cultural contexts.

Resilience in trauma-exposed refugees: the moderating effect of coping style on resilience variables

Research with survivors of torture has generated considerable variability in prevalence rates of posttraumatic stress disorder (PTSD). Multiple risk and resilience factors may affect this variability, increasing or decreasing the likelihood of experiencing psychological distress. This study sought to investigate the effect of several such resilience factors, coping style, social support, cognitive appraisals, and social comparisons on PTSD symptom severity. Furthermore, this study examined whether coping style moderated the relationship between resilience variables and PTSD symptoms. Seventy-five torture survivors completed an intake interview and several self-report measures upon entry into a treatment program for survivors of torture. Results indicated that emotion-focused coping styles significantly moderated the relationship between cognitive appraisal and social comparison variables and PTSD, and usually increased the likelihood of developing severe symptoms. These results indicate that the salience of resilience variables may differ depending on the individual's coping style, which present implications for clinical practice with torture survivors.

Socio-economic, socio-political and socio-emotional variables explaining school bullying: a country-wide multilevel analysis

Why do some countries, regions and schools have more bullying than others? What socio-economic, socio-political and other larger contextual factors predict school bullying? These open questions inspired this study with 53.316 5th- and 9th-grade students (5% of the national student population in these grades), from 1,000 schools in Colombia. Students completed a national test of citizenship competencies, which included questions about bullying and about families, neighborhoods and their own socio-emotional competencies. We combined these data with community violence and socio-economic conditions of all Colombian municipalities, which allowed us to conduct multilevel analyses to identify municipality- and school-level variables predicting school bullying. Most variance was found at the school level. Higher levels of school bullying were related to more males in the schools, lower levels of empathy, more authoritarian and violent families, higher levels of community violence, better socio-economic conditions, hostile attributional biases and more beliefs supporting aggression. These results might reflect student, classroom and school contributions because student-level variables were aggregated at the school level. Although in small portions, violence from the decades-old-armed conflict among guerrillas, paramilitaries and governmental forces predicted school bullying at the municipal level for 5th graders. For 9th graders, inequality in land ownership predicted school bullying. Neither poverty, nor population density or homicide rates contributed to explaining bullying. These results may help us advance toward understanding how the larger context relates to school bullying, and what socio-emotional competencies may help us prevent the negative effects of a violent and unequal environment.

Age differences and changes of coping behavior in three age groups: findings from the Georgia Centenarian Study

With increasing age, older adults are more likely to be challenged by an increasing number of physical, functional and social losses. As a result, coping with losses becomes a central theme in very late life. This study investigated age differences and age changes in active behavioral, active cognitive and avoidance coping and related coping to adaptational outcomes, such as physical and mental health. Sixty-one sexagenarians, 46 octogenarians, and 47 centenarians from the Georgia Centenarian Study participated in this longitudinal study to assess coping with health and family events. The results indicated age group differences in active behavioral coping, suggesting that centenarians were less likely to use this mode of coping. Centenarians and octogenarians were also more likely to experience decreases in active behavioral coping over time, while sexagenarians were more likely to experience increases in this coping mode. No significant differences in coping with health versus family events were obtained suggesting that coping is consistent across life domains. Moderate levels of stability were obtained for coping in all age groups. Active behavioral and active cognitive coping predicted functional health, active behavioral coping predicted social relations, and avoidance coping predicted negative affect.

The well being of children living in chronic war zones: The Palestinian—Israeli case

The paper presents a comprehensive review and integration of available studies on the effects of severe traumatic experiences on children, especially in the context of short and enduring exposure to harsh events and adversities, as they relate to children who live in violent war zones, in particular in Israel and the Palestinian territories. The review focuses on the role of risk and protective factors in determining the debilitating and damaging effects as well as resiliencies of short term and chronic catastrophic experiences on the future well being of children and emerging adults.

Returning home: resettlement of formerly abducted children in Northern Uganda

This exploratory qualitative study considers the subjective resettlement experiences of children forced into armed conflict in Northern Uganda from the perspectives of 11 former child combatants and 11 adult community members. A thematic analysis was performed on the narrative data. The bioecological model was used to provide a conceptual framework for key themes. Major findings included the overarching impact of ongoing armed conflict on returnees' lives, the important role of the family in supporting children's resettlement, the harassment of former child soldiers by community members, and the community's inability to support systematically the returning children in tangible ways. This study recommends that humanitarian services at all levels strengthen the capacity of families to care for the material and psychoemotional needs of former child soldiers within their communities.