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Kaddoura R, Elbejjani M, Tamim H, Mahfoud ZR, Salameh P, Mirza F, Charafeddine L. Building a maternal and child cohort amidst Lebanon's socioeconomic collapse: preliminary results and navigating research challenges. Popul Health Metr 2024; 22:5. [PMID: 38528603 DOI: 10.1186/s12963-024-00325-1] [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: 10/02/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024] Open
Abstract
The impact of conflict and crisis on maternal and child health underscores the need for reliable research in vulnerable populations. Lebanon, amidst ongoing economic collapse, political instability, and healthcare system strain, offers a case study for exploring these impacts, particularly on preterm babies and their development. This study aims to assess the feasibility of establishing a prospective cohort of mothers and their full-term and preterm babies in Lebanon, examining the association between social determinants, preterm birth, and developmental outcomes amidst the nation's multifaceted crises. The planned cohort involves 50 full-term and 50 preterm mother-baby pairs recruited at birth and followed up to 9-12 months post-birth. Data collection spans social determinants, perceived stress, social support, quality of life, and developmental assessments. Challenges in recruitment, follow-up, and data collection in the context of Lebanon's socio-political and economic turmoil are evaluated, alongside ethical considerations for research in vulnerable populations. Preliminary findings highlight substantial recruitment and follow-up challenges, notably due to population mobility, economic instability, and healthcare access issues. Despite these obstacles, 113 mother-baby pairs have been recruited. Early analysis reveals significant stress and reduced quality of life among mothers, particularly those with preterm infants, against a backdrop of declining birth rates and healthcare worker exodus. Conducting research in crisis settings like Lebanon presents unique methodological and ethical challenges but remains crucial for understanding and improving health outcomes in vulnerable populations. The study underscores the importance of adaptable research designs and ethical diligence in crisis research, highlighting the need for interventions tailored to these contexts. Establishing a mother and child cohort in Lebanon's crisis-ridden setting is faced with many challenges but is essential for guiding future interventions. Research in such contexts is needed to address health disparities and supporting vulnerable populations, emphasizing the need for dedicated funding and innovative research approaches in times of crisis.
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Affiliation(s)
- Rima Kaddoura
- American University of Beirut (AUB), Beirut, Lebanon
| | | | - Hani Tamim
- American University of Beirut (AUB), Beirut, Lebanon
- Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus
| | - Fadi Mirza
- Latifa Hospital & Private Practice, Dubai, United Arab Emirates
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Rice RC, Gil DV, Baratta AM, Frawley RR, Hill SY, Farris SP, Homanics GE. Inter- and transgenerational heritability of preconception chronic stress or alcohol exposure: Translational outcomes in brain and behavior. Neurobiol Stress 2024; 29:100603. [PMID: 38234394 PMCID: PMC10792982 DOI: 10.1016/j.ynstr.2023.100603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024] Open
Abstract
Chronic stress and alcohol (ethanol) use are highly interrelated and can change an individual's behavior through molecular adaptations that do not change the DNA sequence, but instead change gene expression. A recent wealth of research has found that these nongenomic changes can be transmitted across generations, which could partially account for the "missing heritability" observed in genome-wide association studies of alcohol use disorder and other stress-related neuropsychiatric disorders. In this review, we summarize the molecular and behavioral outcomes of nongenomic inheritance of chronic stress and ethanol exposure and the germline mechanisms that could give rise to this heritability. In doing so, we outline the need for further research to: (1) Investigate individual germline mechanisms of paternal, maternal, and biparental nongenomic chronic stress- and ethanol-related inheritance; (2) Synthesize and dissect cross-generational chronic stress and ethanol exposure; (3) Determine cross-generational molecular outcomes of preconception ethanol exposure that contribute to alcohol-related disease risk, using cancer as an example. A detailed understanding of the cross-generational nongenomic effects of stress and/or ethanol will yield novel insight into the impact of ancestral perturbations on disease risk across generations and uncover actionable targets to improve human health.
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Affiliation(s)
- Rachel C. Rice
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniela V. Gil
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Annalisa M. Baratta
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Remy R. Frawley
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shirley Y. Hill
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sean P. Farris
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gregg E. Homanics
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
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Vostanis P, Hassan S, Fatima SZ, O’Reilly M. Youth-led co-production of mental health promotion in Pakistan: intergenerational influences. Health Promot Int 2024; 39:daae010. [PMID: 38381915 PMCID: PMC10880878 DOI: 10.1093/heapro/daae010] [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] [Indexed: 02/23/2024] Open
Abstract
Youth with mental health needs face barriers in seeking and accessing help, especially in resource-constrained settings in Majority World Countries. Community engagement is thus important for mental health promotion, particularly in addressing stigma. Engagement can be enhanced by involving peer educators and by relating to intergenerational experiences in the sociocultural context of the community. The aim of this study was to explore how intergenerational experiences and perspectives can inform the co-production of youth-led mental health promotion in a Majority World Country, Pakistan. We recruited 11 families (one grandmother, mother and granddaughter in each family) as advisers from two disadvantaged areas of Karachi, and 14 peer educators. Training for peer educators included seminars, experiential activities, three participatory workshops with family advisers and supervision. A sub-sample of family advisers and peer educators attended four focus groups, and peer educators completed reflective diaries following each activity. Data were integrated and subjected to thematic codebook analysis. The three themes related to enabling and hindering factors towards co-production of mental health promotion, incorporation of intergenerational resilience and cascading knowledge to communities. The findings highlighted potential benefits of youth-led mental health promotion that contextualizes intergenerational experiences for those communities. Peer educator roles should be supported by training, and mental health promotion should be integrated within local service systems.
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Affiliation(s)
- Panos Vostanis
- Department of School of Media, Communication and Sociology, University of Leicester, University Road, Leicester LE1 7RH, UK
| | - Sajida Hassan
- Icon for Child and Adult Nurturing (ICAN), Empire Square 501, Sharfabad, Karachi 75400, Pakistan
| | - Syeda Zeenat Fatima
- Icon for Child and Adult Nurturing (ICAN), Empire Square 501, Sharfabad, Karachi 75400, Pakistan
| | - Michelle O’Reilly
- Department of School of Media, Communication and Sociology, University of Leicester, University Road, Leicester LE1 7RH, UK
- Leicestershire Partnership NHS Trust, Groby Road, Leicester LE3 9PQ, UK
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Byansi W, Galvin M, Chiwaye L, Luvuno Z, Kim AW, Sundararajan R, Tsai AC, Moolla A. Adverse childhood experiences, traumatic events, and mental health among adults at two outpatient psychiatric facilities in Johannesburg, South Africa: a cross-sectional analysis. BMC Psychiatry 2023; 23:581. [PMID: 37563695 PMCID: PMC10413614 DOI: 10.1186/s12888-023-05085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Adverse childhood experiences and adult trauma, including sexual abuse, physical abuse, neglect, and interpersonal violence, are highly prevalent in low-resource settings and associated with adverse psychological outcomes. However, there is limited focus on the impact of ACEs and trauma on mental health in sub-Saharan Africa. Therefore, this study examines the impact of traumatic events and ACEs on depression, anxiety, and stress scores among outpatients receiving psychiatric care at two public mental health treatment facilities in Johannesburg, South Africa. METHODS A sample of 309 participants were recruited between January and June 2022 at Helen Joseph Hospital and Alexandra 18th Avenue Clinic. Participants completed screening measures for mental health outcomes, including the 9-item Patient Health Questionnaire (PHQ-9), the 7-item General Anxiety Disorder scale (GAD-7) and the 10-item Perceived Stress Scale. We fitted modified Poisson and linear regression models to estimate the impact of ACEs and adult experiences of trauma on depression, anxiety, and stress scale scores. RESULTS 47.57% (n = 147) of participants screened positive for anxiety, 44.66% (n = 138) for depression, and 17% (n = 54) for severe stress. More females screened positive for anxiety (65.31%), depression (65.94%), and stress (77.78%). Each ACE was associated with a 12% increased risk of depression, a 10% increased risk of anxiety, and a 17% increased risk of stress. In separately estimated models, each additional traumatic event during adulthood was associated with a 16% increased risk for depression, an 8% increased risk of anxiety, and a 26% increased risk of stress. Across all models, being male and self-reported physical health were consistently associated with a reduced risk for depression, anxiety, and stress. CONCLUSIONS ACEs and experiences of traumatic events as adults were associated with significantly increased risks of anxiety, depression, and severe stress. Given high exposure to ACEs and trauma and the associated impact on the mental health of individuals, families, and communities, there is a need to strengthen and scale innovative combination interventions that address multiple stressors impacting people in low-resource settings.
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Affiliation(s)
- William Byansi
- School of Social Work, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
| | - Michael Galvin
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Boston Medical Center, Department of Psychiatry, Boston, MA, USA
- Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
| | - Lesley Chiwaye
- Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
| | - Zoleka Luvuno
- Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
| | - Andrew W Kim
- Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
- Department of Anthropology, University of California, Berkeley, United States
| | - Radhika Sundararajan
- Weill Cornell Center for Global Health, New York City, New York, United States
- Department of Emergency Medicine, Weill Cornell Medicine, New York City, New York, United States
| | - Alexander C Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Aneesa Moolla
- Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
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Haar K, El-Khani A, Lodi R, Molin V, Pelosi A, Yassine A, Campello G, Maalouf W. Assessing the Efficacy of a Brief Universal Family Skills Programme on Violence and Substance-Use Indicators in Youth in Trentino and Parma, Italy: Study Protocol for a Multi-Centre, Non-Blinded, Cluster-Randomised Controlled Trial (cRCT) of Family UNited. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6548. [PMID: 37623134 PMCID: PMC10454720 DOI: 10.3390/ijerph20166548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
Homes in which families are experiencing stressful and challenging circumstances can foster a social space that engenders violent behaviours in parents, inadequate childcare, and the exposure of children to criminal and antisocial behaviours at an early age in addition to many other negative social and health consequences throughout their development. Family Skills Training offers a combination of parenting knowledge, skill building, competency enhancement, and support to strengthen family protective factors, such as communication, trust, problem-solving skills, and conflict resolution. Through over a decade-long experience piloting evidence-based family skills packages globally, we developed a universal open-source family skills package, "Family UNited" (FU), designed for families with children aged 8 to 15 years living in low- and middle-income countries (LMIC). The current study aims to explore the efficacy, fidelity, and acceptability of FU in Trentino and Parma, Italy. We plan to conduct a multi-site, non-blinded, two-armed, cluster-randomised controlled trial to assess efficacy in 160 families: the intervention group receiving FU and the waitlist/control group only receiving FU after the completion of all data collection points. We will prospectively collect outcome data, assessing changes in parenting skills and family adjustment in caregivers, children's behaviour, resilience capacities, and attitudes towards peer violence. To assess programme delivery, fidelity, feasibility, and acceptability we will include an embedded process evaluation. This study aims to evaluate the improvement in parenting skills, child well-being, and family mental health after participation in FU, compared to no intervention. Even though this trial is to be conducted in a high-income country, such results complement the existing piloting experience in LMIC. with impact-related measures encouraging the adoption of such approaches globally and beyond the EU borders.
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Affiliation(s)
- Karin Haar
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Aala El-Khani
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Riccardo Lodi
- S.O.L.E. Italia, Strada Corte Delle Grazie 21, 43126 Parma, Italy;
| | - Valentina Molin
- Department of Sociology and Social Research, University of Trento, Via Tarter 2 Baselga di Piné, 30122 Trento, Italy;
| | - Annalisa Pelosi
- Neurosciences Unit, Department of Medicine and Surgery, University of Parma, Via Volturno 139, 43125 Parma, Italy;
| | - Ali Yassine
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Giovanna Campello
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
| | - Wadih Maalouf
- Prevention, Treatment and Rehabilitation Section (PTRS), Drugs, Laboratory and Scientific Services Branch (DLSSB), Division for Policy Analysis and Public Affairs (DPA), United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria; (K.H.); (A.E.-K.); (A.Y.); (G.C.)
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Stewart SL, Dimos T, Poss JW. Treatment Seeking Children and Youth who have Experienced Warzone Trauma: Examining the Mental Health Care Planning Needs. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01570-5. [PMID: 37428420 DOI: 10.1007/s10578-023-01570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 07/11/2023]
Abstract
This study compares mental health treatment-seeking children and youth who have experienced warzone-related trauma to other treatment-seeking children and youth to determine similarities and differences and aid in care planning. Data from 53 agencies across Ontario from 2015-2022 were analysed, resulting in a sample of 25,843 individuals, 188 of which met the warzone and immigration criteria. Individuals who experienced warzone-related trauma were less likely to: (a) have a psychiatric diagnosis; (b) speak English, and; (c) have close friends. Collaborative Action Plans (CAPS) related to traumatic life events, parenting, and informal support were triggered at a higher rate for those who experienced warzone-related trauma compared to those who did not. This study highlights areas where children and youth who have experienced warzone-related trauma require improved access to services. Findings also highlight issues related to a needs-based approach to service delivery to facilitate improved outcomes for these vulnerable children and their families.
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Affiliation(s)
- Shannon L Stewart
- Faculty of Education, University of Western Ontario, London, ON, Canada
| | - Tatiana Dimos
- Faculty of Education, University of Western Ontario, London, ON, Canada.
| | - Jeffrey W Poss
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Veronese G, Mahamid F, El-Khoudary B, Bdier D, Ismail A, Diab M. Quality of life is associated with vaccine reluctance via mental health and fear of covid-19: an exploratory investigation on a Palestinian sample. PSYCHOL HEALTH MED 2023; 28:2647-2659. [PMID: 36544425 DOI: 10.1080/13548506.2022.2160872] [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: 09/14/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
Quality of life (QoL) has been studied as an antecedent of good mental health in contexts characterized by extreme poverty and acute conflict. The covid-19 crisis exacerbated the risks of health-related consequences in such contexts. Vaccination campaigns have been started worldwide to contain the virus outbreak with high rates of hesitancy and refusal. Our exploratory study sheds light on the relationship between QoL and vaccine reluctance via mental health and fear of covid-19 in a Palestinian population affected by military occupation or socioeconomic marginalization. Who-QolBref, Fcov-19, and Dass were administered to 1122 Palestinian adults living in the occupied territories and Israel. Structural equation modelling was applied to test the relations between variables. Results showed that fear of COVID-19, stress, anxiety and depression mediated the association between QoL and vaccination reluctance with a good model fit (χ2 (5) = 828.37; p = .001; GFI=.93; AGFI=.94; RMSEA=.046; NFI=.94; CFI=.95). QoL and mental health were negatively associated with stress (βX, Y = - .35; p < .001), depression (βX, Y = -.37; p < .001), and anxiety (βX, Y = -.36; p < .001). QoL and fear of COVID- 19 (βX, Y = -.16; p < .001) were inversely correlated. A positive effects was found between stress (βM, Y = .17; p < .001), anxiety (βM, Y = .18; p < .001), and depression (βM, Y = .17; p < .001), fear of COVID-19 and vaccination reluctance (βX, Y = .23; p < .001). According to our findings, Public health measures to ease the social suffering of people with low QoL due to conflict and social marginality might favour the acceptance of the vaccine.
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Affiliation(s)
- Guido Veronese
- Department of Human Sciences & Education, the University of Milano-Bicocca, Milano, Italy
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Fayez Mahamid
- Department of Psychology, An-Najah National University, Nablus, Palestine
| | | | - Dana Bdier
- Department of Human Sciences & Education, the University of Milano-Bicocca, Milano, Italy
- Department of Psychology, An-Najah National University, Nablus, Palestine
| | - Anas Ismail
- Department of Human Sciences & Education, the University of Milano-Bicocca, Milano, Italy
| | - Marwan Diab
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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Opio A, Olido K, Awachorac J, Oryema C, Onen D. Contextualizing Potential Factors Impacting on Behaviors of Primary School Adolescents in Northern Uganda. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:269-288. [PMID: 36210516 DOI: 10.1111/jora.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Our study contextualized empirical factors influencing adolescent behaviors. An assessment using focus group discussion (FGD) was done with randomly selected adolescents in primary schools in Northern Uganda to explore the influence of child poverty and parenting among other factors on adolescents' behaviors. A semi-structured interview guide and in-depth interviews were also conducted for parents/guardians and teachers, respectively. Adolescents expressed desirable developmental outcomes contrary to teachers' concerns regarding achieving them. Parenting and places of residence had a significant positive impact on adolescent behaviors, with the village residence having a much earlier influence compared to parenting. Our findings revealed a scanty understanding of child poverty, parenting, and adolescent development among parents/guardians. Any action-oriented toward awareness would promote adolescent behavioral development.
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ALEKOZAY M, NIAZI AUR, NAJM AF. Prevalence of emotional and behavioral problems among schoolchildren in Herat – Afghanistan. GLOBAL HEALTH JOURNAL 2023. [DOI: 10.1016/j.glohj.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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War trauma, mental health, aggression, and violent-extremism among former ISIS terrorists. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Mohammed R, Neuner F. Putative juvenile terrorists: the relationship between multiple traumatization, mental health, and expectations for reintegration among Islamic State recruited adolescent and young adult fighters. Confl Health 2022; 16:58. [DOI: 10.1186/s13031-022-00489-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/20/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In several conflicts worldwide children are recruited as fighters in irregular forces. These children need to be reintegrated into the society after the conflict. However, concurrent to various reservations in the communities, the reintegration of former child soldiers is challenged by the fact that many of the affected children were indoctrinated by the armed group and traumatized through war events. Even several years after the defeat of the terrorist organization ISIS in Iraq, systematic efforts towards the reintegration of children who had been recruited by ISIS are notably absent.
Methods
we conducted clinical interviews with a sample of N = 59 adolescents and young adults who were incarcerated for terrorism in the prisons of the Kurdistan Region of Iraq to assess levels and types of trauma exposure, PTSD, depression, readiness to reintegrate and ongoing identification with ISIS.
Results
We found high levels of PTSD and depression that were associated with trauma exposure. The subjective readiness to reintegrate into the communities was associated with trauma exposure and was mediated by depression, even after controlling for the influence of ongoing identification with the armed group.
Conclusion
The study indicates that trauma-related mental ill-health should be considered in efforts to reintegrate young former terrorists.
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Awuah WA, Ng JC, Mehta A, Yarlagadda R, Khor KS, Abdul-Rahman T, Hussain A, Kundu M, Sen M, Hasan MM. Vulnerable in silence: Paediatric health in the Ukrainian crisis. Ann Med Surg (Lond) 2022; 82:104369. [PMID: 36268421 PMCID: PMC9577396 DOI: 10.1016/j.amsu.2022.104369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/11/2022] [Indexed: 11/26/2022] Open
Abstract
The Russian invasion of Ukraine is a humanitarian disaster. It has a wide-ranging impact on the livelihood and the health of those affected by the war. In the midst of constant shelling and casualties, children are more vulnerable to injuries, infections, malnutrition, and trauma, all of which can have serious consequences for their physical and mental health. Children, unlike adults, are simply subjected to the horrors of war with no pre-existing ability to deal with the consequences. We hope to highlight the effects of the current Ukrainian war on the health of the paediatric population, with a particular emphasis on surgical care, cancer care, infectious disease, to name a few. We hope to help contextualize future data and encourage the development of a system to protect and serve the war's most vulnerable population.
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Desrosiers A, Freeman J, Mitra R, Bond L, Santo LD, Farrar J, Borg R, Jambai M, Betancourt TS. Alternative Delivery Platforms for Expanding Evidence-based Mental Health Interventions for Youth in Sierra Leone: A Pilot Study. VULNERABLE CHILDREN AND YOUTH STUDIES 2022; 18:131-142. [PMID: 36684805 PMCID: PMC9857864 DOI: 10.1080/17450128.2022.2094518] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 06/20/2022] [Indexed: 06/01/2023]
Abstract
Given the high rates of mental health problems and poor service access among youth in war-affected countries throughout Sub-Saharan Africa, incorporating evidence-based mental health interventions into alternative delivery platforms could improve service access in these settings. We conducted a randomized controlled pilot study with high-risk Sierra Leonean youth to investigate the feasibility of implementing the Youth Readiness Intervention (YRI), a cognitive behavioral and interpersonal therapy-based group intervention, within an employment promotion program (EPP) and preliminary effects of the YRI on mental health outcomes. Participants were 175 youth (females=62%) ages 18-30 recruited via flyers and radio announcements. Participants were assigned to geographic clusters stratified by gender; clusters were randomized into YRI+EPP (n=58) or EPP-only (n=57). Statistically matched controls were recruited from comparable chiefdoms (n=60). The 12-session YRI was delivered bi-weekly, following EPP completion. Qualitative findings indicated that the YRI was highly feasible and acceptable as integrated into the EPP. Mixed linear effects models showed promising trends. Compared with controls, both YRI+EPP and EPP-only males reported significantly reduced post-traumatic stress symptoms, and YRI+EPP reported marginally significantly reduced emotional regulation difficulties. EPP-only females reported significantly reduced functional impairment compared to controls. Findings suggest that the YRI can be feasibly implemented within an EPP. Integrating the YRI into existing delivery platforms may help increase access to mental health care in Sierra Leone and provide a leverage point for scaling up evidence-based mental health interventions in other low-resource settings globally. [Clinicaltrials.gov; NCT0360361; 5/18/18].
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Affiliation(s)
- Alethea Desrosiers
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Jordan Freeman
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Romita Mitra
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Laura Bond
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Leila Dal Santo
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Jordan Farrar
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Ryan Borg
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
| | - Musu Jambai
- Caritas-Freetown, 19 Savage Street, Freetown, Sierra Leone
| | - Theresa S. Betancourt
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467
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Markosian C, Layne CM, Petrosyan V, Shekherdimian S, Kennedy CA, Khachadourian V. War in the COVID-19 era: Mental health concerns in Armenia and Nagorno-Karabakh. Int J Soc Psychiatry 2022; 68:481-483. [PMID: 33736534 DOI: 10.1177/00207640211003940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Christopher M Layne
- University of California, Los Angeles-Duke University National Center for Child Traumatic Stress, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Varduhi Petrosyan
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, AM
| | - Shant Shekherdimian
- Division of Pediatric Surgery, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Cheryl A Kennedy
- Department of Psychiatry, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Vahe Khachadourian
- Gerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, AM.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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15
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Corbit J, Didkowsky N, Gora V, Reddy H, Muhammad S, Callaghan T. Facilitating the prosocial development of Rohingya refugee children. J Exp Child Psychol 2022; 220:105414. [PMID: 35366609 DOI: 10.1016/j.jecp.2022.105414] [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: 01/17/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022]
Abstract
Prosociality is essential for the success of human societies. Children's prosocial development is found to increase in contexts that foster collaboration or emotion perspective taking and is negatively affected by exposure to extreme psychosocial trauma and adversity. Based on these findings, we assessed the effect of collaboration and emotion perspective taking on three types of prosocial behavior-helping, sharing, and comforting-in Rohingya children living in a refugee settlement in India (N = 122; age range = 4-11 years). Half of the children were born in Myanmar (i.e., experienced forced migration from genocide), and half were born in the refugee settlement after their families left Myanmar. We also included a small sample of Rohingya Canadian children (N = 20; age range = 3-12 years) as a within-culture comparison of overall levels of prosocial responding, which were higher in this group relative to children in a refugee settlement. We assigned children in the refugee settlement to one of three conditions-Collaboration, Emotion Perspective Taking (intervention conditions), or Drawing (control condition)-and assessed the three types of prosocial responding following the intervention. Prosocial responding was highest after Collaboration for children born in the refugee settlement and was highest after Emotion Perspective Taking for children born in Myanmar. Overall, these findings point to the potential prosocial benefit in refugee contexts for intervention programs that are responsive to children's lived experience.
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Affiliation(s)
- John Corbit
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
| | - Nora Didkowsky
- Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Vikas Gora
- SAVE THE CHILDREN | GM - State Programme Telangana Andhra Pradesh State Programme Office, Secunderabad, Telangana State, India
| | - Harini Reddy
- SAVE THE CHILDREN | GM - State Programme Telangana Andhra Pradesh State Programme Office, Secunderabad, Telangana State, India
| | - Saifullah Muhammad
- Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Tara Callaghan
- Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia B2G 2W5, Canada
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16
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Pandi-Perumal SR, Kumar VM, Pandian NG, de Jong JT, Andiappan S, Corlateanu A, Mahalaksmi AM, Chidambaram SB, Kumar RR, Ramasubramanian C, Sivasubramaniam S, Bjørkum AA, Cutajar J, Berk M, Trakht I, Vrdoljak A, Meira e Cruz M, Eyre HA, Grønli J, Cardinali DP, Maercker A, van de Put WACM, Guzder J, Bjorvatn B, Tol WA, Acuña-Castroviejo D, Meudec M, Morin CM, Partinen M, Barbui C, Jordans MJD, Braakman MH, Knaevelsrud C, Pallesen S, Sijbrandij M, Golombek DA, Espie CA, Cuijpers P, Agudelo HAM, van der Velden K, van der Kolk BA, Hobfoll SE, Devillé WLJM, Gradisar M, Riemann D, Axelsson J, Benítez-King G, Macy RD, Poberezhets V, Hoole SRH, Murthy RS, Hegemann T, Heinz A, Salvage J, McFarlane AC, Keukens R, de Silva H, Oestereich C, Wilhelm J, von Cranach M, Hoffmann K, Klosinski M, Bhugra D, Seeman MV. Scientists Against War: A Plea to World Leaders for Better Governance. SLEEP AND VIGILANCE 2022; 6:1-6. [PMID: 35317215 PMCID: PMC8930284 DOI: 10.1007/s41782-022-00198-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Seithikurippu R. Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada
- grid.412431.10000 0004 0444 045XSaveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Namasivayam Ganesh Pandian
- grid.258799.80000 0004 0372 2033Institute for Integrated Cell-Material Sciences (WPI-iCeMS), A210, Kyoto University Institute for Advanced Study, Yoshida Ushinomiya-cho, Sakyo-ku, Kyoto, 606-8501 Japan
| | - Joop T. de Jong
- grid.509540.d0000 0004 6880 3010Department of Cultural Psychiatry and Global Mental Health, Amsterdam UMC, Amsterdam, The Netherlands
- grid.189504.10000 0004 1936 7558Boston University School of Medicine, Boston, USA
| | - Sudalaikannu Andiappan
- grid.10214.360000 0001 2186 7912Department of Gandhian Studies and Ramalingar Philosophy, School of Religions, Philosophy and Humanist Thought, Madurai Kamaraj University, Madurai, Tamil Nadu India
| | - Alexandru Corlateanu
- grid.28224.3e0000 0004 0401 2738Department of Respiratory Medicine, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Arehally Marappa Mahalaksmi
- grid.411962.90000 0004 1761 157XDepartment of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, 570015 India
| | - Saravana Babu Chidambaram
- grid.411962.90000 0004 1761 157XDepartment of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, 570015 India
| | - Ramasamy Rajesh Kumar
- Global Community Educational Foundation (NGCEF), 7 Peterlee Pl, Hebersham, NSW 2770 Australia
| | | | - Sudhakar Sivasubramaniam
- grid.411780.b0000 0001 0683 3327Department of Biotechnology, Manonmaniam Sundaranar University, Tirunelveli, Tamil Nadu 627012 India
| | - Alvhild Alette Bjørkum
- grid.477239.c0000 0004 1754 9964Department of Safety, Chemistry and Biomedical Laboratory Sciences, Faculty of Engineering and Science, Western Norway University of Applied Sciences, Kronstad, Bergen, Norway
| | - JosAnn Cutajar
- grid.4462.40000 0001 2176 9482Department of Gender and Sexualities, Faculty for Social Wellbeing, University of Malta, Room # 114, Guze Cassar Pullicino Building, Msida, 2080 MSD Malta
| | - Michael Berk
- grid.414257.10000 0004 0540 0062Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Australia
| | - Ilya Trakht
- grid.21729.3f0000000419368729Department of Medicine, Columbia University, New York, NY USA
| | - Anton Vrdoljak
- grid.413034.10000 0001 0741 1142Faculty of Civil Engineering, Architecture and Geodesy, University of Mostar, Kampus Sveučilišta, Maticehrvatskeb. b, 88000 Mostar, Bosnia and Herzegovina
| | - Miguel Meira e Cruz
- grid.9983.b0000 0001 2181 4263Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Av. Prof. Egas Moniz, 1649–028 Lisboa, Portugal
| | - Harris A. Eyre
- grid.414257.10000 0004 0540 0062Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Australia
- grid.266102.10000 0001 2297 6811Global Brain Health Institute at University of California, San Francisco (UCSF), San Francisco, CA USA
- grid.8217.c0000 0004 1936 9705Trinity College Dublin, Dublin, Ireland
- grid.39382.330000 0001 2160 926XDepartment of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- grid.36193.3e0000000121590079Neuroscience-Inspired Policy Initiative, Organisation for Economic Co-operation and Development (OECD) and the PRODEO Institute and Meadows Mental Health Policy Institute, Paris, France
- grid.267308.80000 0000 9206 2401Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX USA
| | - Janne Grønli
- grid.7914.b0000 0004 1936 7443Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Dainiel P. Cardinali
- grid.412525.50000 0001 2097 3932Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Andreas Maercker
- grid.7400.30000 0004 1937 0650Psychopathology and Clinical Intervention, University of Zurich, Binzmuhlestr. 14/17, 8044 Zurich, Switzerland
| | - Willem A. C. M. van de Put
- grid.11505.300000 0001 2153 5088Section of International Health Policy, Institute for Tropical Medicine Antwerp, Antwerp, Belgium
- grid.256023.0000000008755302XInstitute of International Humanitarian Affairs (IIHA), Fordham University, Bronx, NY USA
| | - Jaswant Guzder
- Division of Social and Transcultural Psychiatry, 1033 Pine Ave, Montreal, Canada
- grid.414980.00000 0000 9401 2774Trauma and Global Health Program, Institute of Community and Family Psychiatry, Sir Mortimer B. Davis, Jewish General Hospital, Montreal, QC Canada
| | - Bjørn Bjorvatn
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- grid.412008.f0000 0000 9753 1393Norway and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Wietse A. Tol
- grid.5254.60000 0001 0674 042XSection of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- grid.12380.380000 0004 1754 9227Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- AArq International, Amsterdam, The Netherlands
| | - Darío Acuña-Castroviejo
- grid.4489.10000000121678994Centro de Investigación Biomédica, Departamento de Fisiología, Facultad de Medicina, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain
| | - Marie Meudec
- grid.11505.300000 0001 2153 5088Outbreak Research Team and Department of Public Health, Institute of Tropical Medicine (ITM), Antwerpen, Belgium
| | - Charles M. Morin
- grid.23856.3a0000 0004 1936 8390École de Psychologie, Centre d’étude des troubles du sommeil, Centrede recherche CERVO/Brain Research Center, Université Laval, Québec, Canada
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, Valimotie 21, 00380 Helsinki, Finland
- grid.7737.40000 0004 0410 2071Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Corrado Barbui
- grid.5611.30000 0004 1763 1124WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- grid.5611.30000 0004 1763 1124Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mark J. D. Jordans
- grid.487424.90000 0004 0414 0756Research and Development Department, War Child Holland, Amsterdam, The Netherlands
- grid.7177.60000000084992262Amsterdam Institute of Social Science Research, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Mario H. Braakman
- grid.12295.3d0000 0001 0943 3265Department of Transcultural Forensic Psychiatry, Tilburg University, Tilburg, The Netherlands
| | - Christine Knaevelsrud
- grid.14095.390000 0000 9116 4836Psychologische Psychotherapeutin, Klinisch-Psychologische Intervention, Freie Universität Berlin, Fachbereich Erziehungswissenschaftund Psychologie, Habelschwerdter Allee 45, 14195 Berlin, Germany
| | - Ståle Pallesen
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, University of Bergen, Christiesgt.12, 5015 Bergen, Norway
| | - Marit Sijbrandij
- Faculty of Behavioural and Movement Sciences, Clinical Psychology, World Health Organization (WHO) Collaborating Center, Van der Boechorststraat 7, 1081BT Amsterdam, Netherlands
| | - Diego Andrés Golombek
- grid.11560.330000 0001 1087 5626Universidad Nacional de Quilmes/CONICET, R.S. Peña 352, 1876 Bernal, Buenos Aires, Argentina
| | - Colin A. Espie
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
- grid.4991.50000 0004 1936 8948Sir Jules Thorn Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, Oxford, OX1 3QU UK
| | - Pim Cuijpers
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- grid.12380.380000 0004 1754 9227WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- grid.1374.10000 0001 2097 1371Faculty of Medicine, University of Turku, Turku, Finland
| | | | - Koos van der Velden
- grid.10417.330000 0004 0444 9382Department of Public Health, Radboudumc, Nijmegen, The Netherlands
| | - Bessel A. van der Kolk
- grid.189504.10000 0004 1936 7558Department of Psychiatry, Boston University School of Medicine, Boston, USA
| | | | - Walter L. J. M. Devillé
- National Knowledge and Advisory Center on Migrants, Refugees and Health (Pharos), Utrecht, The Netherlands
- grid.7177.60000000084992262Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Dieter Riemann
- grid.7708.80000 0000 9428 7911Leiter der Abteilung für Klinische Psychologie and Psychophysiologie, Zentrum für Psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - John Axelsson
- grid.10548.380000 0004 1936 9377Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden
- grid.4714.60000 0004 1937 0626Department Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Gloria Benítez-King
- grid.419154.c0000 0004 1776 9908Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Calzada México-Xochimilco No 101, Colonia San Lorenzo, Huipulco, 14370 Mexico City, CDMX México
| | - Robert D. Macy
- International Trauma Center, Beverly Farms, Beverly, MA 01915 USA
- grid.38142.3c000000041936754XHarvard Medical School-McLean Hospital Developmental Trauma, Boston, MA USA
- Boston Children’s Foundation, 850 Summer St, South Boston, MA 02127 USA
| | - Vitalii Poberezhets
- grid.446037.2Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | | | - Rangaswamy Srinivasa Murthy
- grid.416861.c0000 0001 1516 2246Formally of Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka India
| | - Thomas Hegemann
- Bayerisches Zentrumfür Transkulturelle Medizin, Landshuter Allee 21, 80637 München, Germany
| | - Andreas Heinz
- grid.6363.00000 0001 2218 4662Department Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jane Salvage
- grid.3575.40000000121633745Midwifery Leadership Consultant, World Health Organization, Geneva, Switzerland
- grid.15538.3a0000 0001 0536 3773Kingston University, London, UK
| | - Alexander C. McFarlane
- grid.1010.00000 0004 1936 7304Department of Psychiatry, The University of Adelaide, Adelaide, 5000 Australia
| | - Rob Keukens
- GGZ Ecademy Coöperatie UA, Keltenstraat 14, 5037 KD, Tilburg, The Netherlands
- Federation Global Initiative on Psychiatry (FGIP), P.O. Box 1956, 1200 BZ Hilversum, The Netherlands
- grid.3575.40000000121633745Supervisor Capacity Building Community Mental Health Ukraine World Health Organization, Geneva, Switzerland
| | - Harendra de Silva
- grid.8065.b0000000121828067Formally of Department of Paediatrics, University of Colombo, Colombo, Sri Lanka
| | - Cornelia Oestereich
- Institut für systemische Therapie und Beratung, Leisewitzstraße 26, 30175 Hannover, Germany
| | - Jochen Wilhelm
- grid.8664.c0000 0001 2165 8627DeutschesZentrum für Lungenforschung (DZL), Justus-Liebig-Universität Gießen (JLU), Gießen, Germany
| | - Michael von Cranach
- grid.434949.70000 0001 1408 3925Hochschule München, Eggenthal, Grub 4, 87653 München, Germany
| | - Klaus Hoffmann
- Forensic Psychiatry and Psychotherapy, Feursteinstr. 55, 78479 Reichenau, Germany
- grid.9811.10000 0001 0658 7699Zentrum für Psychiatrie Reichenau, Akademisches Lehrkrankenhaus der Universität Konstanz, Rechtsfähige Anstalt des öffentlichen Rechts, Reichenau, Germany
| | - Matthias Klosinski
- grid.6936.a0000000123222966Facharzt für Kinder- und Jugendpsychiatrie und -psychotherapie Systemischer Berater (SG), Systemischer Therapeut (SG), TU München, Klinikum rechts der Isar, München, Germany
| | - Dinesh Bhugra
- grid.13097.3c0000 0001 2322 6764Professor Emeritus, Mental Health and Cultural Diversity, Institute of Psychiatry, Psychology and Neuroscience, Kings College, London, SE5 8AF UK
| | - Mary V. Seeman
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada
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17
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Peltzer K, Pengpid S. Suicidal ideation, plans, and attempts: Prevalence and associated factors in school-going adolescents in Sierra Leone in 2017. JOURNAL OF PSYCHOLOGY IN AFRICA 2021. [DOI: 10.1080/14330237.2021.2001993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
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18
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Oppong Asante K, Quarshie ENB, Onyeaka HK. Epidemiology of suicidal behaviours amongst school-going adolescents in post-conflict Sierra Leone. J Affect Disord 2021; 295:989-996. [PMID: 34706473 DOI: 10.1016/j.jad.2021.08.147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/17/2021] [Accepted: 08/27/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Children and young people living in post-conflict contexts are at an increased risk of suicidal behaviours (ideations and attempts). Not much is known about the extent of suicidal behaviours amongst adolescents in most notable post-conflict countries in sub-Saharan Africa, including Sierra Leone. METHODS We performed a secondary analysis of data from the 2017 Sierra Leone World Health Organisation Global School-based Student Health Survey conducted amongst students in secondary schools nationwide. We estimated the 12-month prevalence and performed bivariable and multivariable analyses to assess the correlates of suicidal behaviours. RESULTS Of the 2,798 analytic sample, 14.6% (males = 15.1%, females = 14.0%) reported suicidal ideation, and the 12-month prevalence estimate of suicide attempt was 19.6% (male = 20.9%, females =17.8%). The factors associated with suicidal behaviours were multi-layered. While no statistically significant gender association with suicide ideation or attempt was observed at the personal level, being aged 18 or older, loneliness, and health risk behaviours (cannabis use, and leisure time sedentary behaviour) were associated with increased odds of suicidal behaviours. Within the family context, parental monitoring was associated with increased odds of suicidal ideation, but parental supervision was associated with reduced odds of suicide ideation. LIMITATIONS The cross-sectional nature of the data did not support causal inferences. CONCLUSIONS Taken together, professional mental healthcare would be helpful in treating adolescent emotional problems (e.g., depression and loneliness) related to suicidal behaviours; but prevention and intervention programmes targeted at addressing adolescent health risk behaviours, and familial and interpersonal problems may yield more favourable outcomes.
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Affiliation(s)
- Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Legon, Accra, Ghana; Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | - Emmanuel Nii-Boye Quarshie
- School of Psychology, University of Leeds, Lifton Place, Leeds LS2 9JT, UK; Department of Psychology, University of Ghana, Legon, Accra, Ghana.
| | - Henry K Onyeaka
- Department of Psychiatry, Massachusetts General Hospital/Mclean Hospital, Boston, USA; Harvard Medical School, Boston, USA
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19
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Haar K, El-Khani A, Mostashari G, Hafezi M, Malek A, Maalouf W. Impact of a Brief Family Skills Training Programme ("Strong Families") on Parenting Skills, Child Psychosocial Functioning, and Resilience in Iran: A Multisite Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111137. [PMID: 34769656 PMCID: PMC8583328 DOI: 10.3390/ijerph182111137] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022]
Abstract
Caregivers have a key role in protecting children’s wellbeing, and, with appropriate skills, can prevent a multitude of negative social outcomes, particularly in challenged or humanitarian settings. Accordingly, the Strong Families programme was designed as a light touch family skills programme, with a focus of supporting caregiving during stressful situations. To evaluate the short-term impact of the Strong Families programme, we performed a time-convenience, randomized, controlled trial in Iran. A total of 292 families (63% from Iranian decent, 39% from Afghan decent, and 1% other), with children aged eight to twelve years, were recruited through ten centers in Iran and allocated to an intervention (n = 199) or waitlist/control group (n = 93). The two groups did not differ demographically at baseline. We assessed families prospectively, through three scales, PAFAS (parenting and family adjustment scales), SDQ (strengths and difficulties questionnaire), and CYRM-R (child and youth resilience measure). Caregivers in the intervention group improved (highly) statistically significantly on all but one PAFAS subscales (parental consistency, coercive parenting, positive encouragement, parental adjustment, family relationships, and parental teamwork), which was not noted in the waitlist group. On the SDQ, there were (highly) significant positive changes in scores in the intervention group on all sub-scales and the “total difficulty scale“, whereas the waitlist/control group also improved on three (prosocial, conduct problems, and hyperactivity) of the five SDQ subscales. Children originating from Afghanistan improved significantly on the overall resilience scale of the CYRM-R in the intervention group, but not in the waitlist/control group. Overall, all our stratified results of the different scales reflect an accentuated improvement in families with higher levels of problems at baseline. Our comparative results indicated a strong alignment of the strong families programme with its intended short-term impact, per its logical frame on parenting practices and family management skills, children behaviour, caregivers and children mental health, and capacity to cope with stress. We postulate that the potential nudging or diffusion of knowledge (cross-contamination between intervention and waitlist/control group) at the community level could explain improvements in the waitlist/control group on some indicators, however, further research on this is recommend.
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Affiliation(s)
- Karin Haar
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, Division of Operations, United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria;
- Correspondence: (K.H.); (W.M.); Tel.: +43-1-26060-83126 (K.H.); +43-1-26060-5182 (W.M.)
| | - Aala El-Khani
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, Division of Operations, United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria;
| | - Gelareh Mostashari
- United Nations Office on Drugs and Crime, Field Office I.R. of Iran, P.O. Box 15875-4557, Tehran 1994715311, Iran; (G.M.); (M.H.); (A.M.)
| | - Mahdokht Hafezi
- United Nations Office on Drugs and Crime, Field Office I.R. of Iran, P.O. Box 15875-4557, Tehran 1994715311, Iran; (G.M.); (M.H.); (A.M.)
| | - Atoosa Malek
- United Nations Office on Drugs and Crime, Field Office I.R. of Iran, P.O. Box 15875-4557, Tehran 1994715311, Iran; (G.M.); (M.H.); (A.M.)
| | - Wadih Maalouf
- Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, Division of Operations, United Nations Office on Drugs and Crime (UNODC), Wagramer Strasse 5, A-1400 Vienna, Austria;
- Correspondence: (K.H.); (W.M.); Tel.: +43-1-26060-83126 (K.H.); +43-1-26060-5182 (W.M.)
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20
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Parker M, Fergus CA, Brown C, Atim D, Ocitti J, Atingo J, Allen T. Legacies of humanitarian neglect: long term experiences of children who returned from the Lord's Resistance Army in Uganda. Confl Health 2021; 15:43. [PMID: 34051846 PMCID: PMC8164804 DOI: 10.1186/s13031-021-00374-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/27/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Much has been written about the short-term challenges facing children returning 'home' from rebel fighting groups, but little is known about the longer term day to day realities of return. This article presents findings from the first long-term assessment of the social and economic challenges facing an officially registered group of children who passed through an internationally-financed reception centre after a period of time with the Lord's Resistance Army (LRA). METHODS Records from a reception centre were used to trace a random sample of individuals to their current location. Two hundred and thirty in-depth semi-structured interviews were carried out and 40 follow-up interviews between 2013 and 2016. Interviews were informed by long-term ethnographic research in the region. These interviews were subsequently coded and analysed to describe the long-term day to day realities of return. RESULTS At the time of interview, 90% of formerly abducted people returned 'home' six or more years ago, and 75% returned nine or more years ago. The majority have managed to access family land for farming, but concerns about what they may have done to survive whilst living with the LRA adversely affects their day-to-day lives. However, some important differences were noted: those men and women who spent less time with the LRA are more likely to live on ancestral land with close relatives; and they are more likely to report experiencing stigma and a spiritual affliction called 'cen'. In contrast, those who spent the longest time with the LRA are less likely to report these problems, they are mainly living in urban locations and tend to manage slightly better. Children born of war are vulnerable to abuse, irrespective of current residence. CONCLUSIONS Research findings question the merits of post-conflict reintegration programmes emphasising immediate family reunifications, without follow-up monitoring, social protection, education and skills training. By overlooking the diverse experiences of those who lived and fought with the LRA, and failing to anticipate or respond to the long term socio-political and economic challenges facing children on their return, reception centre processes not only failed to foster social reintegration, but they also inadvertently exacerbated the vulnerability of returning children.
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Affiliation(s)
- Melissa Parker
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.
| | - Cristin A Fergus
- Firoz Lalji Centre for Africa, London School of Economics and Political Science, London, UK
| | - Charlotte Brown
- Firoz Lalji Centre for Africa, London School of Economics and Political Science, London, UK
| | | | | | | | - Tim Allen
- Firoz Lalji Centre for Africa, London School of Economics and Political Science, London, UK
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Sharpe D, Rajabi M, Chileshe C, Joseph SM, Sesay I, Williams J, Sait S. Mental health and wellbeing implications of the COVID-19 quarantine for disabled and disadvantaged children and young people: evidence from a cross-cultural study in Zambia and Sierra Leone. BMC Psychol 2021; 9:79. [PMID: 33992113 PMCID: PMC8123096 DOI: 10.1186/s40359-021-00583-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/29/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone. METHOD A total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool. RESULTS The data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12-14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating. CONCLUSION The study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.
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Affiliation(s)
- Darren Sharpe
- Institute for Connected Communities (ICC), University of East London, Stratford Campus, Water Lane, London, E15 4LZ UK
| | - Mohsen Rajabi
- Institute for Connected Communities (ICC), University of East London, Stratford Campus, Water Lane, London, E15 4LZ UK
- Department of Psychology, University of Tehran, Tehran, Iran
| | | | - Sitali Mayamba Joseph
- Department of Clinical Psychology, Kwame Nkrumah University, Kabwe, Zambia
- Philosophy in Physical Education and Sport, University of Zambia, Lusaka, Zambia
| | | | | | - Siraj Sait
- School of Business and Law, University of East London, London, UK
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