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Theresa S Betancourt - One of the best experts on this subject based on the ideXlab platform.
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classifying childhood War trauma Exposure latent profile analyses of sierra leone s former child soldiers
Journal of Child Psychology and Psychiatry, 2020Co-Authors: Rochelle L Frounfelker, Alethea Desrosiers, Robert T Brennan, Jordan Farrar, Theresa S BetancourtAbstract:Background Former child soldiers are at elevated risk for mental health problems (e.g., traumatic stress, emotion dysregulation, and internalizing and externalizing problems). To examine which groups of former child soldiers are more likely to have difficulties with emotion regulation, interpersonal relationships, and mental health postconflict, we explored patterns of War trauma Exposure and their effects on subsequent mental health problems among former child soldiers in Sierra Leone. Methods Participants were 415 (23.86% female) Sierra Leonean former child soldiers participating in a 15-year, four-wave longitudinal study. At T1 (2002), 282 former child soldiers (aged 10-17) were recruited. T2 (2004) included 186 participants from T1 and an additional cohort of self-reintegrated former child soldiers (NT2 = 132). T3 (2008) and T4 (2016/2017) participants were youth enrolled in previous waves (NT3 = 315; NT4 = 364). Latent profile analysis (LPA) was used to classify participants based on the first-time reports of eight forms of War Exposure (separation and loss of assets, parental loss, loss of loved ones, witnessing violence, victimization, perpetrating violence, noncombat activities, and deprivation). ANOVA examined whether patterns of War Exposure were associated with sociodemographic characteristics and mental health outcomes between T1 and T4. Results LPA identified two profiles: higher Exposure versus lower Exposure, using cumulative scores of eight forms of War-related trauma Exposure. The 'higher War Exposure' group comprised 226 (54.5%) former child soldiers and the 'lower War Exposure' group included 189 (45.5%). Significantly higher levels of violence-related and combat experiences characterized the group exposed to more traumatic events. The 'higher War Exposure' group reported more PTSD symptoms at T2, more hyperarousal symptoms across all waves, and more difficulties in emotion regulation at T4. Conclusions Former child soldiers exposed to higher levels of War-related traumatic events and loss should be prioritized for mental health services immediately postconflict and as they transition into adulthood.
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associations between mental health and ebola related health behaviors a regionally representative cross sectional survey in post conflict sierra leone
PLOS Medicine, 2016Co-Authors: Theresa S Betancourt, Robert T Brennan, Patrick Vinck, Tyler J Vanderweele, Dayo Spencerwalters, Joshua Jeong, Adeyinka M Akinsuluresmith, Phuong PhamAbstract:Background Little attention has been paid to potential relationships between mental health, trauma, and personal Exposures to Ebola virus disease (EVD) and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors. Methods and Findings Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between War Exposures, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, and personal EVD Exposure (e.g., having family members or friends diagnosed with EVD) and EVD-related health behaviors among 1,008 adults (98% response rate) from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January–April 2015). Primary outcomes were EVD risk behaviors (14 items, Cronbach’s α = 0.84) and EVD prevention behaviors (16 items, Cronbach’s α = 0.88). Main predictors comprised War Exposures (8 items, Cronbach’s α = 0.85), anxiety (10 items, Cronbach’s α = 0.93), depression (15 items, Cronbach’s α = 0.91), and PTSD symptoms (16 items, Cronbach’s α = 0.93). Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037), PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008), having a friend diagnosed with EVD (b = −0.04; 95% CI −0.08, −0.00; p = 0.036), and War Exposures (b = −0.09; 95% CI −0.17, −0.02; p = 0.013). EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008), having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011), and higher levels of War Exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003), independent of mental health. PTSD symptoms were associated with lower levels of EVD prevention behavior (b = −0.24; 95% CI −0.43, −0.06; p = 0.009). Conclusions In post-conflict settings, past War trauma and mental health problems are associated with health behaviors related to combatting EVD. The associations between War trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms. Considering the role of mental health in the prevention of disease transmission may help fight continuing and future Ebola outbreaks in post-conflict Sierra Leone. This sample is specific to Freetown and the Western Area and may not be representative of all of Sierra Leone. In addition, our main outcomes as well as personal EVD Exposure, War Exposures, and mental health predictors rely on self-report, and therefore raise the possibility of common methods bias. However, the findings of this study may be relevant for understanding dynamics related to EVD and mental health in other major capital cities in the EVD-affected countries of West Africa.
Phuong Pham - One of the best experts on this subject based on the ideXlab platform.
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associations between mental health and ebola related health behaviors a regionally representative cross sectional survey in post conflict sierra leone
PLOS Medicine, 2016Co-Authors: Theresa S Betancourt, Robert T Brennan, Patrick Vinck, Tyler J Vanderweele, Dayo Spencerwalters, Joshua Jeong, Adeyinka M Akinsuluresmith, Phuong PhamAbstract:Background Little attention has been paid to potential relationships between mental health, trauma, and personal Exposures to Ebola virus disease (EVD) and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors. Methods and Findings Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between War Exposures, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, and personal EVD Exposure (e.g., having family members or friends diagnosed with EVD) and EVD-related health behaviors among 1,008 adults (98% response rate) from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January–April 2015). Primary outcomes were EVD risk behaviors (14 items, Cronbach’s α = 0.84) and EVD prevention behaviors (16 items, Cronbach’s α = 0.88). Main predictors comprised War Exposures (8 items, Cronbach’s α = 0.85), anxiety (10 items, Cronbach’s α = 0.93), depression (15 items, Cronbach’s α = 0.91), and PTSD symptoms (16 items, Cronbach’s α = 0.93). Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037), PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008), having a friend diagnosed with EVD (b = −0.04; 95% CI −0.08, −0.00; p = 0.036), and War Exposures (b = −0.09; 95% CI −0.17, −0.02; p = 0.013). EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008), having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011), and higher levels of War Exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003), independent of mental health. PTSD symptoms were associated with lower levels of EVD prevention behavior (b = −0.24; 95% CI −0.43, −0.06; p = 0.009). Conclusions In post-conflict settings, past War trauma and mental health problems are associated with health behaviors related to combatting EVD. The associations between War trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms. Considering the role of mental health in the prevention of disease transmission may help fight continuing and future Ebola outbreaks in post-conflict Sierra Leone. This sample is specific to Freetown and the Western Area and may not be representative of all of Sierra Leone. In addition, our main outcomes as well as personal EVD Exposure, War Exposures, and mental health predictors rely on self-report, and therefore raise the possibility of common methods bias. However, the findings of this study may be relevant for understanding dynamics related to EVD and mental health in other major capital cities in the EVD-affected countries of West Africa.
Andrew Rasmussen - One of the best experts on this subject based on the ideXlab platform.
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the mental health of civilians displaced by armed conflict an ecological model of refugee distress
Epidemiology and Psychiatric Sciences, 2017Co-Authors: Kenneth E Miller, Andrew RasmussenAbstract:Early research on the mental health of civilians displaced by armed conflict focused primarily on the direct effects of Exposure to War-related violence and loss. Largely overlooked in this War Exposure model were the powerful effects of ongoing stressors related to the experience of displacement itself. An ecological model of refugee distress is proposed, drawing on research demonstrating that mental health among refugees and asylum seekers stems not only from prior War Exposure, but also from a host of ongoing stressors in their social ecology, or displacement-related stressors. Implications of this model for addressing the mental health and psychosocial needs of refugees and other displaced populations are considered.
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War Exposure daily stressors and mental health in conflict and post conflict settings bridging the divide between trauma focused and psychosocial frameworks
Social Science & Medicine, 2010Co-Authors: Kenneth E Miller, Andrew RasmussenAbstract:This paper seeks to bridge the divisive split between advocates of trauma-focused and psychosocial approaches to understanding and addressing mental health needs in conflict and post-conflict settings by emphasizing the role that daily stressors play in mediating direct War Exposure and mental health outcomes. The authors argue that trauma-focused advocates tend to overemphasize the impact of direct War Exposure on mental health, and fail to consider the contribution of stressful social and material conditions (daily stressors). Drawing on the findings of recent studies that have examined the relationship of both War Exposure and daily stressors to mental health status, a model is proposed in which daily stressors partially mediate the relationship of War Exposure to mental health. Based on that model, and on the growing body of research that supports it, an integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology.
Robert T Brennan - One of the best experts on this subject based on the ideXlab platform.
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classifying childhood War trauma Exposure latent profile analyses of sierra leone s former child soldiers
Journal of Child Psychology and Psychiatry, 2020Co-Authors: Rochelle L Frounfelker, Alethea Desrosiers, Robert T Brennan, Jordan Farrar, Theresa S BetancourtAbstract:Background Former child soldiers are at elevated risk for mental health problems (e.g., traumatic stress, emotion dysregulation, and internalizing and externalizing problems). To examine which groups of former child soldiers are more likely to have difficulties with emotion regulation, interpersonal relationships, and mental health postconflict, we explored patterns of War trauma Exposure and their effects on subsequent mental health problems among former child soldiers in Sierra Leone. Methods Participants were 415 (23.86% female) Sierra Leonean former child soldiers participating in a 15-year, four-wave longitudinal study. At T1 (2002), 282 former child soldiers (aged 10-17) were recruited. T2 (2004) included 186 participants from T1 and an additional cohort of self-reintegrated former child soldiers (NT2 = 132). T3 (2008) and T4 (2016/2017) participants were youth enrolled in previous waves (NT3 = 315; NT4 = 364). Latent profile analysis (LPA) was used to classify participants based on the first-time reports of eight forms of War Exposure (separation and loss of assets, parental loss, loss of loved ones, witnessing violence, victimization, perpetrating violence, noncombat activities, and deprivation). ANOVA examined whether patterns of War Exposure were associated with sociodemographic characteristics and mental health outcomes between T1 and T4. Results LPA identified two profiles: higher Exposure versus lower Exposure, using cumulative scores of eight forms of War-related trauma Exposure. The 'higher War Exposure' group comprised 226 (54.5%) former child soldiers and the 'lower War Exposure' group included 189 (45.5%). Significantly higher levels of violence-related and combat experiences characterized the group exposed to more traumatic events. The 'higher War Exposure' group reported more PTSD symptoms at T2, more hyperarousal symptoms across all waves, and more difficulties in emotion regulation at T4. Conclusions Former child soldiers exposed to higher levels of War-related traumatic events and loss should be prioritized for mental health services immediately postconflict and as they transition into adulthood.
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associations between mental health and ebola related health behaviors a regionally representative cross sectional survey in post conflict sierra leone
PLOS Medicine, 2016Co-Authors: Theresa S Betancourt, Robert T Brennan, Patrick Vinck, Tyler J Vanderweele, Dayo Spencerwalters, Joshua Jeong, Adeyinka M Akinsuluresmith, Phuong PhamAbstract:Background Little attention has been paid to potential relationships between mental health, trauma, and personal Exposures to Ebola virus disease (EVD) and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors. Methods and Findings Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between War Exposures, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, and personal EVD Exposure (e.g., having family members or friends diagnosed with EVD) and EVD-related health behaviors among 1,008 adults (98% response rate) from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January–April 2015). Primary outcomes were EVD risk behaviors (14 items, Cronbach’s α = 0.84) and EVD prevention behaviors (16 items, Cronbach’s α = 0.88). Main predictors comprised War Exposures (8 items, Cronbach’s α = 0.85), anxiety (10 items, Cronbach’s α = 0.93), depression (15 items, Cronbach’s α = 0.91), and PTSD symptoms (16 items, Cronbach’s α = 0.93). Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037), PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008), having a friend diagnosed with EVD (b = −0.04; 95% CI −0.08, −0.00; p = 0.036), and War Exposures (b = −0.09; 95% CI −0.17, −0.02; p = 0.013). EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008), having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011), and higher levels of War Exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003), independent of mental health. PTSD symptoms were associated with lower levels of EVD prevention behavior (b = −0.24; 95% CI −0.43, −0.06; p = 0.009). Conclusions In post-conflict settings, past War trauma and mental health problems are associated with health behaviors related to combatting EVD. The associations between War trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms. Considering the role of mental health in the prevention of disease transmission may help fight continuing and future Ebola outbreaks in post-conflict Sierra Leone. This sample is specific to Freetown and the Western Area and may not be representative of all of Sierra Leone. In addition, our main outcomes as well as personal EVD Exposure, War Exposures, and mental health predictors rely on self-report, and therefore raise the possibility of common methods bias. However, the findings of this study may be relevant for understanding dynamics related to EVD and mental health in other major capital cities in the EVD-affected countries of West Africa.
Cvetana Crnobaric - One of the best experts on this subject based on the ideXlab platform.
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torture vs other cruel inhuman and degrading treatment is the distinction real or apparent
Archives of General Psychiatry, 2007Co-Authors: Metin Basoglu, Maria Livanou, Cvetana CrnobaricAbstract:CONTEXT: After the reports of human rights abuses by the US military in Guantanamo Bay, Iraq, and Afghanistan, questions have been raised as to whether certain detention and interrogation procedures amount to torture. OBJECTIVE: To examine the distinction between various forms of ill treatment and torture during captivity in terms of their relative psychological impact. DESIGN AND SETTING: A cross-sectional survey was conducted with a population-based sample of survivors of torture from Sarajevo in Bosnia and Herzegovina, Banja Luka in Republica Srpska, Rijeka in Croatia, and Belgrade in Serbia. PARTICIPANTS: A total of 279 survivors of torture accessed through linkage sampling in the community (Banja Luka, Sarajevo, and Rijeka) and among the members of 2 associations for War veterans and prisoners of War (Belgrade). MAIN OUTCOME MEASURES: Scores on the Semi-structured Interview for Survivors of War, Exposure to Torture Scale, Structured Clinical Interview for DSM-IV, and Clinician-Administered PTSD (posttraumatic stress disorder) Scale for DSM-IV. RESULTS: Psychological manipulations, humiliating treatment, Exposure to aversive environmental conditions, and forced stress positions showed considerable overlap with physical torture stressors in terms of associated distress and uncontrollability. In regression analyses, physical torture did not significantly relate to posttraumatic stress disorder (odds ratio, 1.41, 95% confidence interval, 0.89-2.25) or depression (odds ratio, 1.41, 95% confidence interval, 0.71-2.78). The traumatic stress impact of torture (physical or nonphysical torture and ill treatment) seemed to be determined by perceived uncontrollability and distress associated with the stressors. CONCLUSIONS: Ill treatment during captivity, such as psychological manipulations, humiliating treatment, and forced stress positions, does not seem to be substantially different from physical torture in terms of the severity of mental suffering they cause, the underlying mechanism of traumatic stress, and their long-term psychological outcome. Thus, these procedures do amount to torture, thereby lending support to their prohibition by international law. Language: en
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torture vs other cruel inhuman and degrading treatment commentary is the distinction real or apparent
Archives of General Psychiatry, 2007Co-Authors: Metin Basoglu, Maria Livanou, Cvetana Crnobaric, Steven H MilesAbstract:Context: After the reports of human rights abuses by the US military in Guantanamo Bay, Iraq, and Afghanistan, questions have been raised as to whether certain detention and interrogation procedures amount to torture. Objective: To examine the distinction between various forms of ill treatment and torture during captivity in terms of their relative psychological impact. Design and Setting: A cross-sectional survey was conducted with a population-based sample of survivors of torture from Sarajevo in Bosnia and Herzegovina, Banja Luka in Republica Srpska, Rijeka in Croatia, and Belgrade in Serbia. Participants: A total of 279 survivors of torture accessed through linkage sampling in the community (Banja Luka, Sarajevo, and Rijeka) and among the members of 2 associations for War veterans and prisoners of War (Belgrade). Main Outcome Measures: Scores on the Semi-structured Interview for Survivors of War, Exposure to Torture Scale, Structured Clinical Interview for DSM-IV, and Clinician-Administered PTSD (posttraumatic stress disorder) Scale for DSM-IV. Results: Psychological manipulations, humiliating treatment, Exposure to aversive environmental conditions, and forced stress positions showed considerable overlap with physical torture stressors in terms of associated distress and uncontrollability. In regression analyses, physical torture did not significantly relate to posttraumatic stress disorder (odds ratio, 1.41,95% confidence interval, 0.89-2.25) or depression (odds ratio, 1.41,95% confidence interval, 0.71-2.78). The traumatic stress impact of torture (physical or nonphysical torture and ill treatment) seemed to be determined by perceived uncontrollability and distress associated with the stressors. Conclusions: III treatment during captivity, such as psychological manipulations, humiliating treatment, and forced stress positions, does not seem to be substantially different from physical torture in terms of the severity of mental suffering they cause, the underlying mechanism of traumatic stress, and their long-term psychological outcome. Thus, these procedures do amount to torture, thereby lending support to their prohibition by international law.
