Search

Background: Parenting interventions in humanitarian settings have prioritized the acquisition of parenting knowledge and skills, while overlooking the adverse effects of stress and distress on parenting—a key mediator of refugee children's mental health. We evaluated the effectiveness of the Caregiver Support Intervention (CSI), which emphasizes caregiver wellbeing together with training in positive parenting. Methods: We conducted a two‐arm randomized controlled trial of the CSI with Syrian refugees in Lebanon, with an intent‐to‐treat design, from September 2019–December 2020. A total of 480 caregivers from 240 families were randomized to the CSI or a waitlist control group (1:1). Retention from baseline to endline was 93%. Data on parenting and caregiver psychological wellbeing were collected at baseline, endline, and three‐month follow‐up. Prospective trial registration: ISRCTN22321773. Results: We did not find a significant change on overall parenting skills at endline (primary outcome endpoint) (d =.11, p =.126) or at follow‐up (Cohen's d =.15, p =.054). We did find a significant effect on overall parenting skills among participants receiving the full intervention—the sub‐sample not interrupted by (COVID‐19) (d = 0.25, p <.05). The CSI showed beneficial effects in the full sample at endline and follow‐up on harsh parenting (d = −.17, p <.05; d =.19, p <.05), parenting knowledge (d =.63, p <.001; d =.50, p <.001), and caregiver distress (d = −.33, p <.001; d =.23, p <.01). We found no effects on parental warmth and responsiveness, psychosocial wellbeing, stress, or stress management. Changes in caregiver wellbeing partially mediated the impact of the CSI on harsh parenting, accounting for 37% of the reduction in harsh parenting. Conclusions: The CSI reduced harsh parenting and caregiver distress, and demonstrated the value of addressing caregiver wellbeing as a pathway to strengthening parenting in adversity. These effects were achieved despite a pandemic‐related lockdown that impacted implementation, a severe economic crisis, and widespread social unrest. Replication under less extreme conditions may more accurately demonstrate the intervention's full potential. [ABSTRACT FROM AUTHOR]

Daily stressors may mediate the relation between exposure to disaster-related stressors and psychological and psychosocial distress among youth in disaster-affected countries. A sample of 427 Sri Lankan Sinhalese, Tamil, and Muslim youth (mean age = 14.5) completed a survey with measures of exposure to disaster-related stressors and daily stressors, psychological distress (posttraumatic stress, depression, and anxiety), and psychosocial distress. The results indicated that daily stressors significantly mediated relations between war- and tsunami-related stressors and psychological and psychosocial distress. Some daily stressors not directly related to disaster also predicted functioning. These results point to the need for policies and interventions that focus on reducing proximal daily stressors that are salient to Sri Lankan youth exposed to disasters. [ABSTRACT FROM AUTHOR]

The article focuses on the recommendations to enhance the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings epidemiological assessments. It states that the IASC assessments have limited functions including the narrow focus on post traumatic stress disorder, and failure to distinguish between distress reactions and actual disorder. It mentions that the recommendations would be of great help in assessing mental health.

This article describes a methodology for developing culturally grounded assessment measures in conflict and postconflict situations. A mixed-method design was used in Kabul, Afghanistan, to identify local indicators of distress and develop the 22-item Afghan Symptom Checklist (ASCL). The ASCL contains several indigenous items and items familiar to Western mental health professionals. The ASCL was pilot tested and subsequently administered to 324 adults in 8 districts of Kabul. It demonstrated excellent reliability (alpha=.93) and good construct validity, correlating strongly with a measure of exposure to war-related violence and loss (r=.70). Results of the survey indicate moderate levels of distress among Afghan men and markedly higher levels of distress and impaired functioning among women (and widows in particular). [ABSTRACT FROM AUTHOR]

This study examined the relative contribution of 2 exile-related variables—social isolation and daily activity level—and war experiences of violence and loss, to levels of PTSD and depressive symptomatology in 2 groups of Bosnian refugees, 1 clinical group (N = 59) and the other a nonclinical community (N = 40) group. As hypothesized, exposure to war-related violence was highly predictive of PTSD symptoms in both groups; in addition, social isolation was significantly related to PTSD symptomatology in the community group. In contrast, depressive symptomatology was accounted for primarily by the exile-related stressors. For the clinical group, depressive symptoms were also accounted for by experiences of war-related loss. The implications of these findings for mental health interventions with refugees are considered. [ABSTRACT FROM AUTHOR]

Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. This article reports rates of past trauma and current stressors among Darfur refugees and gauges the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in 2 refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress, and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress ( rs = .19–.31) than were war-related traumatic events ( rs = .09–.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees’ hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events. [ABSTRACT FROM AUTHOR]