Using Mental Health Indicators to Identify Postdisaster Gender-Based Violence among Women Displaced by Hurricane Katrina
Using Mental Health Indicators to Identify Postdisaster Gender-Based Violence among Women Displaced by Hurricane Katrina
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DOI：
10.1089/jwh.2007.0694
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发表时间：
2008-11-01
影响因子：
3.5
通讯作者：
Lawry, Lynn
中科院分区：
文献类型：
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作者：
Anastario, Michael P.;Larrance, Ryan;Lawry, Lynn
目标：评估境内流离失所者中的基于性别的暴力充其量也是困难的。在复杂的人道主义灾难中，GBV调查有时可能是危险的，并可能导致低估真实的流行率。我们开发了一种使用心理健康指标来识别更有可能接触灾后GBV(PDGBV)的女性的方法。方法：我们系统地随机抽样居住在路易斯安那州和密西西比州旅行拖车公园的国内流离失所者，并在2006年4月和5月的8周期间使用卫生需求评估调查访问受访者。对194名女性进行了GBV和抑郁症状筛查。结果：女性年龄18~85岁，平均43.3岁。在用患者健康问卷-9(PHQ-9)评估的9种症状中，有4种与PDGBV有关。在有睡眠失调的女性中，发生PDGBV的几率是没有睡眠失调的女性的2.5倍(95%可信区间1.2-5.1)。食欲失调使患病风险增加3.8倍(95%CI 1.4~10.3)，低自尊增加2.3倍(95%CI 1.2~4.6)，自杀意念增加2.7倍(95%CI 1.1~6.7)。在患有PDGBV的女性中，该症状群的内部一致性信度较高。筛查所有四种症状均为阳性的女性患PDGBV的可能性是后者的2.7倍(95%可信区间为1.03-7.1)。结论：抑郁症的几种症状，但不是所有症状都表明接触了PDGBV。睡眠失调、食欲失调、低自尊和自杀意念应被视为有助于确定女性国内流离失所者中PDGBV暴露流行率的次要指标。在直接提问可能不安全和可靠的情况下，该模型可能有助于识别暴露于PDGBV的女性。
Objective: Assessment of gender-based violence (GBV) among internally displaced persons (IDPs) is at best difficult. In complex humanitarian disasters, GBV inquiry can sometimes be dangerous and may lead to underestimation of the true prevalence. We developed a method of identifying women who have greater odds of having been exposed to postdisaster GBV (PDGBV) using mental health indicators.Methods: We systematically random sampled IDPs living in travel trailer parks in Louisiana and Mississippi and interviewed respondents using a health needs assessment survey during an 8-week period in April and May 2006. Women (n = 194) were screened for GBV and symptoms of depression.Results: Women were on average 43.3 years old (range 18-85). Of the nine symptoms assessed with the Patient Health Questionnaire-9 (PHQ- 9), four were associated with PDGBV. Among women with sleep dysregulation, the odds of PDGBV were 2.5 times higher in comparison with women without sleep dysregulation (95% CI 1.2-5.1). Appetite dysregulation increased the odds by 3.8 (95% CI 1.4-10.3), low self-esteem increased the odds by 2.3 (95% CI 1.2-4.6), and suicidal ideation increased the odds by 2.7 (95% CI 1.1-6.7). The internal consistency reliability of this symptom cluster was higher among women with PDGBV. Women screening positive on all four symptoms were 2.7 times more likely to have experienced PDGBV (95% CI 1.03-7.1).Conclusions: Several but not all symptoms of depression indicated exposure to PDGBV. Sleeping dysregulation, appetite dysregulation, low self-esteem, and suicidal ideation should be considered secondary indicators useful for identifying the prevalence of PDGBV exposure among female IDPs. This model may be useful for identifying women with exposure to PDGBV in settings where direct questioning may not be safe and reliable.