Context matters: community characteristics and mental health among war-affected youth in Sierra Leone
Context matters: community characteristics and mental health among war-affected youth in Sierra Leone
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DOI：
10.1111/jcpp.12131
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发表时间：
2014-03-01
影响因子：
7.6
通讯作者：
Brennan, Robert T.
中科院分区：
文献类型：
--
作者：
Betancourt, Theresa S.;McBain, Ryan;Brennan, Robert T.
背景全球有超过10亿儿童和青少年生活在受战争影响的环境中。目前，只有有限的研究调查了受战争影响的青年中被破坏的社会生态和不良心理健康结果之间的联系。在这项研究中，我们研究了三个社区层面的特征--社区内的社会障碍和集体效能，如照顾者所报告的，以及青年所报告的感知耻辱--与冲突后塞拉利昂男女前儿童兵的外化行为和内化症状有关。（30%女性，基线平均年龄：16.6岁）和他们的主要照顾者参加了2004年和2008年的访谈，作为塞拉利昂受战争影响青年的更大前瞻性队列研究的一部分。两点增长模型进行了估计，以检查社区层面的特征和外部化和内部化的结果之间的关系在整个时间points.ResultsBoth社会障碍的社区内，由照顾者报告，和感知的耻辱，由青年，与青少年的外在化和内在化得分呈正相关，表明基线和随访时每种水平的较高水平与两个时间点的较高水平的心理健康问题相关（p< .05）。集体效能和心理健康结果之间的关系是不显着的（p> .05）。ConclusionsThis study provides a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers.结果表明，社区内的社会混乱和感知到的耻辱都与青少年前战斗人员的外化和内化问题存在重要关系。此外，这些关系在4年的随访期内持续存在。这些结果强调了冲突后社会环境的重要性，以及制定冲突后干预措施的必要性，这些干预措施除了满足家庭和个人的需求外，还应满足社区一级的进程。
BackgroundWorldwide, over one billion children and adolescents live in war‐affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war‐affected youth. In this study, we examine three community‐level characteristics – social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth – in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in postconflict Sierra Leone.MethodsA total of 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war‐affected youth in Sierra Leone. Two‐point growth models were estimated to examine the relationship between community‐level characteristics and externalizing and internalizing outcomes across the time points.ResultsBoth social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively covaried with youths' externalizing and internalizing scores – indicating that higher levels of each at baseline and follow‐up were associated with higher levels of mental health problems at both time points (p< .05). The relationship between collective efficacy and mental health outcomes was nonsignificant (p> .05).ConclusionsThis study offers a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex‐combatants. Moreover, these relationships persisted over a 4‐year period of follow‐up. These results underscore the importance of the postconflict social environment and the need to develop postconflict interventions that address community‐level processes in addition to the needs of families and individuals.