Promoting Mental Health and Psychosocial Well-Being in Children Affected by Political Violence: Part I–Current Evidence for an Ecological Resilience Approach
01 Jan 2013-pp 11-27
TL;DR: The authors reviewed findings on resilience in children affected by political violence from a socio-ecological perspective and recommended that practitioners interested in building on resilience processes start program development with context-sensitive participative assessments and commit to closely monitoring preventive interventions.
Abstract: Research on the mental health and psychosocial well-being of children in areas of political violence has largely focused on investigating the relation between exposure to armed conflict events and posttraumatic stress symptomatology. Comparatively little knowledge is available on protective processes in this population, which may be highly informative in the development of preventive interventions. This chapter reviews findings on resilience in children affected by political violence from a socio-ecological perspective. Despite limitations of current knowledge, the available evidence suggests that strengthening protective processes at the family level may be a fruitful preventive strategy. Furthermore, current knowledge highlights the complexity of sociocultural processes. For example, ideological commitment and religious beliefs may promote mental health but at a larger societal cost, and the promotion of traditional practices may inadvertently be associated with reinforcing stigma or marginalization. We recommend that practitioners interested in building on resilience processes start program development with context-sensitive participative assessments and commit to closely monitoring preventive interventions.
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01 Dec 2013
TL;DR: The present article aims at presenting a review of research findings and discussing them in order to promote a reflection on the characteristics of Down syndrome and its impact on child development and family, focusing on the risk and protection factors that affect this population with disabilities' health.
Abstract: The birth of a child requires a rearrangement of roles in the family. However, if this birth is marked by the arrival of a child with a disability, it may cause instability in the family, due to the break of parental expectations about an ideal baby. The present article aims at presenting a review of research findings and discussing them in order to promote a reflection on the characteristics of Down syndrome (DS) and its impact on child development and family, focusing on the risk and protection factors that affect this population ́s health. The Bioecological theory of Human Development, which establishes inter relationship of individual and environmental factors, has been used as theoretical framework for the discussions of the results.From this theory, the Birth of a child with Down syndrome requires an adaptation of the family context, since children with DS are exposed to environmental factors that may influence their development. Nevertheless, scientific literature points out to the advances of knowledge in the area, and it identifies risk and protective factors that can work for the development of children with DS. In conclusion, the risk and protection factors potentially of children with DS are very similar to the children without disabilities. An important emphasis should be placed on factors of the macrosystem for the population with disabilities, more specifically for people with DS, as the advancement of knowledge about this syndrome and the development of specific public policies can increase life quality and
299 citations
TL;DR: Postconflict development agendas must be retooled to target the vulnerabilities characterizing conflict-affected youth, and these approaches must be collaborative across bodies responsible for the care of youth and families.
Abstract: BACKGROUND: Children and adolescents exposed to armed conflict are at high risk of developing mental health problems. To date, a range of psychosocial approaches and clinical/psychiatric interventions has been used to address mental health needs in these groups. AIMS: To provide an overview of peer-reviewed psychosocial and mental health interventions designed to address mental health needs of conflict-affected children, and to highlight areas in which policy and research need strengthening. METHODS: We used standard review methodology to identify interventions aimed at improving or treating mental health problems in conflict-affected youth. An ecological lens was used to organize studies according to the individual, family, peer/school, and community factors targeted by each intervention. Interventions were also evaluated for their orientation toward prevention, treatment, or maintenance, and for the strength of the scientific evidence of reported effects. RESULTS: Of 2305 studies returned from online searches of the literature and 21 sources identified through bibliography mining, 58 qualified for full review, with 40 peer-reviewed studies included in the final narrative synthesis. Overall, the peer-reviewed literature focused largely on school-based interventions. Very few family and community-based interventions have been empirically evaluated. Only two studies assessed multilevel or stepped-care packages. CONCLUSIONS: The evidence base on effective and efficacious interventions for conflict-affected youth requires strengthening. Postconflict development agendas must be retooled to target the vulnerabilities characterizing conflict-affected youth, and these approaches must be collaborative across bodies responsible for the care of youth and families. Language: en
213 citations
Cites background from "Promoting Mental Health and Psychos..."
...Current applications of this theoretical framework with children in adversity have focused on transactions taking place between risk and protective factors at different socio-ecological levels—that is, the family, peer, school, and wider-community levels.(10,11) When resources at any level are compromised, the risk of poor developmental outcomes and poor mental health adjustment increases; for example, among children and youth exposed to conflict, adverse mental health outcomes triggered by exposure to horrific events are compounded by war-related damage to the extended support systems (family, social, economic, political) that usually foster healthy child development....
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TL;DR: The Adaptation and Development after Persecution and Trauma (ADAPT) model as mentioned in this paper offers a unifying, conceptual framework to underpin policy, and there is a growing consensus concerning the scope and components of mental health and psychosocial interventions.
Abstract: There is a growing consensus concerning the scope and components of mental health and psychosocial interventions needed to assist populations exposed to mass conflict. The Adaptation and Development after Persecution and Trauma (ADAPT) model offers a unifying, conceptual framework to underpin policy
195 citations
01 Jan 2012
TL;DR: The authors argue that cultural values are the "bedrock" of resilience: they underpin the meaning attributed to great suffering, hope for the future, and a sense of emotional, social, and moral order to ordinary and extraordinary aspects of life.
Abstract: The authors report on their multidisciplinary and longitudinal studies of Afghan families that included paired interviews with adolescents and adult caregivers. The authors argue that cultural values are the “bedrock” of resilience: they underpin the meaning attributed to great suffering, hope for the future, and a sense of emotional, social, and moral order to ordinary and extraordinary aspects of life. Remarkably, they show that war-related trauma is not the principal driver of poor mental health: traumatic experiences are linked to fractured family relationships and a failure to achieve personal, social, and cultural milestones. Resilience, meanwhile, rests upon a demonstration of family unity. In the context of structural disadvantage that includes poverty, crowded living conditions, and exposure to violence, the authors also show that cultural dictates come to entrap Afghans in the pursuit of honor and respectability, a core facet of psychosocial resilience. The chapter highlights linkages between psychosocial and structural resilience, cautioning against a simplistic view of culture as a set of protective resources. The authors discuss the ramifications of social policies that raise not just hope, but undue expectations without sufficient resource provision.
145 citations
TL;DR: The findings highlight an important interplay between caregiver and child mental health within the postconflict setting and the need for psychosocial interventions to extend beyond the individual to account for family dynamics.
Abstract: BACKGROUND: Trauma from witnessing events such as bombings and killings as well as direct victimization or participation in violence has been associated with psychosocial distress and poor mental health among war-exposed children and adolescents. This study examines the relationship between caregiver mental health and child internalizing (anxiety and depression) symptoms over a 4-year period in postconflict Sierra Leone. METHODS: The sample included 118 adolescent Sierra Leonean youth (73% male; mean age = 16.5 years at Time 1) and their caregivers (40% male; mean age = 39.0 at Time 1). To measure depression and anxiety symptoms, the Hopkins Symptom Checklist-25 was used with adults and the Oxford Measure of Psychosocial Adjustment - previously validated for use with children and adolescents in the region - was used to assess youth. A multivariate hierarchical linear model (HLM) for studying change within dyads was implemented to study covariation in internalizing symptoms among caregivers and youth over time; these models also included covariates at the individual, family and community levels. The relationship of caregiver mental health to child's internalizing was tested in a latent variable extension of the HLM. RESULTS: The latent variable extension estimated that a one standard deviation (SD) change in caregiver anxiety/depression was associated with a.43 SD change in youth internalizing (p CONCLUSIONS: The findings highlight an important interplay between caregiver and child mental health within the postconflict setting and the need for psychosocial interventions to extend beyond the individual to account for family dynamics. Language: en
143 citations
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"Promoting Mental Health and Psychos..." refers background in this paper
...Researchers have built on the stress paradigm of Lazarus and Folkman ( 1984 ) in an attempt to explain individual variation in psychological outcomes after exposure to political violence....
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TL;DR: An apparatus for measuring at least two of the following characteristics of a fluid; pH, partial pressure of dissolved gas or gases therein, inorganic ion concentration, hemoglobin, temperature, and the like, the apparatus comprising a vessel having a flow channel for fluid passing therethrough and means for inducing turbulence in the channel at specified locations.
Abstract: An apparatus for measuring at least two of the following characteristics of a fluid; pH, partial pressure of dissolved gas or gases therein, inorganic ion concentration, hemoglobin, temperature, and the like, the apparatus comprising a vessel having a flow channel for fluid passing therethrough and means for inducing turbulence in the channel at specified locations; sensors for the above enumerated fluid characteristics located in the vessel along the channel and within the area of induced turbulent flow; and integral heat-exchanging means e.g., cartridge heaters, within the vessel and external solid state circuitry for maintaining or achieving a preselected temperature in a fluid passing through the vessel and in the sensors. Also disclosed is such an apparatus adapted to the analysis of very small quantities of fluids, e.g., blood, including components for sample storage and transfer, preheating, propulsion and electronic read out and display.
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...Finally, the macrosystem represents consistencies in the form of culture or subculture that permeate the micro-, meso-, and exosystems (Bronfenbrenner, 1979 ) ....
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...Researchers advocating an ecological approach have often referred to the early work of Bronfenbrenner, more speci fi cally his 1979 monograph (Bronfenbrenner, 1979 ) ....
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TL;DR: A critical appraisal of resilience, a construct connoting the maintenance of positive adaptation by individuals despite experiences of significant adversity, concludes that work on resilience possesses substantial potential for augmenting the understanding of processes affecting at-risk individuals.
Abstract: This paper presents a critical appraisal of resilience, a construct connoting the maintenance of positive adaptation by individuals despite experiences of significant adversity. As empirical research on resilience has burgeoned in recent years, criticisms have been levied at work in this area. These critiques have generally focused on ambiguities in definitions and central terminology; heterogeneity in risks experienced and competence achieved by individuals viewed as resilient; instability of the phenomenon of resilience; and concerns regarding the usefulness of resilience as a theoretical construct. We address each identified criticism in turn, proposing solutions for those we view as legitimate and clarifying misunderstandings surrounding those we believe to be less valid. We conclude that work on resilience possesses substantial potential for augmenting the understanding of processes affecting at-risk individuals. Realization of the potential embodied by this construct, however, will remain constrained without continued scientific attention to some of the serious conceptual and methodological pitfalls that have been noted by skeptics and proponents alike.
7,392 citations
TL;DR: An examination of converging findings from variable-focused and person-focused investigations of resilience suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems.
Abstract: The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity. The most surprising conclusion emerging from studies of these children is the ordinariness of resilience. An examination of converging findings from variable-focused and person-focused investigations of these phenomena suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems. The conclusion that resilience is made of ordinary rather than extraordinary processes offers a more positive outlook on human development and adaptation, as well as direction for policy and practice aimed at enhancing the development of children at risk for problems and psychopathology.
5,961 citations
"Promoting Mental Health and Psychos..." refers background in this paper
...…exposure to adversity (e.g., poverty, chronic maltreatment, violence) and (b) positive psychosocial well-being, as illustrated in de fi nitions by Masten ( 2001 ) , “good outcomes in spite of serious threats to adaptation or development,” and Luthar, Cicchetti and Becker ( 2000 ) , “a dynamic…...
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...The resilience literature has often pointed to cognitive capacity as a useful resource in dealing with adversity (Masten, 2001 ) , and studies with violence-exposed populations in high-income countries seem to con fi rm this (Breslau, Lucia, & Alvarado, 2006 ) ....
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...…that resilience concerned a group of “invulnerable” children, but more current fi ndings have shown that resilience may be achieved through relatively ordinary means including intelligence, self-esteem, and the availability of committed caregivers or other attachment fi gures (Masten, 2001 ) ....
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