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Caregiver—child mental health: a prospective study in conflict and refugee settings / Catherine PANTER-BRICK in Journal of Child Psychology and Psychiatry, 55-4 (April 2014)
[article]
Titre : Caregiver—child mental health: a prospective study in conflict and refugee settings Type de document : Texte imprimé et/ou numérique Auteurs : Catherine PANTER-BRICK, Auteur ; Marie-Pascale GRIMON, Auteur ; Mark EGGERMAN, Auteur Article en page(s) : p.313-327 Mots-clés : Violence prosocial behaviour adolescence parenting parent—child relationships Index. décimale : PER Périodiques Résumé : Background In humanitarian settings, family-level drivers of mental health are insufficiently documented; we examined the strength of caregiver—child associations with two-wave, family-level Afghan data. Methods We recruited a gender-balanced sample of 681 caregiver—child dyads (n = 1,362 respondents) using stratified random-sampling in government schools in Kabul (364 dyads) and refugee schools in Peshawar (317 dyads). One year after baseline, we re-interviewed 64% of Kabul and 31% of Peshawar cohorts (n = 331 dyads, 662 respondents), retaining fewer Peshawar families due to refugee repatriation. In multivariable analyses adjusted for baseline, we assessed the extent to which caregiver mental health (Self-Report Questionnaire, SRQ-20) was associated with child symptom scores of post-traumatic stress (Child Revised Impact of Events Scale, CRIES), depression (Depression Self-Rating Scale, DSRS), psychiatric difficulties, impact, and prosocial strength (Strength and Difficulties Questionnaire, SDQ). Results Caregiver mental health was prospectively associated with all eight measures of child mental health at follow-up, adjusted for baseline. For post-traumatic stress, caregiver mental health had a predictive impact comparable to the child experiencing one or two lifetime trauma events. For depression, caregiver mental health approached the predictive impact of female gender. Thus a one SD change in caregiver SRQ-20 was associated with a 1.04 point change on CRIES and a 0.65 point change in DSRS. For multi-informant SDQ data, caregiver—child associations were strongest for caregiver ratings. For child-rated outcomes, associations were moderated by maternal literacy, a marker of family-level dynamics. Both adults and children identified domestic violence and quality of home life as independent risk and protective factors. Conclusions In the context of violence and displacement, efforts to improve child mental health require a thoughtful consideration of the mental health cascade across generations and the cluster of adversities that impact family wellbeing. We identify culturally meaningful leverage points for building family-level resilience, relevant to the prevention and intervention agenda in global mental health. En ligne : http://dx.doi.org/10.1111/jcpp.12167 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=229
in Journal of Child Psychology and Psychiatry > 55-4 (April 2014) . - p.313-327[article] Caregiver—child mental health: a prospective study in conflict and refugee settings [Texte imprimé et/ou numérique] / Catherine PANTER-BRICK, Auteur ; Marie-Pascale GRIMON, Auteur ; Mark EGGERMAN, Auteur . - p.313-327.
in Journal of Child Psychology and Psychiatry > 55-4 (April 2014) . - p.313-327
Mots-clés : Violence prosocial behaviour adolescence parenting parent—child relationships Index. décimale : PER Périodiques Résumé : Background In humanitarian settings, family-level drivers of mental health are insufficiently documented; we examined the strength of caregiver—child associations with two-wave, family-level Afghan data. Methods We recruited a gender-balanced sample of 681 caregiver—child dyads (n = 1,362 respondents) using stratified random-sampling in government schools in Kabul (364 dyads) and refugee schools in Peshawar (317 dyads). One year after baseline, we re-interviewed 64% of Kabul and 31% of Peshawar cohorts (n = 331 dyads, 662 respondents), retaining fewer Peshawar families due to refugee repatriation. In multivariable analyses adjusted for baseline, we assessed the extent to which caregiver mental health (Self-Report Questionnaire, SRQ-20) was associated with child symptom scores of post-traumatic stress (Child Revised Impact of Events Scale, CRIES), depression (Depression Self-Rating Scale, DSRS), psychiatric difficulties, impact, and prosocial strength (Strength and Difficulties Questionnaire, SDQ). Results Caregiver mental health was prospectively associated with all eight measures of child mental health at follow-up, adjusted for baseline. For post-traumatic stress, caregiver mental health had a predictive impact comparable to the child experiencing one or two lifetime trauma events. For depression, caregiver mental health approached the predictive impact of female gender. Thus a one SD change in caregiver SRQ-20 was associated with a 1.04 point change on CRIES and a 0.65 point change in DSRS. For multi-informant SDQ data, caregiver—child associations were strongest for caregiver ratings. For child-rated outcomes, associations were moderated by maternal literacy, a marker of family-level dynamics. Both adults and children identified domestic violence and quality of home life as independent risk and protective factors. Conclusions In the context of violence and displacement, efforts to improve child mental health require a thoughtful consideration of the mental health cascade across generations and the cluster of adversities that impact family wellbeing. We identify culturally meaningful leverage points for building family-level resilience, relevant to the prevention and intervention agenda in global mental health. En ligne : http://dx.doi.org/10.1111/jcpp.12167 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=229