Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries / Wietse A. TOL in Journal of Child Psychology and Psychiatry, 54-4 (April 2013)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 54-4 (April 2013) . - p.445-460 Titre : Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries Type de document : Texte imprimé et/ou numérique Auteurs : Wietse A. TOL, Auteur ; Suzan SONG, Auteur ; Mark J. D. JORDANS, Auteur Article en page(s) : p.445-460 Mots-clés : Armed conflict  war  resilience  psychological resilience  developing countries Index. décimale : PER Périodiques Résumé : Background Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions. Methods We performed a systematic review of peer-reviewed qualitative and quantitative studies focused on resilience and mental health in children and adolescents affected by armed conflict in low- and middle-income countries. Results Altogether 53 studies were identified: 15 qualitative and mixed methods studies and 38 quantitative, mostly cross-sectional studies focused on school-aged children and adolescents. Qualitative studies identified variation across socio-cultural settings of relevant resilience outcomes, and report contextually unique processes contributing to such outcomes. Quantitative studies focused on promotive and protective factors at different socio-ecological levels (individual, family-, peer-, school-, and community-levels). Generally, promotive and protective factors showed gender-, symptom-, and phase of conflict-specific effects on mental health outcomes. Conclusions Although limited by its predominantly cross-sectional nature and focus on protective outcomes, this body of knowledge supports a perspective of resilience as a complex dynamic process driven by time- and context-dependent variables, rather than the balance between risk- and protective factors with known impacts on mental health. Given the complexity of findings in this population, we conclude that resilience-focused interventions will need to be highly tailored to specific contexts, rather than the application of a universal model that may be expected to have similar effects on mental health across contexts. En ligne : http://dx.doi.org/10.1111/jcpp.12053 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=194 [article] Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries [Texte imprimé et/ou numérique] / Wietse A. TOL, Auteur ; Suzan SONG, Auteur ; Mark J. D. JORDANS, Auteur . - p.445-460. in Journal of Child Psychology and Psychiatry > 54-4 (April 2013) . - p.445-460 Mots-clés : Armed conflict  war  resilience  psychological resilience  developing countries Index. décimale : PER Périodiques Résumé : Background Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions. Methods We performed a systematic review of peer-reviewed qualitative and quantitative studies focused on resilience and mental health in children and adolescents affected by armed conflict in low- and middle-income countries. Results Altogether 53 studies were identified: 15 qualitative and mixed methods studies and 38 quantitative, mostly cross-sectional studies focused on school-aged children and adolescents. Qualitative studies identified variation across socio-cultural settings of relevant resilience outcomes, and report contextually unique processes contributing to such outcomes. Quantitative studies focused on promotive and protective factors at different socio-ecological levels (individual, family-, peer-, school-, and community-levels). Generally, promotive and protective factors showed gender-, symptom-, and phase of conflict-specific effects on mental health outcomes. Conclusions Although limited by its predominantly cross-sectional nature and focus on protective outcomes, this body of knowledge supports a perspective of resilience as a complex dynamic process driven by time- and context-dependent variables, rather than the balance between risk- and protective factors with known impacts on mental health. Given the complexity of findings in this population, we conclude that resilience-focused interventions will need to be highly tailored to specific contexts, rather than the application of a universal model that may be expected to have similar effects on mental health across contexts. En ligne : http://dx.doi.org/10.1111/jcpp.12053 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=194

Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial / Mark J. D. JORDANS in Journal of Child Psychology and Psychiatry, 51-7 (July 2010)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 51-7 (July 2010) . - p.818-826 Titre : Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : Mark J. D. JORDANS, Auteur ; Ivan H. KOMPROE, Auteur ; Wietse A. TOL, Auteur ; Joop T.V.M. DE JONG, Auteur ; Brandon A. KOHRT, Auteur ; Nagendra P. LUITEL, Auteur ; Robert D. MACY, Auteur Année de publication : 2010 Article en page(s) : p.818-826 Langues : Anglais (eng) Mots-clés : Psychosocial war children efficacy Index. décimale : PER Périodiques Résumé : Background: In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal. Methods: A cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children (n = 325) (mean age = 12.7, SD = 1.04, range 11–14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group. Results: Comparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = .41 to .58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, .97 to 4.44), psychological difficulties (−2.19; 95% CI, −3.82 to −.56), and aggression (−4.42; 95% CI, −6.16 to −2.67). An age effect for treatment was found for hope (.90; 95% CI, −1.54 to −.26). Conclusions: A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2010.02209.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=101 [article] Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial [Texte imprimé et/ou numérique] / Mark J. D. JORDANS, Auteur ; Ivan H. KOMPROE, Auteur ; Wietse A. TOL, Auteur ; Joop T.V.M. DE JONG, Auteur ; Brandon A. KOHRT, Auteur ; Nagendra P. LUITEL, Auteur ; Robert D. MACY, Auteur . - 2010 . - p.818-826. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 51-7 (July 2010) . - p.818-826 Mots-clés : Psychosocial war children efficacy Index. décimale : PER Périodiques Résumé : Background: In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal. Methods: A cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children (n = 325) (mean age = 12.7, SD = 1.04, range 11–14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group. Results: Comparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = .41 to .58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, .97 to 4.44), psychological difficulties (−2.19; 95% CI, −3.82 to −.56), and aggression (−4.42; 95% CI, −6.16 to −2.67). An age effect for treatment was found for hope (.90; 95% CI, −1.54 to −.26). Conclusions: A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2010.02209.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=101

Psychosocial interventions for disruptive behaviour problems in children in low- and middle-income countries: a systematic review and meta-analysis / Matthew D. BURKEY in Journal of Child Psychology and Psychiatry, 59-9 (September 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-9 (September 2018) . - p.982-993 Titre : Psychosocial interventions for disruptive behaviour problems in children in low- and middle-income countries: a systematic review and meta-analysis Type de document : Texte imprimé et/ou numérique Auteurs : Matthew D. BURKEY, Auteur ; Megan HOSEIN, Auteur ; Isabella MORTON, Auteur ; Marianna PURGATO, Auteur ; Ahmad ADI, Auteur ; Mark KURZROK, Auteur ; Brandon A. KOHRT, Auteur ; Wietse A. TOL, Auteur Article en page(s) : p.982-993 Langues : Anglais (eng) Mots-clés : Child behaviour  disruptive behaviour disorders  psychosocial interventions  low-income countries  meta-analysis Index. décimale : PER Périodiques Résumé : Background Most of the evidence for psychosocial interventions for disruptive behaviour problems comes from Western, high-income countries. The transferability of this evidence to culturally diverse, low-resource settings with few mental health specialists is unknown. Methods We conducted a systematic review with random-effects meta-analysis of randomized controlled trials examining the effects of psychosocial interventions on reducing behaviour problems among children (under 18) living in low- and middle-income countries (LMIC). Results Twenty-six randomized controlled trials (representing 28 psychosocial interventions), evaluating 4,441 subjects, met selection criteria. Fifteen (54%) prevention interventions targeted general or at-risk populations, whereas 13 (46%) treatment interventions targeted children selected for elevated behaviour problems. Most interventions were delivered in group settings (96%) and half (50%) were administered by non-specialist providers. The overall effect (standardized mean difference, SMD) of prevention studies was ?0.25 (95% confidence interval (CI): ?0.41 to ?0.09; I2: 78%) and of treatment studies was ?0.56 (95% CI: ?0.51 to ?0.24; I2: 74%). Subgroup analyses demonstrated effectiveness for child-focused (SMD: ?0.35; 95% CI: ?0.57 to ?0.14) and behavioural parenting interventions (SMD: ?0.43; 95% CI: ?0.66 to ?0.20), and that interventions were effective across age ranges. Conclusions Our meta-analysis supports the use of psychosocial interventions as a feasible and effective way to reduce disruptive behaviour problems among children in LMIC. Our study provides strong evidence for child-focused and behavioural parenting interventions, interventions across age ranges and interventions delivered in groups. Additional research is needed on training and supervision of non-specialists and on implementation of effective interventions in LMIC settings. En ligne : https://doi.org/10.1111/jcpp.12894 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368 [article] Psychosocial interventions for disruptive behaviour problems in children in low- and middle-income countries: a systematic review and meta-analysis [Texte imprimé et/ou numérique] / Matthew D. BURKEY, Auteur ; Megan HOSEIN, Auteur ; Isabella MORTON, Auteur ; Marianna PURGATO, Auteur ; Ahmad ADI, Auteur ; Mark KURZROK, Auteur ; Brandon A. KOHRT, Auteur ; Wietse A. TOL, Auteur . - p.982-993. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-9 (September 2018) . - p.982-993 Mots-clés : Child behaviour  disruptive behaviour disorders  psychosocial interventions  low-income countries  meta-analysis Index. décimale : PER Périodiques Résumé : Background Most of the evidence for psychosocial interventions for disruptive behaviour problems comes from Western, high-income countries. The transferability of this evidence to culturally diverse, low-resource settings with few mental health specialists is unknown. Methods We conducted a systematic review with random-effects meta-analysis of randomized controlled trials examining the effects of psychosocial interventions on reducing behaviour problems among children (under 18) living in low- and middle-income countries (LMIC). Results Twenty-six randomized controlled trials (representing 28 psychosocial interventions), evaluating 4,441 subjects, met selection criteria. Fifteen (54%) prevention interventions targeted general or at-risk populations, whereas 13 (46%) treatment interventions targeted children selected for elevated behaviour problems. Most interventions were delivered in group settings (96%) and half (50%) were administered by non-specialist providers. The overall effect (standardized mean difference, SMD) of prevention studies was ?0.25 (95% confidence interval (CI): ?0.41 to ?0.09; I2: 78%) and of treatment studies was ?0.56 (95% CI: ?0.51 to ?0.24; I2: 74%). Subgroup analyses demonstrated effectiveness for child-focused (SMD: ?0.35; 95% CI: ?0.57 to ?0.14) and behavioural parenting interventions (SMD: ?0.43; 95% CI: ?0.66 to ?0.20), and that interventions were effective across age ranges. Conclusions Our meta-analysis supports the use of psychosocial interventions as a feasible and effective way to reduce disruptive behaviour problems among children in LMIC. Our study provides strong evidence for child-focused and behavioural parenting interventions, interventions across age ranges and interventions delivered in groups. Additional research is needed on training and supervision of non-specialists and on implementation of effective interventions in LMIC settings. En ligne : https://doi.org/10.1111/jcpp.12894 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368

Screening for psychosocial distress amongst war-affected children: cross-cultural construct validity of the CPDS / Mark J. D. JORDANS in Journal of Child Psychology and Psychiatry, 50-4 (April 2009)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 50-4 (April 2009) . - p.514-523 Titre : Screening for psychosocial distress amongst war-affected children: cross-cultural construct validity of the CPDS Type de document : Texte imprimé et/ou numérique Auteurs : Mark J. D. JORDANS, Auteur ; Ivan H. KOMPROE, Auteur ; Wietse A. TOL, Auteur ; Joop T.V.M. DE JONG, Auteur Année de publication : 2009 Article en page(s) : p.514-523 Langues : Anglais (eng) Mots-clés : Screening psychosocial-distress cross-cultural-validation war children Index. décimale : PER Périodiques Résumé : Background: Large-scale psychosocial interventions in complex emergencies call for a screening procedure to identify individuals at risk. To date there are no screening instruments that are developed within low- and middle-income countries and validated for that purpose. The present study assesses the cross-cultural validity of the brief, multi-informant and multi-indicator Child Psychosocial Distress Screener (CPDS). Methods: The CPDS data of total samples in targeted catchment areas of a psychosocial care program in four conflict-affected countries (Burundi n = 4193; Sri Lanka n = 2573; Indonesia n = 1624; Sudan n = 1629) were studied to examine the cross-cultural construct validity of the CPDS across settings. First, confirmatory factor analyses were done to determine the likelihood of pre-determined theory-based factor structures in each country sample. Second, multi-sample confirmatory factor analyses were done within each country sample to test measurement equivalence of the factor structure as a measure of construct validity. Results: A 3-factor structure reflecting the theoretical premises of the instrument (e.g., child distress, child resilience and contextual factors) was found in the samples from Burundi, Sri Lanka and Indonesia, albeit with context specific deviations. The robustness of the 3-factor structure as an indicator of construct validity was confirmed within these three samples by means of multi-sample confirmatory factor-analyses. A 3-factor structure was not found in the Sudan sample. Conclusions: This study demonstrates the comparability of the assessment by the CPDS of the construct 'non-specific psychosocial distress' across three out of four countries. Robustness of the factor structure of the CPDS within different samples refers to the construct validity of the instrument. However, owing to context-specific deviations of inter-item relationships, the CPDS scores cannot be compared cross-culturally, a finding that confirms the need for attention to contextual factors when screening for non-specific psychosocial distress. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2008.02028.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=724 [article] Screening for psychosocial distress amongst war-affected children: cross-cultural construct validity of the CPDS [Texte imprimé et/ou numérique] / Mark J. D. JORDANS, Auteur ; Ivan H. KOMPROE, Auteur ; Wietse A. TOL, Auteur ; Joop T.V.M. DE JONG, Auteur . - 2009 . - p.514-523. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 50-4 (April 2009) . - p.514-523 Mots-clés : Screening psychosocial-distress cross-cultural-validation war children Index. décimale : PER Périodiques Résumé : Background: Large-scale psychosocial interventions in complex emergencies call for a screening procedure to identify individuals at risk. To date there are no screening instruments that are developed within low- and middle-income countries and validated for that purpose. The present study assesses the cross-cultural validity of the brief, multi-informant and multi-indicator Child Psychosocial Distress Screener (CPDS). Methods: The CPDS data of total samples in targeted catchment areas of a psychosocial care program in four conflict-affected countries (Burundi n = 4193; Sri Lanka n = 2573; Indonesia n = 1624; Sudan n = 1629) were studied to examine the cross-cultural construct validity of the CPDS across settings. First, confirmatory factor analyses were done to determine the likelihood of pre-determined theory-based factor structures in each country sample. Second, multi-sample confirmatory factor analyses were done within each country sample to test measurement equivalence of the factor structure as a measure of construct validity. Results: A 3-factor structure reflecting the theoretical premises of the instrument (e.g., child distress, child resilience and contextual factors) was found in the samples from Burundi, Sri Lanka and Indonesia, albeit with context specific deviations. The robustness of the 3-factor structure as an indicator of construct validity was confirmed within these three samples by means of multi-sample confirmatory factor-analyses. A 3-factor structure was not found in the Sudan sample. Conclusions: This study demonstrates the comparability of the assessment by the CPDS of the construct 'non-specific psychosocial distress' across three out of four countries. Robustness of the factor structure of the CPDS within different samples refers to the construct validity of the instrument. However, owing to context-specific deviations of inter-item relationships, the CPDS scores cannot be compared cross-culturally, a finding that confirms the need for attention to contextual factors when screening for non-specific psychosocial distress. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2008.02028.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=724

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