Psychological approaches to the study of armed conflict have focused on analyzing post-traumatic stress outcomes, and on evaluating the intensity of exposure to violent confrontation. Nevertheless, psychometrically valid tools required for measuring these traumatic experiences are scarce To validate the Extreme Experiences scale (EX 2 ) for armed conflict contexts for its use in Colombia, and to provide a framework for validation in conflict contexts around the world This Cross-sectional aims to validate the scale with 187 participants, study of validate with 187 participants, comprising population with high exposure to conflict (former combatants and a set of armed conflict victims) and low conflict-exposed individuals (control group). Structures of two domains and 18 items were confirmed: Direct Extreme Experiences (dEX 2 ) and Indirect Extreme Experiences (iEX 2 ); these dimensions were also validated by expert judgment, producing 14-item version. Good levels of internal consistency were found, with a KR-20 of 0.80 for the 18-item version, and 0.77 for the 14-item. The scale differentiates between population with 'high exposure to conflict' from population with 'low exposure' (d np > 0.5 and area under the ROC >0.90). The scale scores have significant correlation with some mental health constructs. The EX 2 scale has good internal consistency, as well as structural validity with regard to exposed groups. This scale can be potentially validated for its use in countries with armed confrontation history. In future versions, the scale may include additional items in order to improve content validity.
Background Populations exposed to Armed Conflict Experiences (ACE) show different levels of impact in their mental health (i.e. clinical and positive components); however, there is limited evidence related to mental health of general population (civilians not classified as victims) exposed to ACE. Government guided mental health assessments exclude this population. The use of a newly validated Extreme Experiences Scale (EX2) seems appropriate to classify victims, ex-combatants, and civilians for their mental health assessment. Methods Here, we propose a novel approach to identify relationships between individuals classified with different levels of ACE exposure—independent of their legal role in the armed conflict, and mental health outcomes. According to the cut-off points derived from the scores of EX2, we classified the sample in low and high exposure to ACE. Results The high-level ACE group (scores > 2.5) included 119 subjects, and the low-level ACE was constituted by 66 subjects. Our results evidence that people with high exposure to ACE experiment higher odds to present anxiety disorders, risk of suicide, or post-traumatic stress disorder, as well as increased cognitive empathy (i.e., fantasy dimension). Conclusion These findings allowed us to identify the influence of ACE on mental health outcomes beyond the conventional frame (victim or ex-combatant), and to discuss effective interventions and implementation of mental health strategies in these communities. We expect to help the health system to focus on key vulnerable subjects by including civilians not recognized as victims, which are neglected from most of the public health screening, assessment, and interventions.
Background: Most of the population exposed to armed conflict experiences (ACE) live in low-income countries with limited resources for social investment and mental health. Populations exposed to ACE (e.g. victims and ex-combatants) show different levels of affectation in their mental health. In this work, we aim to identify relationships between different levels of ACE and mental health outcomes.Methods: We start classifying the population in two groups: low and high exposition to ACE using the Extreme Experiences Scale (EX2). We then use a Binary Logistic Regression (BLR) and a Lineal Regression to explore the relationships between low and high levels of ACE, the empathy dimensions of the Interpersonal Reactivity Index (IRI), and the presence or absence of mental health conditions. Being ACE levels our independent variable and categories derived from Axis I diagnosis of Mini-International Neuropsychiatric Interview and dimensions of IRI scale as dependent variables. Results were obtained by calculating the Odd Ratio, Beta values, and a coefficient interval of 95%.Results: According to the cut-off points derived from the Scores of EX2 scale, the general sample were distributed in two groups: The group of high level of ACE (scores >2.5) with 119 subjects, and the low-level ACE group (scores<2.5) with 66 subjects. Our results evidence that people with high exposition to ACE experiment a higher Fantasy dimension of IRI scale and higher odds to present anxiety disorders, risk of suicide, or PTSD.Conclusion: These findings allowed us to identify the influence of ACE on mental health outcomes, to classify exposed populations, and to design effective strategies of intervention and implementation of mental health programs in these communities.
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