Background: The ability to adapt to the psychosocial disruptions associated with the refugee experience may influence the course of complicated grief reactions. Objective: We examine these relationships amongst Myanmar refugees relocated to Malaysia who participated in a six-week course of Integrative Adapt Therapy (IAT). Method: Participants (n = 170) included Rohingya, Chin, and Kachin refugees relocated to Malaysia. At baseline and six-week post-treatment, we applied culturally adapted measures to assess symptoms of Prolonged Complex Bereavement Disorder (PCBD) and adaptive capacity to psychosocial disruptions, based on the Adaptive Stress Index (ASI). The ASI comprises five sub-scales of safety/security (ASI-1); bonds and networks (ASI-2); injustice (ASI-3); roles and identity (ASI-4); and existential meaning (ASI-5). Results: Multilevel linear models indicated that the relationship between baseline and posttreatment PCBD symptoms was mediated by the ASI scale scores. Further, ASI scale scores assessed posttreatment mediated the relationship between baseline and posttreatment PCBD symptoms. Mediation of PCBD change was greatest for the ASI II scale representing disrupted bonds and networks. Conclusion: Our findings are consistent with the informing model of IAT in demonstrating that changes in adaptive capacity, and especially in dealing with disrupted bonds and networks, may mediate the process of symptom improvement over the course of therapy. Mecanismos psicosociales de cambio en los síntomas del trastorno de duelo complejo persistente entre los refugiados de myanmar en el transcurso de la terapia de adaptación integrativa Antecedentes: La capacidad de adaptarse a las alteraciones psicosociales asociadas con la experiencia de los refugiados puede influir en el curso de las reacciones de duelo complicadas. Objetivo: Examinamos estas relaciones entre los refugiados de Myanmar reubicados en Malasia que participaron en un proceso de seis semanas de Terapia de Adaptación Integrativa (IAT por sus siglas en ingles). Método: Los participantes (n = 170) incluyeron refugiados rohingya, chin y kachin reubicados en Malasia. Al inicio y seis semanas después del tratamiento, aplicamos instrumentos adaptados culturalmente para evaluar los síntomas del trastorno de duelo complejo prolongado (PCBD por sus siglas en ingles) y la capacidad de adaptación a las alteraciones psicosociales, según el índice de estrés adaptativo (ASI). El ASI comprende cinco subescalas de seguridad/protección (ASI-1); lazos y redes (ASI-2); injusticia (ASI-3); roles e identidad (ASI-4); y significado existencial (ASI-5). Resultados: Los modelos lineales multinivel indicaron que la relación entre los síntomas de PCBD basales y posteriores al tratamiento estuvo mediada por las puntuaciones de la escala ASI. Además, los puntajes de la escala ASI evaluados después del tratamiento median la relación entre los síntomas de PCBD basales y posteriores al tratamiento. La mediación del cambio de PCBD fue mayor para la escala ASI II que representa los lazos y...
BackgroundMental illness among Malaysian children is gradually reaching a fundamentally alarming point as it persistently shows increasing trend. The existing literature on the etiologies of children’s mental illness, highlights the most common cause to be ineffective or impaired parenting. Thus, efforts to combat mental illness in children should focus on improving the quality of parenting. Documented interventional studies focusing on this issue, particularly in Malaysia, are scarce and commonly report poor treatment outcomes stemming from inconvenient face-to-face instructions. Consequently, proposing an accessible online and digital-assisted parenting program is expected to reach a larger number of parents, as it can overcome substantial barriers. Hence, this study aims to develop a universal digital-assisted preventive parenting intervention called DaPI, that aims to enhance mental health of children in Malaysia.MethodsA total of 200 parents of children aged 10–14 years will be recruited and randomized into two groups either intervention or waitlist-control based on a 1:1 ratio for a duration of 8 weeks. Those in the intervention group will receive eight sessions of the DaPI program that focus mainly on parenting and children’s mental health. The primary outcome of this study will essentially focus on the changes in parent-reported parenting behavior and parental self-efficacy. The secondary outcome will be changes in children’s mental health (i.e., behavioral problems and emotional maladjustment). Assessments will be arranged pre- and post-intervention as well as at the 1-month follow-up. Analyses will be conducted using a paired t-test and multivariate analysis of covariance.DiscussionThe expected outcome will be the establishment of DaPI in promoting children’s mental health by targeting changes in parenting behavior and parental self-efficacy in Malaysia. Findings from this study will be beneficial for policymakers to invest in parenting programs that could provide support to parents in enhancing their child’s overall development.Clinical trial registration[www.irct.ir], identifier [IRCT20211129053207N1].
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