Potentially traumatic events, coping strategies and associations with mental health and well-being measures among conflict-affected youth in Eastern Democratic Republic of Congo

Abstract

BackgroundYouth in conflict and post-conflict settings are exposed to a variety of potentially-traumatic events that impact their mental health and well-being. The purposes of this study were to examine coping strategies among conflict-affected youth exposed to potentially-traumatic events and the relationship to psychological symptoms and well-being in the Democratic Republic of Congo (DRC).MethodsA total of 434 male and female youth (ages 10–15 years) completed data collection with a trained Congolese interviewer. The survey instrument included measures of exposure to potentially traumatic events, an adapted coping strategies checklist, and measures of psychosocial distress and well-being. Exploratory factor analyses was used to identify coping strategies and Hierarchical regression was used to assess how coping strategies were associated with psychological symptoms including internalizing and externalizing problems and well-being outcomes including prosocial behavior and self-esteem.ResultsExploratory Factor analysis suggested four coping strategies; problem-focused, emotion-focused, avoidance and faith-based strategies. Problem-focused coping strategies were associated with greater internalizing and externalizing problems and lower prosocial behavior in both boys and girls. However, when problem-focused strategies were used with emotion-focused coping strategies, the result was fewer internalizing problems in girls and fewer externalizing problems in boys and girls. Emotion-focused, avoidance and faith based strategies were associated with better self-esteem.ConclusionThese results suggest a complex relationship between coping strategies, psychological symptoms and well-being and contradict evidence that problem-focused strategies benefit mental health while emotion-focused strategies harm mental health, particularly in conflict and post-conflict settings. The results suggest coping flexibility, or use of multiple coping strategies may be particularly useful to improving mental health and well-being. The need for context specific understandings of coping strategies in conflict-affected populations is highlighted by the results of the study.

Mental Health Outcomes in Communities Exposed to Armed Conflict Experiences

“…This allowed us to suggest that the EX 2 cut-off point of 2.5 is sensitive and reliable to discriminate population's mental health outcomes according to their low or high level of exposition to ACE. A similar cut-off point was previously reported for traumatic events (not only in armed con ict context) by Cherewick et al (43), where scores for potentially traumatic events were 2.2 and 2.3 for males and females respectively (43). This contributes to solving gaps presented in previous studies to classify the level of ACE in countries such as Colombia (19,21,23,24,44,45).…”

Factors associated with common mental health problems of humanitarian workers in South Sudan

“…However, establishing appropriate, protective forms of coping in humanitarian settings may be challenging. Coping strategies in situations of conflict may, as suggested by recent work in conflict-affected populations [ 87 ], require distinct adaptation to be effective.…”

Acceptability and feasibility of using actigraphy to assess habitual physical activity and sleep parameters in men and women living in rural communities in conflict-affected Eastern Democratic Republic of Congo

“…People experiencing poor mental health suffer substantial distress and may be more vulnerable to further violence, suicidality, and poor physical health and harmful health practices such as alcohol and drug abuse. Evidence has consistently demonstrated elevated rates of mental distress, most commonly reported as symptoms of post-traumatic stress disorder (PTSD) and depression, amongst diverse adult populations that have experienced conflict and internal displacement (Mollica et al ., 1993 ; Roberts et al ., 2009 ; Mugisha et al ., 2015 ; Vonnahme et al ., 2015 ; Cherewick et al ., 2016 ). For example, in Uganda, PTSD, and depression amongst internally displaced persons have ranged between 44.5% and 75.3% (Mugisha et al ., 2015 ).…”