Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents

Scharpf, Florian; Kyaruzi, Edna; Landolt, Markus A.; Hecker, Tobias

doi:10.1080/20008198.2019.1676005

Cited by 17 publications

(22 citation statements)

References 49 publications

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“…There is compelling evidence that compromised parenting mediates the impact of war and displacement on children's mental health (Palosaari et al ., 2013; Panter-Brick et al ., 2014 b ; Saile et al ., 2014; Song et al ., 2014; El-Khani et al ., 2016; Sim et al ., 2018; Eltanamly et al ., 2019; Scharpf et al ., 2019). War-related violence and loss, coupled with continuous exposure to stressors such as poverty, unemployment, poor housing, a lack of access to basic resources, and the loss of social support networks, exact a toll on parents' mental health and psychosocial wellbeing (Eltanamly et al ., 2019).…”

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confidence: 99%

Strengthening parenting in conflict-affected communities: development of the Caregiver Support Intervention

et al. 2020

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Background There is robust evidence that compromised parenting, stemming from persistently high stress, mediates the impact of war and displacement on children's mental health and psychosocial wellbeing. Parenting interventions generally prioritize the acquisition of parenting knowledge and skills, while under-attending to parental stress and distress. This paper describes the development of the Caregiver Support Intervention (CSI), a nine-session group intervention for conflict-affected parents of children aged 3–13, that aims to strengthen parenting both indirectly, by lowering stress and improving psychosocial wellbeing among parents, and directly, by increasing knowledge and skill related to positive parenting. Methods We describe the multi-phase, iterative process by which we developed the CSI, and illustrate the essential role of community input in shaping the intervention and strengthening its cultural fit and perceived usefulness. We used focus group data from participants in successive cycles of implementation, feedback, and revision, as well as quantitative data and expert consultation to develop a culturally and empirically grounded intervention. Results This mixed-method, iterative approach to intervention development enabled us to develop a psychosocial intervention for conflict-affected caregivers that is feasible, acceptable, and perceived by participants as useful in addressing their own wellbeing and their parenting. Focus group data support the underlying model in which caregiver wellbeing powerfully influences parenting. Conclusions Programs aimed at strengthening parenting in conflict-affected communities should substantively address caregiver wellbeing. An iterative approach incorporating community feedback can help ensure intervention acceptability and feasibility. We also illustrate the feasibility of involving men in parenting interventions.

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Strengthening parenting in conflict-affected communities: development of the Caregiver Support Intervention

et al. 2020

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“…Limitations of the described model predominantly re ect those of the original observational study, which may have affected study ndings, for example the use of instruments and cut-off scores that had not been validated in Burundian (refugee) samples as well as reporter biases such as over-and underreporting of symptoms (Scharpf et al, 2019;Scharpf, Mkinga, Neuner, et al, 2020). Moreover, as the proposed model was developed based on ndings from Burundian refugee families living in Tanzanian refugee camps, its generalizability to other populations and contexts is limited.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, we conducted a small survey on childrens and parents awareness and use of existing mental health and psychosocial services in the camps as well as their coping resources. We took the following measures in order to increase the appropriateness of the assessment for the camp context and the cultural background of the sample: qualitative evaluations of the study instruments by members of the refugee communities in each camp who were also employed as research assistants, use of translators from the refugee community to increase participantsc omprehension of questions and a pilot assessment in the rst camp (Scharpf et al, 2019;Scharpf, Mkinga, Neuner, et al, 2020).…”

Section: Summary Of Study Procedures and Main Ndingsmentioning

confidence: 99%

A Task-shifting and Family-focused Approach Towards Mental Health Care for Youth Living in Refugee Camps

Scharpf

Hecker

2021

Preprint

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Background: In humanitarian emergencies with few specialist resources for mental health care, it is a practical and ethical necessity to allocate available resources to interventions that target youth most in need of support and address contextually relevant factors of influence. Based on the findings of an extensive epidemiological observational study with 230 Burundian refugee youth aged 7 to 15 years and both their caregivers in three refugee camps, we propose a multi-layered mental health service model that is characterized by task-shifting from professionals to non-professionals, close-meshed collaboration between different agencies within camps and inclusion of families at all stages. Discussion: The model prioritizes the identification of youth with clinically relevant mental health problems through extensive screening, who are then provided with trauma- and/or family-focused interventions depending on a more detailed assessment of needs. We emphasize the importance of incorporating evidence-based interventions and evaluating all model components and discuss caveats and limitations concerning the implementation of the model. Conclusion: The paper aims to sensitize researchers and practitioners in the field of mental health care for youth in refugee and other humanitarian settings to the importance of conducting epidemiological assessments of the specific need for interventions and of contextually relevant intervention targets.

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“…Trained interpreters were always present in case a participant was not proficient in Swahili (for details on the procedure see [34]). After the interviews, families received a material compensation of 8 US Dollars.…”

Section: Methodsmentioning

confidence: 99%

A socio-ecological analysis of risk, protective and promotive factors for the mental health of Burundian refugee children living in refugee camps

Scharpf

Mkinga

Masath

et al. 2020

Eur Child Adolesc Psychiatry

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Children and adolescents’ mental health risk and resilience arise from a complex interplay of factors on several socio-ecological levels. However, little is known about the factors that shape the mental health of refugee youth living in refugee camps close to ongoing conflict. We conducted a cross-sectional study with a representative sample of 217 Burundian refugee children aged 7–15 and their mothers residing in refugee camps in Tanzania to investigate associations between risk, protective and promotive factors from various ecological levels (individual, microsystem, exosystem), and children’s post-traumatic stress disorder (PTSD) symptoms, internalizing and externalizing problems, and prosocial behavior. Data were collected using structured clinical interviews and analyzed using multiple regression models. Exposure to violence across all contexts and engagement coping were risk factors for PTSD symptoms and internalizing problems, while only violence by mothers seemed to increase children’s vulnerability for externalizing problems. A differential impact of violence exposures on prosocial behavior was observed. Higher-quality friendships appeared to protect youth from PTSD symptoms and externalizing problems, while they also promoted children’s prosocial behavior, just as mothers’ social support networks. Prevention and intervention approaches should integrate risk, protective and promotive factors for refugee youth’s mental health across multiple ecological contexts and take into account context-specific and adaptive responses to war and displacement.

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Prevalence and co-existence of morbidity of posttraumatic stress and functional impairment among Burundian refugee children and their parents

Cited by 17 publications

References 49 publications

Strengthening parenting in conflict-affected communities: development of the Caregiver Support Intervention

Strengthening parenting in conflict-affected communities: development of the Caregiver Support Intervention

A Task-shifting and Family-focused Approach Towards Mental Health Care for Youth Living in Refugee Camps

A socio-ecological analysis of risk, protective and promotive factors for the mental health of Burundian refugee children living in refugee camps

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