Testing a cycle of family violence model in conflict-affected, low-income countries: A qualitative study from Timor-Leste

Rees, Susan; Thorpe, Rosamund; Tol, Wietse A.; Fonseca, Mira; Silove, Derrick

doi:10.1016/j.socscimed.2015.02.013

Cited by 40 publications

(40 citation statements)

References 50 publications

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“…A focus on states of chronic and uncontrollable anger in survivors of extreme trauma creates an important bridge that links individual reactions to the stability of the family and the wider social network. A cycle of violence model posits that, in some instances, aggressive outbursts amongst survivors may be implicated in family conflict, generating a multiplier effect of mental health problems in intimate partners and potentially children, a cycle of violence that may have profound transgenerational effects. Recent applications of multilevel statistical techniques allow examination of these transactional effects both within conjugal couples and families, thereby broadening the scope of epidemiology to increase its ecological and contextual significance.…”

Section: Towards An Ecological Epidemiologymentioning

confidence: 99%

The contemporary refugee crisis: an overview of mental health challenges

2017

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There has been an unprecedented upsurge in the number of refugees worldwide, the majority being located in low-income countries with limited resources in mental health care. This paper considers contemporary issues in the refugee mental health field, including developments in research, conceptual models, social and psychological interventions, and policy. Prevalence data yielded by cross-sectional epidemiological studies do not allow a clear distinction to be made between situational forms of distress and frank mental disorder, a shortcoming that may be addressed by longitudinal studies. An evolving ecological model of research focuses on the dynamic inter-relationship of past traumatic experiences, ongoing daily stressors and the background disruptions of core psychosocial systems, the scope extending beyond the individual to the conjugal couple and the family. Although brief, structured psychotherapies administered by lay counsellors have been shown to be effective in the short term for a range of traumatic stress responses, questions remain whether these interventions can be sustained in low-resource settings and whether they meet the needs of complex cases. In the ideal circumstance, a comprehensive array of programs should be provided, including social and psychotherapeutic interventions, generic mental health services, rehabilitation, and special programs for vulnerable groups. Sustainability of services, ensuring best practice, evidence-based approaches, and promoting equity of access must remain the goals of future developments, a daunting challenge given that most refugees reside in settings where skills and resources in mental health care are in shortest supply.

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Section: Towards An Ecological Epidemiologymentioning

confidence: 99%

The contemporary refugee crisis: an overview of mental health challenges

2017

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“…Further empirical research that investigates and contributes to theorizing the cycle of violence in conflict-affected societies is important, for various reasons. Firstly, unlike in societies not affected by conflict, violence is not restricted to families and individuals but is also organized by state and non-state parties and occurs at societal level as well [42], and there is reason to assume that broader societal conflict may transfer to families from different socio-ecological levels and vice versa [43,44]. In conflict-affected countries, substantial higher levels of domestic or familial violence often occur [45,46].…”

Section: Discussionmentioning

confidence: 99%

How Legacies of Genocide Are Transmitted in the Family Environment: A Qualitative Study of Two Generations in Rwanda

Berckmoes

Eichelsheim

Rutayisire³

et al. 2017

Societies

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Abstract:The 1994 genocide against the Tutsi in Rwanda and its aftermath led to large-scale individual traumatization, disruption of family structures, shifts in gender roles, and tensions in communities, which are all ongoing. Previous research around the world has demonstrated the transgenerational effects of mass violence on individuals, families and communities. In Rwanda, in light of recurrent episodes of violence in the past, attention to the potential 'cycle of violence' is warranted. The assumption that violence is passed from generation to generation was first formulated in research on domestic violence and child abuse, but is receiving increasing attention in conflict-affected societies. However, the mechanisms behind intergenerational transmission are still poorly understood. Based on qualitative research with 41 mothers and their adolescent children, we investigated how legacies of the 1994 genocide and its aftermath are transmitted to the next generation through processes in the family environment in Rwanda. Our findings reveal direct and indirect pathways of transmission. We also argue that intergenerational effects might best be described as heterotypic: genocide and its aftermath lead to multiple challenges in the children's lives, but do not necessarily translate into new physical violence. Further research is needed on how children actively engage with conflict legacies of the past.

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“…In particular, confirmation of a grief-anger class and the social factors associated with the pattern, has the potential to add support to a cycles of violence model which postulates that exposure to the traumas of past conflict (in this instance, specifically traumatic losses and deprivations) may contribute to risk of subsequent family conflict in the aftermath of the violence [30]. We note however, that explosive anger associated with grief may be both a cause and a consequence of family conflict, resulting in a complex reciprocal and interacting effect that generates a vicious cycle of instability in the household.…”

Section: Discussionmentioning

confidence: 99%

“…Other forms of adversity, for example conditions of material deprivation during and in the aftermath of conflict, may compound and prolong anger and grief. Symptoms of grief and anger in survivors of trauma may lead to ongoing conflict within families, representing one of the more severe longer-term psychosocial consequence of earlier exposure to mass violence [30]. …”

Section: Introductionmentioning

confidence: 99%

Identifying a combined construct of grief and explosive anger as a response to injustice amongst survivors of mass conflict: A latent class analysis of data from Timor-Leste

et al. 2017

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Previous studies have identified high rates of explosive anger amongst post-conflict populations including Timor-Leste. We sought to test whether explosive anger was integrally associated with symptoms of grief amongst the Timorese, a society that has experienced extensive conflict-related losses. In 2010 and 2011 we recruited adults (n = 2964), 18-years and older, living in an urban and a rural village in Timor-Leste. We applied latent class analysis to identify subpopulations based on symptoms of explosive anger and grief. The best fitting model comprised three classes: grief (24%), grief-anger (25%), and a low symptom group (51%). There were more women and urban dwellers in the grief and grief-anger classes compared to the reference class. Persons in the grief and grief-anger classes experienced higher rates of witnessing murder and atrocities and traumatic losses, ongoing poverty, and preoccupations with injustice for the two historical periods of conflict (the Indonesian occupation and the later internal conflict). Compared to the reference class, only the grief-anger class reported greater exposure to extreme deprivations during the conflict, ongoing family conflict, and preoccupations with injustice for contemporary times; and compared to the grief class, greater exposure to traumatic losses, poverty, family conflict and preoccupations with injustice for both the internal conflict and contemporary times. A substantial number of adults in this post-conflict country experienced a combined constellation of grief and explosive anger associated with extensive traumatic losses, deprivations, and preoccupations with injustice. Importantly, grief-anger may be linked to family conflict in this post-conflict environment.

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Testing a cycle of family violence model in conflict-affected, low-income countries: A qualitative study from Timor-Leste

Cited by 40 publications

References 50 publications

The contemporary refugee crisis: an overview of mental health challenges

The contemporary refugee crisis: an overview of mental health challenges

How Legacies of Genocide Are Transmitted in the Family Environment: A Qualitative Study of Two Generations in Rwanda

Identifying a combined construct of grief and explosive anger as a response to injustice amongst survivors of mass conflict: A latent class analysis of data from Timor-Leste

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