Abstract:Adverse life experiences are a major risk factor for psychopathology. Studies from industrialized countries have consistently shown the detrimental effects of child maltreatment on the mental health of the victims. Research in war-affected populations, however, has mostly been restricted to the psychological damage caused by the war. Both war trauma and child maltreatment have rarely been studied simultaneously. In a comparative study of 2 generations living in severely war-affected regions in Northern Uganda,… Show more
“…However this longitudinal study seemingly supporting the susceptibility hypothesis cannot rule out possible self-medication, since predeployment alcohol abuse may have developed as a consequence of self-medication secondary to earlier stressors (e.g., child maltreatment). Olema et al [ 39 ] examined two generations of northern Ugandans highly affected by war-trauma and child maltreatment and found both factors independently predicting symptoms of PTSD and depression in the young generation, but only child maltreatment remained a significant predictor in the guardian generation. They concluded that the impact of child maltreatment on mental health may outweigh the effects of war-related experiences.…”
BackgroundIt is likely that alcohol use and abuse increase during and after violent conflicts. The most prominent explanation of this phenomenon has been referred to as self-medication hypothesis. It predicts that psychotropic substances are consumed to deal with conflict-related psychic strains and trauma. In northern Uganda, a region that has been affected by a devastating civil war and is characterized by high levels of alcohol abuse we examined the associations between war-trauma, childhood maltreatment and problems related to alcohol use. Deducing from the self-medication hypothesis we assumed alcohol consumption moderates the relationship between trauma-exposure and psychopathology.MethodsA cross-sectional epidemiological survey targeting war-affected families in post-conflict northern Uganda included data of male (n = 304) and female (n = 365) guardians. We used standardized questionnaires in an interview format to collect data on the guardians’ socio-demography, trauma-exposure, alcohol consumption and symptoms of alcohol abuse, PTSD and depression.ResultsSymptoms of current alcohol use disorders were present in 46 % of the male and 1 % of the female respondents. A multiple regression model revealed the unique contributions of emotional abuse in the families of origin and trauma experienced outside the family-context in the prediction of men’s alcohol-related symptoms. We found that alcohol consumption moderated the dose-effect relationship between trauma-exposure and symptoms of depression and PTSD. Significant interactions indicated that men who reported more alcohol-related problems experienced less increase in symptoms of PTSD and depression with increasing trauma-exposure.ConclusionsThe gradual attenuation of the dose-effect the more alcohol-related problems were reported is consistent with the self-medication hypothesis. Hence, the functionality of alcohol consumption has to be considered when designing and implementing addiction treatment in post-conflict contexts.
“…However this longitudinal study seemingly supporting the susceptibility hypothesis cannot rule out possible self-medication, since predeployment alcohol abuse may have developed as a consequence of self-medication secondary to earlier stressors (e.g., child maltreatment). Olema et al [ 39 ] examined two generations of northern Ugandans highly affected by war-trauma and child maltreatment and found both factors independently predicting symptoms of PTSD and depression in the young generation, but only child maltreatment remained a significant predictor in the guardian generation. They concluded that the impact of child maltreatment on mental health may outweigh the effects of war-related experiences.…”
BackgroundIt is likely that alcohol use and abuse increase during and after violent conflicts. The most prominent explanation of this phenomenon has been referred to as self-medication hypothesis. It predicts that psychotropic substances are consumed to deal with conflict-related psychic strains and trauma. In northern Uganda, a region that has been affected by a devastating civil war and is characterized by high levels of alcohol abuse we examined the associations between war-trauma, childhood maltreatment and problems related to alcohol use. Deducing from the self-medication hypothesis we assumed alcohol consumption moderates the relationship between trauma-exposure and psychopathology.MethodsA cross-sectional epidemiological survey targeting war-affected families in post-conflict northern Uganda included data of male (n = 304) and female (n = 365) guardians. We used standardized questionnaires in an interview format to collect data on the guardians’ socio-demography, trauma-exposure, alcohol consumption and symptoms of alcohol abuse, PTSD and depression.ResultsSymptoms of current alcohol use disorders were present in 46 % of the male and 1 % of the female respondents. A multiple regression model revealed the unique contributions of emotional abuse in the families of origin and trauma experienced outside the family-context in the prediction of men’s alcohol-related symptoms. We found that alcohol consumption moderated the dose-effect relationship between trauma-exposure and symptoms of depression and PTSD. Significant interactions indicated that men who reported more alcohol-related problems experienced less increase in symptoms of PTSD and depression with increasing trauma-exposure.ConclusionsThe gradual attenuation of the dose-effect the more alcohol-related problems were reported is consistent with the self-medication hypothesis. Hence, the functionality of alcohol consumption has to be considered when designing and implementing addiction treatment in post-conflict contexts.
“…Syrian refugees have described how war trauma and severe stress caused by poor living environments and uncertainty about the future made it difficult to maintain positive parenting strategies (El‐Khani, Ulph, Peters, & Calam, ). Longitudinal studies in Afghanistan, Sierra Leone, and Pakistan demonstrate the intergenerational transmissional impact of war, such as family violence, substance abuse and harsh parenting as only a few of the related consequences of war on family functioning (Betancourt, McBain, Newnham, & Brennan, ; Olema, Catani, Ertl, Saile, & Neuner, ; Panter‐Brick et al, ). These may compromise school aged children's physical and mental development in terms of complex cognitive and socioemotional abilities, including self‐esteem, self‐regulation skills and coping skills (Tol, Song, & Jordans, ).…”
A child's adjustment to wartime stress is reliant not only on individual responses and qualities, but very significantly on the availability of support that they may receive from their parent or caregivers and quality of relationships. Strengthening parental support has the potential to be valuable. A pilot two‐arm randomised controlled trial investigated the feasibility of delivering and evaluating the “Caring for Children Through Conflict and Displacement” intervention with caregivers in the West Bank. Feasibility to recruit and train non‐specialist staff on‐the‐ground to screen families for eligibility, collect outcome data, deliver the intervention and to recruit and retain families in the study were examined. Research staff and intervention facilitators were successfully appointed in the field, screened participants and delivered the intervention to 120 caregivers, collecting outcome measures pre‐and post‐delivery. All families completed the outcome measures, with very little missing data. This indicated that the intervention can be delivered feasibly and evaluated with families in this humanitarian context. Preliminary outcome data showed promise that the intervention may have the potential to both improve family functioning and reduce children's problem behaviour. Implications of family‐focused initiatives, particularly within a conflict/post‐conflict context for the prevention of several negative health and social outcomes directions, are discussed.
“… Eckart et al (2012) , in a PTSD-related neuroscientific study comprising mainly Kurdish adult refugees, found that adverse childhood experiences were associated with a negative effect on the hippocampus, possibly increasing vulnerability to the biological and psychological consequences of stress and PTEs later in life. More relevant to the present study, a two-generation study by Olema et al (2014) , involving 100 Ugandan adolescents and their parents, investigated the relative effects of war-related trauma versus experiences of child maltreatment in both generations. Both adolescents and adults were severely affected by both war-related trauma and childhood trauma, yet only maltreatment during childhood significantly accounted for PTSD in the parents.…”
Adverse and potentially traumatic experiences (PTEs) in childhood were examined among 54 adult refugee patients with pre-flight PTEs of war and human rights violations (HRVs) and related to mental health and quality of life at treatment start. Extent of childhood PTEs was more strongly related to mental health and quality of life than the extent of war and HRV experiences. Childhood PTEs were significantly related to arousal and avoidance symptoms of posttraumatic stress disorder (PTSD) and to quality of life, whereas pre-flight war and HRV experiences were significantly related to reexperiencing symptoms of PTSD only. Within childhood adversities, experiences of family violence and external violence, but not of loss and illness, were significantly related to increased mental health symptoms and reduced quality of life. These results point to the importance of taking childhood adverse experiences into account in research and treatment planning for adult refugees with war and HRVs trauma.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.