The Role of Trauma and Mental Health Problems in the Perpetration of Intimate Partner Violence in Post-Genocide Rwanda

Exposure to political violence or war is associated with intimate partner violence (IPV) in post-conflict settings (Clark et al., 2010; Gupta, Reed, Kelly, Stein, & Williams, 2012), and civilians and veterans who develop posttraumatic stress disorder (PTSD) after exposure to combat or violence are more likely to perpetrate violence against an intimate partner (Taft, Watkins, Stafford, Street, & Monson, 2011). Rwandan health professionals estimate that after the 1994 genocide more than one-quarter of the country’s population now suffers from PTSD (Munyandamutsa, Nkubamugisha, Gex-Fabry, & Eytan, 2012). Although the majority of Rwandan women (56%) have experienced IPV in their lifetime (National Institute of Statistics Rwanda, Ministry of Health (MINISANTE) [Rwanda], & ICF International, 2012), mental health problems from trauma have not yet been considered as a factor in efforts against gender-based violence. This study used mixed methods to document and describe the phenomena of trauma exposure, mental health problems, and intimate partner violence in Rwanda. The study examined risk and protective factors associated with the perpetration of physical, sexual, emotional, and financial intimate partner violence, with a particular focus on the role of trauma and mental health. Twenty-nine married men and 16 of their wives from rural and peri-urban communities of Rwanda completed semi-structured in-depth interviews (IDIs). Structured, face-to-face survey interviews were conducted with a representative sample of married men over the age of 35 (N=148) from one southern Rwandan district. Bivariate analyses were conducted to test relationships between risk and protective factors of interest and prior year perpetration of IPV. A series of multivariate logistic regression models tested the relationship between trauma and mental health problems with IPV. More than 30% of the male survey sample reported perpetrating at least one type of IPV in the previous year. Patriarchal attitudes, younger age, alcohol consumption, and anger were significantly associated with IPV perpetration in bivariate analyses. Although male survey respondents reported on average 11.2 lifetime traumatic events, exposure to traumatic events was not significantly associated with perpetration of IPV in bivariate analyses. Twenty-one percent of respondents met diagnostic criteria for PTSD. In multivariate analyses, men who met diagnostic criteria for PTSD were 3 times more likely to report perpetrating physical IPV compared to men without PTSD, OR = 3.13 [1.10, 8.86], and 1.4 times more likely to report emotional IPV perpetration, OR = 1.39, [0.57, 3.35]. Meeting the diagnostic cut-off for depression was associated with IPV in bivariate but not multivariate analyses. Stories from IDI respondents indicated that trauma exposure and the mental health of both male and female partners is important. Study findings confirm the importance of studying unique factors for IPV in a post-conflict setting and indicate that interventions to address mental health should be considered in policies and programs to address IPV in Rwanda. The findings may also have implications for other populations affected by political or community violence in the United States or abroad

Rwanda Country Assessment for Youth Development Accounts

Rwanda Country Assessment for Youth Development Account

Mental health pathways linking maltreatment to interpersonal revictimization during adolescence for girls in the child welfare system

This study compares the association of histories of childhood emotional, physical, and sexual abuse, and physical neglect with revictimization among adolescent girls, and investigates the role of posttraumatic stress and symptoms of depression as mediators. Participants were 234 girls aged 12 to 19 years, who have been involved with the child welfare system in a Midwestern urban area. Data were collected from baseline surveys of a trauma-focused group program to which the participants were referred. The majority of participants were youths of color (75%) who were primarily African American (70%), and the remaining participants were White, non-Hispanic (25%). Data were collected through surveys that assessed histories of child abuse and neglect, symptoms of posttraumatic stress and depression, and experiences of physical, verbal, and relational revictimization in the last 3 months. All types of abuse and neglect were significantly associated with higher frequencies of revictimization and higher levels of posttraumatic stress and depressive symptoms. Parallel mediation analyses demonstrated that both posttraumatic stress and depression fully mediated the relationships between emotional abuse and revictimization, and sexual abuse and revictimization. Physical abuse was fully mediated by posttraumatic stress, but not by depression. Results also indicated that neither posttraumatic stress nor depression were mediators for the relationship between neglect and revictimization. There were similar pathways to revictimization in adolescents from emotional and sexual abuse through posttraumatic stress and depression. Evidence is mounting for the deleterious effects of emotional abuse. There is evidence that treatment of both posttraumatic stress and depression in emotionally and sexually abused adolescents involved in child welfare is warranted to prevent future revictimization

Voices of Youth, Parents, and Stakeholders: Findings From Case Studies in the YouthSave Project

Voices of Youth, Parents, and Stakeholders: Findings From Case Studies in the YouthSave Projec

Mental Health and School Functioning for Girls in the Child Welfare System : the Mediating Role of Future Orientation and School Engagement

This study investigated the association between mental health problems and academic and behavioral school functioning for adolescent girls in the child welfare system and determined whether school engagement and future orientation meditated the relationship. Participants were 231 girls aged between 12 and 19 who had been involved with the child welfare system. Results indicated that 39% of girls reported depressive symptoms in the clinical range and 54% reported posttraumatic symptoms in the clinical range. The most common school functioning problems reported were failing a class (41%) and physical fights with other students (35%). Participants reported a mean number of 1.7 school functioning problems. Higher levels of depression and PTSD were significantly associated with more school functioning problems. School engagement fully mediated the relationship between depression and school functioning and between PTSD and school functioning, both models controlling for age, race, and placement stability. Future orientation was not significantly associated with school functioning problems at the bivariate level. Findings suggest that school engagement is a potentially modifiable target for interventions aiming to ameliorate the negative influence of mental health problems on school functioning for adolescent girls with histories of abuse or neglect

Facilitators and Obstacles in Youth Saving: Perspectives From Ghana and Kenya

Facilitators and Obstacles in Youth Saving: Perspectives From Ghana and Keny

Facilitators and Obstacles in Youth Saving: Perspectives From Ghana and Kenya

Facilitators and Obstacles in Youth Saving: Perspectives From Ghana and Keny

Voices of Youth, Parents, and Stakeholders: Findings From Case Studies in the YouthSave Project

Voices of Youth, Parents, and Stakeholders: Findings From Case Studies in the YouthSave Projec