Stigma, Marginalization and Psychosocial Wellbeing of Orphans in Rwanda : Exploring the Mediation Role of Social Support

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How family relationships predict the effectiveness of a psychosocial group intervention among war-affected children

Family relationships habitually shape the way traumatic events affect children’s mental health in a context of war and violence, but research is scarce on the role these relationships play in the success of psychosocial interventions. This study is a secondary analysis of previously identified family system types that are based on attachment, parenting, and siblingship, and of the influence they have on the effectiveness of teaching recovery techniques (TRT). TRT is a psychosocial group intervention aimed at reducing children’s mental health problems and increasing their psychosocial resources. We tested three hypotheses. First was the compensation hypothesis, which holds that children from families with negative relationships benefit a great deal from the TRT intervention. The second was the accumulative hypothesis, which maintains that children from families with negative relationships do not benefit from the intervention. The third, the buffering hypothesis, states that children from families with positive relationships benefit a great deal from the intervention. The family sample consists of 325 Palestinian mothers and fathers and one of their children (age 10–13). Children participated either in the TRT intervention or waiting-list control groups. Their self-reported post-traumatic stress symptoms, emotional and conduct problems, positive resources, and prosocial behavior were assessed at baseline, three months post-intervention, and at a six-month follow-up. We found that family type was significantly associated with TRT effectiveness, which supports the compensation and buffering hypotheses. Children with insecure and negative family relationships and those from families with discrepant perceptions of relationship quality showed a decline in emotional problems across the three assessments, and an increase in positive resources. Children from families with highly secure, positive relationships and those with moderately secure, neutral relationships showed increased positive resources and prosocial behavior in the control group as well. We argue that a family system approach can deepen understanding of the mechanisms of successful psychosocial interventions and, therefore, that family relations should be taken into account when tailoring such interventions for traumatized children.publishedVersionPeer reviewe

Emotional Awareness and Internalizing Problems : A Preliminary Test of State and Trait Associations among Adolescents

Introduction: Difficulties in emotional awareness (EA) are often linked to the risk of internalizing problems (IP). Most empirical studies have found this association but have not considered possible state- and trait-related fluctuations in EA and IP assessments. Aims: We tested the directionality of the state-level associations, that is, whether EA at Time 1 predicts IP at Time 2 or the other way around. In line with previous research, we hypothesized that low EA would predict a subsequent increase in IP, as difficulties in emotional awareness dispose one to emotional problems. As an alternative model, we tested the trait-level associations between EA and IP. We hypothesized that a negative latent correlation exists between EA and IP, as common factors may cause them to be associated at the trait level. Methods: Participants were 68 students who completed the Levels of Emotional Awareness Scale and the Strength and Difficulties Questionnaire at two-time points with a one-month interval. We used the Cross-lagged Panel Model to test the state-level associations and structural equation modeling to test trait-level effects. Results: Results displayed no directional effect of EA on IP, and neither did IP predict EA within one month. However, we found a trait-level correlation between EA and IP. We discuss the preliminary results between state and trait level EA and IP in the context of the early developmental environment. Conclusions: This study is a preliminary test of state- and trait-level associations between EA and IP, which could be valuable for practitioners and clinicians.publishedVersionPeer reviewe

How is mental health associated with adolescent alpha-amylase and cortisol reactivity and coordination?

To better understand the role of neuroendocrinological regulation in adolescent mental health, stress reactivity needs to be analyzed through both the autonomic nervous system (ANS) and the hypothalamic–pituitary–adrenal (HPA) axis. Accordingly, this study examined how adolescents’ internalizing and externalizing mental health symptoms are associated with their salivary alpha-amylase and cortisol levels, responses, and coordination (symmetry versus asymmetry). We utilized a developmentally salient stress task of mother–adolescent conflict discussion. Eighty 18–20-year-old late adolescents (55% girls) participated in a home laboratory assessment involving a 10-min conflict discussion with their mothers. Five adolescent saliva samples were collected to measure alpha-amylase and cortisol levels before, immediately after, and in 10-min intervals following the conflict discussion, to indicate stress reactivity. Adolescents had reported their internalizing (depression, anxiety, somatization) and externalizing (inattention, hyperactivity, anger control problems) symptoms 1 year earlier as part of a prospective family study. Internalizing symptoms were associated with adolescents’ high baseline cortisol levels, but not with cortisol responses or alpha-amylase levels or responses. In contrast, externalizing symptoms were associated with blunted alpha-amylase responses. Neither internalizing nor externalizing symptoms were associated with asymmetry between alpha-amylase and cortisol reactivity. The mother–adolescent conflict discussion was relevant as a stress stimulus to induce neuroendocrinological stress responses in adolescents. The nature of mental health problems was important for stress reactivity, yet, we found no evidence about mental health problems being related to endocrinological asymmetry in adolescents.Peer reviewe

How stressful life events and violence are related to mental health: the protective role of social relations in African context

Adolescents are universally expected to be at risk for heightened stress and violence, and subsequently to mental health problems. Good social relationships may protect their mental health, but research has mainly focused on singular relations, such as peer popularity or general social support. The current study analyses the buffering role of multiple relationships in an African context. First, how stressful life-events and violent experiences are associated to mental health, and, second, whether good social relationships with parents, siblings and peers can buffer mental health from stress and violence. The participants were 415 Ghanaian students (aged 14–17 years, M = 16.51; 71% girls). They indicated mental health by depressive symptoms and psychological distress and reported the quality of parental (support and control), sibling (warmth and rivalry) and peer relationships, and exposure to stressful life-events and violence. Hierarchical linear regression models with main and interaction effects were used to analyze the data. Only stressful life-events, but not violence, were associated with higher levels of depressive and psychological distress symptoms. Positive sibling relationships played a buffering mental health role, as stressful life-events were not related with increased depressive symptoms among adolescents enjoying warm and intimate siblingships. No protective function was found for parental or peer relationships, although good maternal and peer relationships were associated with lower levels of depressive symptoms in general.publishedVersionPeer reviewe

It Takes Time to Unravel the Ecology of War in Gaza, Palestine : Long-Term Changes in Maternal, Newborn and Toddlers’ Heavy Metal Loads, and Infant and Toddler Developmental Milestones in the Aftermath of the 2014 Military Attacks

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Effectiveness of Psychosocial School Interventions in Finnish Schools for Refugee and Immigrant children, “Refugees Well School” in Finland (RWS-FI) : A Protocol for a Cluster Randomized Controlled Trial

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