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Gaza's hidden crisis: adults, children, and generations of psychological torment to come. 加沙隐藏的危机:成人、儿童和未来几代人的心理折磨。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-23 DOI: 10.1080/20008066.2024.2416824
Arash Javanbakht

For more than a year, the world has been exposed to the ongoing conflict in Gaza, and the destruction, medical devastation, and the death toll of this crisis. What has been largely missing from the picture, has been an attention to the long-term mental health impact of the ongoing trauma among the Palestinian civilians and the Israeli hostages in Gaza. This article anticipates the enduring generational impact of war trauma on mental health of the civilians in Gaza, drawing from the author's clinical and research experiences of Iraqi, Syrian, Afghan, African, and Ukrainian war-exposed civilians, refugees, and survivors of torture. Across most different studies, war exposure leads to PTSD in nearly 30-50% of adult civilians, and similar rates of depression and anxiety. Civilians in Gaza, facing daily horrors and a profound sense of helplessness, are likely experiencing even greater psychological distress. Children, significantly affected during critical developmental stages, are at risk of long-term mental and physical health issues. The psychological, cultural, and epigenetic aspects of the intergenerational transmission of trauma can lead to psychological torment across generations. Addressing the mental health needs of these populations is crucial to mitigating the profound and lasting impact of war.

一年多来,全世界都在关注加沙持续不断的冲突,以及这场危机造成的破坏、医 疗毁坏和死亡人数。然而,人们对加沙的巴勒斯坦平民和以色列人质所遭受的长期精神创伤所带来的长期心理健康影响的关注,却在很大程度上缺失了。本文根据作者对伊拉克、叙利亚、阿富汗、非洲和乌克兰受战争影响的平民、难民和酷刑幸存者的临床和研究经验,预测了战争创伤对加沙平民心理健康的长期影响。在大多数不同的研究中,战争暴露导致近 30-50%的成年平民患上创伤后应激障碍,抑郁症和焦虑症的发病率也类似。加沙的平民每天都面临着恐怖和深深的无助感,他们的心理压力可能更大。儿童在关键的成长阶段受到严重影响,有可能出现长期的身心健康问题。创伤代代相传所带来的心理、文化和表观遗传方面的问题会导致跨代的心理折磨。满足这些人群的心理健康需求对于减轻战争的深远和持久影响至关重要。
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引用次数: 0
Communication on familial suicide: development of the Family Communication on Suicide Questionnaire. 就家庭自杀问题进行沟通:编制自杀问题家庭沟通问卷。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-17 DOI: 10.1080/20008066.2024.2411887
Sonja Radde, Stefan Gutwinski, Keith Harris, Meryam Schouler-Ocak, Felix Bermpohl, Konrad Schnabel, Frauke Stuke, Jonathan Henssler

Introduction: Each suicide affects about five close family members, potentially heightening risk for psychopathology and suicide. Communication style is a key factor in mental health and psychosocial wellbeing of families. Family communication after suicide, however, is insufficiently conceptualised and studied. This study aimed to identify different factors of familial communication after suicide of a relative and to develop a questionnaire assessing the functionality of familial communications following the suicide of a family member.Method: Through literature review, categories for the functionality of family communication after a familial suicide were developed. Items assessing family communication strategies were formulated and reviewed for comprehensibility and classification. Based on this review, the FCSQ (Family Communication on Suicide Questionnaire) was then tested in a multistep exploratory factor analysis on a cohort of suicide-bereaved relatives, utilising principal axis factor extraction. Construct validity of the FCSQ was assessed through correlation analysis and internal consistency via coefficient alpha.Results: Fifty-nine participants were enrolled in the study. Psychometric analyses indicated that family communication after a suicide can be divided into three factors, Honest and Emotional, Derogatory, and Stigmatising. Honest and Emotional formed functional communications, while Derogatory and Stigmatising communications formed two dysfunctional dimensions.Conclusions: The FCSQ is a first-of-a-kind questionnaire to assess functionality of family communications after suicide. Factor analysis indicated good factor structure and internal consistency, especially regarding functional communication patterns, while the Derogatory factor requires further analysis. This questionnaire has the potential to fill a crucial gap in clinical and research practice and can help to identify families and family members at risk after the experience of a family suicide.

引言每一起自杀事件都会影响到约五名近亲属,潜在地增加了心理变态和自杀的风险。沟通方式是影响家庭心理健康和社会心理福祉的关键因素。然而,对自杀后家庭沟通的概念和研究还不够充分。本研究旨在确定亲属自杀后家庭沟通的不同因素,并编制一份问卷,评估家庭成员自杀后家庭沟通的功能:方法:通过文献综述,对家人自杀后家庭沟通的功能进行了分类。制定了评估家庭沟通策略的项目,并对其可理解性和分类进行了审查。在此基础上,利用主轴因子提取法,对一组自杀遗属进行了多步骤探索性因子分析,并对 FCSQ(自杀家庭沟通问卷)进行了测试。通过相关性分析评估了 FCSQ 的结构有效性,并通过阿尔法系数评估了其内部一致性:59名参与者参加了研究。心理测量分析表明,自杀后的家庭沟通可分为三个因子:诚实和情感、贬低和污名化。诚实和情感构成了功能性沟通,而诋毁和污名化构成了两个功能失调维度:FCSQ是首个评估自杀后家庭沟通功能的问卷。因子分析表明,该问卷具有良好的因子结构和内部一致性,尤其是在功能性沟通模式方面。该问卷有可能填补临床和研究实践中的一个重要空白,并有助于识别遭遇家庭自杀后的高危家庭和家庭成员。
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引用次数: 0
Living with grief and thriving after loss: a qualitative study of Chinese parents whose only child has died. 在悲伤中生活,在失去孩子后茁壮成长:对独生子女夭折的中国父母的定性研究。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-11-01 DOI: 10.1080/20008066.2024.2418767
Xin Xu, Jun Wen, Wenli Qian, Ningning Zhou, Wanyue Jiang

Introduction: Chinese bereaved parents over the age of 49 who have lost their only child are known as shidu parents. This study aimed to explore their symptoms of prolonged grief disorder (PGD) and post-traumatic growth (PTG).Methods: Shidu parents who experienced the loss of their only child at least six months prior and had no biological or adopted children at the time of the study were recruited. Eleven shidu parents participated in individual interviews conducted in Mandarin via WeChat video or voice calls. The interview guide was developed by the first researcher and refined through discussions with doctoral students and a professor specializing in bereavement. Reflexive thematic analysis was used to analyse the data from the semi-structured interviews.Results: The interviewees (3 men and 8 women) were aged between 53 and 72 years, and the time since their child's loss ranged from 2.25 to 24 years. Four themes of PGD symptoms were identified: Separation distress, Cognitive, emotional, and behavioural symptoms, Somatic responses and Changes in grief responses. Subtheme of 'feelings of inferiority or shame' and 'somatic responses' were prominent among this group, potentially representing culturally relevant grief reactions. They also experienced genuine PTG that helped them adapt to life without the child: changes in self-perception, changes in interpersonal relationships, and a changed philosophy of life. The subtheme of 'living for self' emerged as a potentially unique PTG among shidu parents.Conclusion: Shidu parents share some important similarities with bereaved individuals across cultures, but also exhibit some unique characteristics. Considering their persistent intense grief, regular screening for grief severity, physical issues, and suicidal ideation is essential. Culturally sensitive interventions that acknowledge and validate their sense of inferiority or shame may be beneficial. Additionally, fostering PTG may support shidu parents in coping with their loss and adapting to life.

导言:中国49岁以上失去独生子女的父母被称为 "师徒父母"。本研究旨在探讨他们的长期悲伤障碍(PGD)和创伤后成长(PTG)症状:方法:招募了至少在六个月前经历过失去独生子女,且在研究期间没有亲生或领养子女的 "志都 "父母。11 位师都父母通过微信视频或语音电话以普通话参加了个别访谈。访谈指南由第一位研究者制定,并通过与博士生和一位专门研究丧亲之痛的教授的讨论加以完善。半结构式访谈的数据分析采用了反思性主题分析法:受访者(3 男 8 女)的年龄在 53 岁至 72 岁之间,他们失去孩子的时间从 2.25 年到 24 年不等。我们确定了四个 PGD 症状主题:分离痛苦、认知、情绪和行为症状、躯体反应和悲伤反应的变化。自卑感或羞耻感 "和 "躯体反应 "这两个副主题在该群体中非常突出,可能代表了与文化相关的悲伤反应。他们还经历了真正的 PTG,这有助于他们适应没有孩子的生活:自我认知的改变、人际关系的改变以及生活理念的改变。为自己而活 "这一子主题可能是师徒家长中独特的 PTG:师徒父母与不同文化背景下的丧亲者有一些重要的相似之处,但也表现出一些独特的特征。考虑到他们持续的强烈悲伤,定期筛查悲伤的严重程度、身体问题和自杀意念至关重要。承认并确认他们的自卑感或羞耻感的具有文化敏感性的干预措施可能是有益的。此外,培养 PTG 可帮助师徒父母应对丧亲之痛并适应生活。
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引用次数: 0
A qualitative evaluation of the use of Problem Management Plus (PM+) among Arabic-speaking migrants with psychological distress in France - The APEX study. 对法国讲阿拉伯语的有心理困扰的移民使用 "问题管理+"(PM+)的定性评估--APEX 研究。
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-03-19 DOI: 10.1080/20008066.2024.2325243
P J Surkan, D Rayes, L Bertuzzi, N Figueiredo, M Melchior, A Tortelli

ABSTRACTBackground: Feasibility studies with non-French speaking migrants in France are needed to inform appropriate adaptation of psychosocial intervention procedures.Objective: To test the WHO Problem Management Plus (PM+) intervention protocol for Arabic-speaking migrants in the Paris metropolitan region.Methods: Between 2019 and 2021 we recruited participants from three accommodation centres receiving asylum seekers or migrants experiencing social and economic difficulties. Participants experiencing psychological distress underwent five PM + sessions with trained helpers. Feasibility was evaluated through 15 interviews with 8 participants, 4 helpers, and 3 study supervisors. Interview topics covered PM + implementation in general and for each component. We also sought to understand problems with delivery and gathered suggestions for improvement. Data were analysed thematically using a deductive approach.Results: We found implementation of PM + to be feasible, with predominantly positive reactions from participants, helpers and study staff. All intervention components were considered beneficial, with breathing exercises considered easy to implement and often sustained. Selection of problems and strategies to address them were described as challenging to execute. Psychosocial support from and rapport with helpers and the use of the native language were considered key strengths of the programme. However, we observed the need for complementary or higher intensity psychological support in some cases. Findings also highlighted the importance of addressing distress among non-specialist helpers delivering PM + . Finally, local guidance to social resources were suggested to be added in the protocol.Conclusion: PM + was well-liked and feasible, with cultural adjustments and increased access to community resources for migrants needed.

摘要:背景:需要对法国的非法语移民进行可行性研究,以便为社会心理干预程序的适当调整提供依据:目的:针对巴黎大都会地区讲阿拉伯语的移民,测试世界卫生组织的 "问题管理+"(PM+)干预方案:在 2019 年至 2021 年期间,我们从接收寻求庇护者或遇到社会和经济困难的移民的三个收容中心招募了参与者。有心理困扰的参与者在训练有素的帮助者的指导下接受了五次 PM + 治疗。通过与 8 名参与者、4 名协助者和 3 名研究督导进行 15 次访谈,对可行性进行了评估。访谈主题涉及 PM + 的总体实施情况和每个组成部分。我们还试图了解实施过程中存在的问题,并收集改进建议。我们采用演绎法对数据进行了专题分析:我们发现 "PM+"的实施是可行的,参与者、协助者和研究人员都给予了积极的评价。所有干预内容都被认为是有益的,其中呼吸练习被认为易于实施,而且通常都能坚持下去。据描述,选择问题和解决问题的策略在实施过程中具有挑战性。来自帮助者的心理支持、与帮助者的融洽关系以及母语的使用被认为是该计划的主要优势。然而,我们注意到,在某些情况下,需要补充或更高强度的心理支持。研究结果还强调了解决提供 PM + 的非专业帮助者的困扰的重要性。最后,我们建议在方案中增加对当地社会资源的指导:PM +广受欢迎且可行,但需要进行文化调整并增加移民获得社区资源的途径。
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引用次数: 0
A sex-specific pathway linking early life maltreatment, vagal activity, and depressive symptoms. 将早期虐待、迷走神经活动和抑郁症状联系起来的性别特异性途径。
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-03-21 DOI: 10.1080/20008066.2024.2325247
Christine Sigrist, Cristina Ottaviani, Luise Baumeister-Lingens, Silvia Bussone, Chiara Pesca, Michael Kaess, Valeria Carola, Julian Koenig

Background: Experiences of early life maltreatment (ELM) are alarmingly common and represent a risk factor for the development of psychopathology, particularly depression. Research has focused on alterations in autonomic nervous system (ANS) functioning as a mediator of negative mental health outcomes associated with ELM. Early alterations in autonomic vagal activity (vmHRV) may moderate the relationship between ELM and depression, particularly when considering forms of emotional maltreatment. Recent evidence suggests that the relationships of both ELM and vmHRV with depression may be non-linear, particularly considering females.Objective: Building on and extending theoretical considerations and previous work, the present work aims to further the current understanding of the complex relationships between ELM exposure, vmHRV, and depression.Methods: This study uses an adaptive modelling approach, combining exploratory network-based analyses with linear and quadratic moderation analyses, drawing on a large sample of males and females across adolescence (total N = 213; outpatient at-risk sample and healthy controls) and adulthood (total N = 85; community-based convenience sample).Results: Exploratory network-based analyses reveal that exposure to emotional abuse is particularly central within a network of ELM subtypes, depressive symptoms, and concurrent vmHRV in both adolescents and adults. In adults, emotional neglect shows strong associations with both emotional abuse and vmHRV and is highly central as a network node, which is not observed in adolescents. Moderator analyses reveal significant interactions between emotional maltreatment and vmHRV predicting depressive symptoms in adult females. Significant quadratic relationships of emotional maltreatment and vmHRV with depression are observed in both adolescent and adult females.Conclusions: The present findings contribute to the understanding of the psychological and physiological mechanisms by which ELM acts as a risk factor for the development of depression. Ultimately, this will contribute to the development of targeted and effective intervention strategies to mitigate the detrimental effects of early adversity.

背景:早年遭受虐待(ELM)的经历非常普遍,令人震惊,是导致精神病理学(尤其是抑郁症)发展的一个危险因素。研究主要集中于自律神经系统(ANS)功能的改变,将其视为与早期虐待相关的负面心理健康结果的中介因素。自律神经迷走神经活动(vmHRV)的早期改变可能会缓和 ELM 与抑郁症之间的关系,尤其是在考虑到情感虐待的形式时。最近的证据表明,ELM和vmHRV与抑郁症的关系可能是非线性的,尤其是女性:本研究以理论考虑和先前的工作为基础并加以扩展,旨在进一步加深当前对 ELM 暴露、vmHRV 和抑郁之间复杂关系的理解:本研究采用了一种适应性建模方法,将基于网络的探索性分析与线性和二次模态分析相结合,并利用了青少年期(总人数=213人;门诊高危样本和健康对照组)和成年期(总人数=85人;社区便利样本)的大量男性和女性样本:基于网络的探索性分析显示,在青少年和成年人中,遭受情感虐待在ELM亚型、抑郁症状和并发vmHRV网络中尤为重要。在成人中,情感忽视与情感虐待和vmHRV都有很强的相关性,并且作为一个网络节点具有高度的中心性,而在青少年中却没有观察到这一点。调节器分析显示,情感虐待与 vmHRV 之间存在显著的交互作用,可预测成年女性的抑郁症状。在青少年和成年女性中,情感虐待和vmHRV与抑郁症之间均存在显著的二次关系:本研究结果有助于人们了解 ELM 作为抑郁症发病风险因素的心理和生理机制。最终,这将有助于制定有针对性的有效干预策略,以减轻早期逆境的有害影响。
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引用次数: 0
Posttraumatic stress and depression symptom classes in parents of trauma-exposed children: a transdiagnostic perspective using pooled individual participant data. 受创伤儿童父母的创伤后应激和抑郁症状分类:利用汇集的个人参与者数据的跨诊断视角。
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI: 10.1080/20008066.2023.2299194
Yaara Sadeh, Leila Graham, Michael Curtis, Melissa Janson, Jeeeun Kim, Ashlyn Schwartz, Andrea Undset, Anna Denejkina

Background: In the aftermath of child trauma, post-traumatic stress (PTS) and depression symptoms often co-occur among trauma exposed children and their parents. Studies have used latent class analysis (LCA) to examine PTS and depression symptoms and identify homogeneous subgroups among trauma exposed children. However, little is known about subgroups or classes of PTS and depression reactions of parents of traumatised children.Objectives: (1) Determine PTS and depression symptom classes at 2-9 months post-trauma, and (2) to examine sociodemographic covariates among parents of trauma exposed children.Methods: Using harmonised individual participant data (n = 702) from eight studies (Australia, UK, US) included in the Prospective studies of Acute Child Trauma and Recovery Data Archive (PACT/R), we modelled these phenomena at the symptom level using LCA.Results: Our LCA yielded three solutions: 'high internalizing symptom' class (11%); 'low PTS-high depression' class (17%); and 'low internalizing symptom' class (72%). Parents of children in the 'low PTS-high depression' class were more likely to have children of older age and be part of an ethnic minority, compared to the 'low internalizing symptoms' class. Mothers were more likely to be in the 'high internalizing symptom' class compared to the 'low internalizing symptoms' class.Conclusions: These findings reveal a qualitative structure and relationship between depression and PTS symptoms that highlights the importance of assessing and targeting a broad range of internalising symptoms in post-trauma psychological treatment.

背景:儿童遭受创伤后,创伤后应激反应(PTS)和抑郁症状往往同时出现在遭受创伤的儿童及其父母身上。研究使用潜类分析法(LCA)来检查创伤后应激反应和抑郁症状,并在受创伤儿童中识别同质亚组。目标:(1) 确定创伤后 2-9 个月的创伤后应激障碍和抑郁症状等级;(2) 研究受创伤儿童父母的社会人口协变量:方法:利用 "急性儿童创伤和康复数据档案前瞻性研究"(PACT/R)中包含的八项研究(澳大利亚、英国、美国)的统一个人参与者数据(n = 702),我们使用 LCA 在症状水平上对这些现象进行了建模:结果:我们的 LCA 得出了三种解决方案:高内化症状 "类(11%)、"低创伤后应激反应-高抑郁 "类(17%)和 "低内化症状 "类(72%)。与 "低内化症状 "类别相比,"低创伤后应激反应-高抑郁 "类别中儿童的父母更有可能有年龄较大的子女,也更有可能是少数民族。与 "低内化症状 "类别相比,母亲更有可能属于 "高内化症状 "类别:这些发现揭示了抑郁症和创伤后应激障碍症状之间的定性结构和关系,强调了在创伤后心理治疗中评估和针对各种内化症状的重要性。
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引用次数: 0
Mental healthcare utilisation among Danish formerly deployed military personnel and their civilian counterparts: a cohort study. 丹麦退役军人及其文职人员的心理保健使用情况:一项队列研究。
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-01-16 DOI: 10.1080/20008066.2023.2296188
Christian Ditlev Gabriel Stoltenberg, Mia Sadowa Vedtofte, Anni Brit Sternhagen Nielsen, Søren Bo Andersen, Volkert Siersma, Kaj Sparle Christensen, Merete Osler

Background: Prior studies comparing the mental healthcare utilisation (MHU) of Danish formerly deployed military personnel (FDP) with the general population have not included data on psychotherapy through the Defence or talking therapy with the general practitioner. This study included these and several other data sources in a comprehensive comparison of MHU between Danish FDP and civilians.Methods: First-time deployed military personnel (N = 10,971) who had returned from a mission to Kosovo, Afghanistan, Iraq or Lebanon between January 2005 and July 2017 were included. A sex and birth-year-matched civilian reference group was randomly drawn from the entire Danish non-deployed population (N = 253,714). Furthermore, a sub-cohort, including male FDP and civilians deemed eligible for military service, was defined. These cohorts were followed up in military medical records and registers covering the primary and secondary civilian health sectors from 2005 to 2018, and the rates of MHU were compared.Results: Approximately half of the initial help-seeking for FDP took place through the Defence (49.4%), and the remainder through the civilian healthcare system. When help-seeking through the Defence was not included, MHU was significantly lower among FDP in the main cohort during the first two years (IRR = 0.84, 95% CI: [0.77, 0.92]) compared to civilians. When help-seeking through the Defence was included, MHU was significantly higher among FDP compared to civilians both in the first two years of follow-up (IRR = 2.01, 95% CI: [1.89, 2.13]) and thereafter (IRR = 1.18, 95% CI: [1.13, 1.23]). In the sub-cohort, these differences were even more pronounced both in the first two years of follow-up and thereafter.Conclusions: MHU was higher among Danish FDP compared to civilians only when data from the Defence was included. The inclusion of data on both civilian and military healthcare services is necessary to evaluate the full impact of deployment on MHU among Danish FDP.

背景:之前对丹麦退役军人(FDP)与普通人群的心理保健利用率(MHU)进行比较的研究并未包括国防心理治疗或全科医生谈话治疗的数据。本研究将这些数据和其他几个数据源纳入丹麦退役军人与平民的精神健康利用率的综合比较中:研究对象包括在 2005 年 1 月至 2017 年 7 月期间从科索沃、阿富汗、伊拉克或黎巴嫩执行任务归来的首次部署的军事人员(N = 10,971 人)。从整个丹麦非部署人口(N = 253,714 人)中随机抽取了一个性别和出生年份相匹配的平民参照组。此外,还定义了一个子队列,其中包括被认为有资格服兵役的男性 FDP 和平民。从2005年到2018年,这些队列在军队医疗记录和涵盖一级和二级民事卫生部门的登记册中进行了跟踪调查,并对MHU的发病率进行了比较:约有一半的退伍军人最初是通过国防部寻求帮助的(49.4%),其余则是通过民间医疗保健系统。如果不包括通过国防部门寻求帮助的情况,与平民相比,主要队列中的女性内失能者在头两年的MHU显著较低(IRR = 0.84,95% CI:[0.77, 0.92])。如果将通过国防部门寻求帮助的情况也包括在内,那么在随访的头两年(IRR = 2.01,95% CI:[1.89, 2.13])和之后(IRR = 1.18,95% CI:[1.13, 1.23]),FDP 的 MHU 都明显高于平民。在亚队列中,这些差异在随访的头两年及其后更为明显:只有在纳入国防数据时,丹麦国防军的 MHU 才高于平民。要评估部署对丹麦国防军 MHU 的全面影响,有必要同时纳入民事和军事医疗服务数据。
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引用次数: 0
A qualitative investigation of gender-based violence prevention and response using digital technologies in low resource settings and refugee populations. 在低资源环境和难民人口中使用数字技术预防和应对性别暴力的定性调查。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-05-09 DOI: 10.1080/20008066.2024.2347106
Luissa Vahedi, Lindsay Stark, Rachel Ding, Caroline Masboungi, Dorcas Erskine, Catherine Poulton, Ilana Seff

Background: Governmental and non-governmental organizations across medical, legal, and psychosocial sectors providing care to survivors of gender-based violence (GBV) and their families rapidly digitalized services during the COVID-19 pandemic. GBV prevention/response services working with women and children who are forcibly displaced and/or living in low-and-middle income countries (LMIC) were no exception to the rapid digitalization trend. Literature is lacking a critical synthesis of best practices and lessons learned since digitalization replaced major operations involved in GBV prevention/response.Objective: This research qualitatively investigated how GBV service providers, located in a range of socio-political settings, navigated the process of digitalizing GBV prevention/response during the COVID-19 crisis.Method: Semi-structured key informant interviews (KII) with GBV service providers in varied sectors were implemented virtually (2020-2021) in Brazil, Guatemala, Iraq, and Italy (regarding forcibly displaced women/girls for the latter). Participants were recruited using purposive and snowball sampling. Interview guides covered a range of topics: perceived changes in violence and service provision, experiences with virtual services, system coordination, and challenges. The KIIs were conducted in Portuguese, Spanish, Arabic, and Italian. Interviews were audio-recorded, transcribed, and translated into English. The research team conducted thematic analysis within and between countries using a structured codebook of data driven and theory driven codes.Results: Major themes concerned the: (1) spectrum of services that were digitalized during the COVID-19 crisis; (2) gender digital divide as a barrier to equitable, safe, and effective service digitalization; (3) digital violence as an unintended consequence of increased digitalization across social/public services.Conclusion: Digitalization is a balancing act with respect to (1) the variety of remotely-delivered services that are possible and (2) the access/safety considerations related to the gender digital divide and digital violence.

背景:在 COVID-19 大流行期间,为性别暴力 (GBV) 幸存者及其家人提供护理的医疗、法律和心理社会部门的政府和非政府组织迅速实现了服务数字化。为被迫流离失所和/或生活在中低收入国家(LMIC)的妇女和儿童提供的性别暴力预防/响应服务也不例外地出现了快速数字化的趋势。自数字化取代性别暴力预防/响应的主要业务以来,文献中缺乏对最佳实践和经验教训的重要综述:本研究定性调查了在 COVID-19 危机期间,处于不同社会政治环境中的性别暴力服务提供者是如何引导性别暴力预防/响应数字化进程的:在巴西、危地马拉、伊拉克和意大利(后者涉及被迫流离失所的妇女/女童),对不同部门的性别暴力服务提供者进行了半结构化关键信息提供者访谈(KII)。通过有目的的抽样和滚雪球抽样招募参与者。访谈指南涵盖了一系列主题:对暴力和服务提供变化的看法、虚拟服务的经验、系统协调和挑战。KII 访谈以葡萄牙语、西班牙语、阿拉伯语和意大利语进行。对访谈进行了录音、转录并翻译成英文。研究小组使用数据驱动和理论驱动的结构化编码手册,在国家内部和国家之间进行了主题分析:主要专题涉及(1) COVID-19 危机期间数字化服务的范围;(2) 性别数字鸿沟是实现公平、安全和有效服务数字化的障碍;(3) 数字暴力是社会/公共服务领域数字化增加的意外后果:结论:数字化是一种平衡行为,涉及(1)各种可能的远程交付服务,以及(2)与性别数字鸿沟和数字暴力有关的访问/安全考虑。
{"title":"A qualitative investigation of gender-based violence prevention and response using digital technologies in low resource settings and refugee populations.","authors":"Luissa Vahedi, Lindsay Stark, Rachel Ding, Caroline Masboungi, Dorcas Erskine, Catherine Poulton, Ilana Seff","doi":"10.1080/20008066.2024.2347106","DOIUrl":"10.1080/20008066.2024.2347106","url":null,"abstract":"<p><p><b>Background:</b> Governmental and non-governmental organizations across medical, legal, and psychosocial sectors providing care to survivors of gender-based violence (GBV) and their families rapidly digitalized services during the COVID-19 pandemic. GBV prevention/response services working with women and children who are forcibly displaced and/or living in low-and-middle income countries (LMIC) were no exception to the rapid digitalization trend. Literature is lacking a critical synthesis of best practices and lessons learned since digitalization replaced major operations involved in GBV prevention/response.<b>Objective:</b> This research qualitatively investigated how GBV service providers, located in a range of socio-political settings, navigated the process of digitalizing GBV prevention/response during the COVID-19 crisis.<b>Method:</b> Semi-structured key informant interviews (KII) with GBV service providers in varied sectors were implemented virtually (2020-2021) in Brazil, Guatemala, Iraq, and Italy (regarding forcibly displaced women/girls for the latter). Participants were recruited using purposive and snowball sampling. Interview guides covered a range of topics: perceived changes in violence and service provision, experiences with virtual services, system coordination, and challenges. The KIIs were conducted in Portuguese, Spanish, Arabic, and Italian. Interviews were audio-recorded, transcribed, and translated into English. The research team conducted thematic analysis within and between countries using a structured codebook of data driven and theory driven codes.<b>Results:</b> Major themes concerned the: (1) spectrum of services that were digitalized during the COVID-19 crisis; (2) gender digital divide as a barrier to equitable, safe, and effective service digitalization; (3) digital violence as an unintended consequence of increased digitalization across social/public services.<b>Conclusion:</b> Digitalization is a balancing act with respect to (1) the variety of remotely-delivered services that are possible and (2) the access/safety considerations related to the gender digital divide and digital violence.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2347106"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11085956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The mental health and traumatic experiences of mothers of children with 22q11DS. 22q11DS 患儿母亲的心理健康和创伤经历。
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-05-23 DOI: 10.1080/20008066.2024.2353532
Alexandra Finless, Andrea L Rideout, Ting Xiong, Holly Carbyn, Patricia Lingley-Pottie, Lisa D Palmer, Andrea Shugar, Donna M McDonald-McGinn, Patrick J McGrath, Anne S Bassett, Cheryl Cytrynbaum, Matt Orr, Ann Swillen, Sandra Meier

Background: 22q11 Deletion Syndrome (22q11DS) is the most common microdeletion syndrome with broad phenotypic variability, leading to significant morbidity and some mortality. The varied health problems associated with 22q11DS and the evolving phenotype (both medical and developmental/behavioural) across the lifespan can strongly impact the mental health of patients as well as their caregivers. Like caregivers of children with other chronic diseases, caregivers of children with 22q11DS may experience an increased risk of traumatisation and mental health symptoms.Objective: The study's primary objective was to assess the frequency of traumatic experiences and mental health symptoms among mothers of children with 22q11DS. The secondary objective was to compare their traumatic experiences to those of mothers of children with other neurodevelopmental disorders (NDDs).Method: A total of 71 mothers of children diagnosed with 22q11DS completed an online survey about their mental health symptoms and traumatic experiences. Descriptive statistics were used to summarise the prevalence of their mental health symptoms and traumatic experiences. Logistic regression models were run to compare the traumatic experiences of mothers of children with 22q11DS to those of 335 mothers of children with other neurodevelopmental disorders (NDDs).Results: Many mothers of children with 22q11DS experienced clinically significant mental health symptoms, including depression (39%), anxiety (25%), and post-traumatic stress disorder (PTSD) symptoms (30%). The types of traumatic events experienced by mothers of children with 22q11DS differed from those of mothers of children with other NDDs as they were more likely to observe their child undergoing a medical procedure, a life-threatening surgery, or have been with their child in the intensive care unit.Conclusion: 22q11DS caregivers are likely to require mental health support and trauma-informed care, tailored to the specific needs of this population as they experience different kinds of traumatic events compared to caregivers of children with other NDDS.

背景:22q11缺失综合征(22q11DS)是最常见的微缺失综合征,具有广泛的表型变异性,可导致严重的发病率和死亡率。与 22q11DS 相关的各种健康问题以及在整个生命周期中不断变化的表型(包括医学和发育/行为)会对患者及其护理人员的心理健康产生严重影响。与其他慢性病患儿的照顾者一样,22q11DS患儿的照顾者也可能面临更高的精神创伤和心理健康症状风险:研究的首要目标是评估 22q11DS 患儿母亲的创伤经历和心理健康症状的频率。次要目标是将她们的创伤经历与其他神经发育障碍(NDDs)患儿母亲的创伤经历进行比较:共有 71 位被确诊为 22q11DS 儿童的母亲完成了有关其心理健康症状和创伤经历的在线调查。我们使用描述性统计来总结她们的心理健康症状和创伤经历的发生率。我们使用逻辑回归模型将 22q11DS 患儿母亲的创伤经历与 335 名其他神经发育障碍(NDD)患儿母亲的创伤经历进行了比较:结果:许多 22q11DS 患儿的母亲都有明显的临床心理健康症状,包括抑郁(39%)、焦虑(25%)和创伤后应激障碍(PTSD)症状(30%)。22q11DS患儿的母亲所经历的创伤事件类型与其他NDDS患儿的母亲不同,因为她们更有可能观察到自己的孩子正在接受医疗程序、危及生命的手术或曾在重症监护室陪伴自己的孩子。
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引用次数: 0
Do multigenerational homes moderate the intergenerational transmission of maternal adverse childhood experiences? 多代同堂的家庭会减缓母亲不良童年经历的代际传播吗?
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-05-29 DOI: 10.1080/20008066.2024.2355757
Yantong Zhu, Gengli Zhang, Shuwei Zhan, Dandan Jiao, Tokie Anme

ABSTRACTBackground: Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.Objective: This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children's behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.Participants and setting: Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.Methods: Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children's behavioural problems. This study used a moderated mediation model.Results: The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children's behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children's behaviour problems via psychological distress.Conclusion: Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.

摘要背景:母亲的不良童年经历(ACEs)可能会导致儿童行为问题的增加。然而,心理困扰和体罚这两种常见的母亲ACE代际传递机制在这些关系中的中介作用尚未在中国样本中得到研究。多代同堂家庭(MGH)是中国的主要居住安排,但有关多代同堂家庭对母亲ACE代际传播影响的研究却十分有限:本研究探讨了体罚和心理困扰对母亲ACE与儿童行为之间关系的平行中介效应,以及家庭寄宿制能否加强或削弱母亲ACE与体罚或心理困扰之间的关系:方法:母亲在网上填写调查问卷,并将其作为一项研究的一部分:母亲填写在线问卷,测量ACE、心理困扰、体罚、家庭结构和儿童行为问题。本研究采用了调节中介模型:结果:研究结果表明,心理困扰和体罚对母亲的 ACE 与儿童行为问题之间的联系起着中介作用。研究发现,体罚的中介作用取决于母亲及其子女是否居住在玛雅卫生院。在通过心理困扰调节母亲的ACE与儿童行为问题之间的间接关系方面,没有发现母婴健康院起到调节作用:我们的研究结果表明,在设计针对中国母亲及其子女(尤其是居住在多发性硬化病院的母亲及其子女)的干预措施时,解决心理困扰和体罚问题非常重要。
{"title":"Do multigenerational homes moderate the intergenerational transmission of maternal adverse childhood experiences?","authors":"Yantong Zhu, Gengli Zhang, Shuwei Zhan, Dandan Jiao, Tokie Anme","doi":"10.1080/20008066.2024.2355757","DOIUrl":"10.1080/20008066.2024.2355757","url":null,"abstract":"<p><p><b>ABSTRACT</b><b>Background:</b> Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.<b>Objective:</b> This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children's behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.<b>Participants and setting:</b> Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.<b>Methods:</b> Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children's behavioural problems. This study used a moderated mediation model.<b>Results:</b> The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children's behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children's behaviour problems via psychological distress.<b>Conclusion:</b> Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2355757"},"PeriodicalIF":5.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
European Journal of Psychotraumatology
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