Skip to main content

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
Cancel
×
×
Home
  • Home
Article
  • Cited by 4
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Fazel, Mina and Betancourt, Theresa S 2017. Preventive mental health interventions for refugee children and adolescents in high-income settings. The Lancet Child & Adolescent Health,

    Dawson, Katie Joscelyne, Amy Meijer, Catherine Steel, Zachary Silove, Derrick and Bryant, Richard A 2017. A controlled trial of trauma-focused therapy versus problem-solving in Islamic children affected by civil conflict and disaster in Aceh, Indonesia. Australian & New Zealand Journal of Psychiatry, p. 000486741771433.

    Fazel, M. 2017. Psychological and psychosocial interventions for refugee children resettled in high-income countries. Epidemiology and Psychiatric Sciences, p. 1.

    Nocon, Agnes Eberle-Sejari, Rima Unterhitzenberger, Johanna and Rosner, Rita 2017. The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis. European Journal of Psychotraumatology, Vol. 8, Issue. sup2, p. 1388709.

    ×
  • Access

Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: Meta-analysis

  • Nexhmedin Morina (a1), Mina Malek (a2), Angela Nickerson (a3) and Richard A. Bryant (a3)
Abstract
Background

The majority of survivors of mass violence live in low- and middle-income countries (LMICs).

 Aims

To synthesise empirical findings for psychological interventions for children and adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.

 Method

Randomised controlled trials with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21812 records were found through July 2016 in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended guidelines.

 Results

Twenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes (g = 1.15) and a medium controlled effect size (g = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and small respectively.

 Conclusions

Psychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted approaches are needed for depressive responses.
      • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: Meta-analysis
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: Meta-analysis
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: Meta-analysis
      Available formats
      ×
Copyright
COPYRIGHT: © Royal College of Psychiatrists, 2017 
Corresponding author
Nexhmedin Morina, University of Münster, Fliednerstr. 21, 48149 Münster, Germany. Email: morina@uni-muenster.de
Footnotes
Hide All
†

See editorial, pp. 243–244, this issue.

Declaration of interest

None.

Footnotes
References
Hide All
1 Pettersson, T, Wallensteen, P. Armed conflicts, 1946–2014. J Peace Res 2015; 52: 536–50.
2 Marshall, MG, Cole, BR. Global Report 2009: Conflict, Governance, and State Fragility. George Mason University Center for Systemic Peace and Center for Global Policy, 2009.
3 Bartov, O. Mirrors of Destruction: War, Genocide and Modern Identity. Oxford University Press, 2000.
4 Brundtland, GH. Mental health of refugees, internally displaced persons and other populations affected by conflict. Acta Psychiatr Scand 2000; 102: 159–61.
5 Steel, Z, Chey, T, Silove, D, Marnane, C, Bryant, RA, van Ommeren, M. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. #JAMA# 2009; #302#: 537–49.
6 Priebe, S, Bogic, M, Ajdukovic, D, Franciskovic, T, Galeazzi, GM, Kucukalic, A, et al. Mental disorders following war in the Balkans: a study in 5 countries. Arch Gen Psychiatry 2010; 67: 518–28.
7 Nemeroff, CB, Bremner, JD, Foa, EB, Mayberg, HS, North, CS, Stein, MB. Posttraumatic stress disorder: a state-of-the-science review. J Psychiatr Res 2006; 40: 1–21.
8 Morina, N, Wicherts, JM, Lobbrecht, J, Priebe, S. Remission from post-traumatic stress disorder in adults: a systematic review and meta-analysis of long term outcome studies. Clin Psychol Rev 2014; 34: 249–55.
9 Kessler, RC, Aguilar-Gaxiola, S, Alonso, J, Chatterji, S, Lee, S, Ormel, J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc 2009; 18: 23–33.
10 Collins, PY, Patel, V, Joestl, SS, March, D, Insel, TR, Daar, AS, et al. Grand challenges in global mental health. Nature 2011; 475: 27–30.
11 World Health Organization. Caring for Children and Adolescents with Mental Disorders. WHO, 2003.
12 Belfer, ML, Remschmidt, H, Nurcombe, B, Okasha, A, Sartorius, N. A global programme for child and adolescent mental health: a challenge in the new millenium. In The Mental Health of Children and Adolescents: An Area of Global Neglect (eds Remschmidt, H, Nurcombe, B, Belfer, ML, Sartorius, N, Okasha, A): 11–111. Wiley, 2007.
13 Morina, N, Rushiti, F, Salihu, M, Ford, JD. Psychopathology and well-being in civilian survivors of war seeking treatment: a follow-up study. Clin Psychol Psychother 2010; 17: 79–86.
14 Tol, WA, Barbui, C, Galappatti, A, Silove, D, Betancourt, TS, Souza, R, et al. Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet 2011; 378: 1581–91.
15 Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009; 62: 1006–12.
16 Uppsala Conflict Data Program. UCDP Conflict Encyclopedia. UCDP (www.ucdp.uu.se/database).
17 Higgins, JPT, Altman, DG, Sterne, JAC. Assessing risk of bias in included studies. In Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (eds Higgins, JPT, Green, S). Cochrane Collaboration, 2011.
18 Lipsey, MW, Wilson, DB. Practical Meta-Analysis. Sage, 2001.
19 Borenstein, M, Hedges, LV, Higgins, JPT, Rothstein, HR. Software. In Introduction To Meta-Analysis. Wiley, 2009.
20 Field, AP, Gillett, R. How to do a meta-analysis. Br J Math Stat Psychol 2010; 63: 665–94.
21 Cohen, J. Statistical Power Analysis for the Behavioral Sciences. Erlbaum, 1988.
22 Sterne, JAC, Sutton, AJ, Ioannidis, JPA, Terrin, N, Jones, DR, Lau, J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 2011; 343: d4002.
23 Duval, S, Tweedie, R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000; 56: 455–63.
24 Betancourt, TS, McBain, R, Newnham, EA, Akinsulure-Smith, AM, Brennan, RT, Weisz, JR, et al. A behavioral intervention for war-affected youth in Sierra Leone: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry 2014; 53: 1288–97.
25 Bolton, P, Bass, J, Betancourt, T, Speelman, L, Onyango, G, Clougherty, KF, et al. Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. JAMA 2007; 298: 519–27.
26 Catani, C, Kohiladevy, M, Ruf, M, Schauer, E, Elbert, T, Neuner, F. Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka. BMC Psychiatry 2009; 9: 22.
27 Ertl, V, Pfeiffer, A, Schauer, E, Elbert, T, Neuner, F. Community-implemented trauma therapy for former child soldiers in northern Uganda: a randomized controlled trial. JAMA 2011; 306: 503–12.
28 Gordon, JS, Staples, JK, Blyta, A, Bytyqi, M, Wilson, AT. Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: a randomized controlled trial. J Clin Psychiatry 2008; 69: 1469–76.
29 Hermenau, K, Hecker, T, Schaal, S, Maedl, A, Elbert, T. Addressing post-traumatic stress and aggression by means of narrative exposure: a randomized controlled trial with ex-combatants in the eastern DRC. J Aggression Maltreat Trauma 2013; 22: 916–34.
30 Jordans, MJD, Komproe, IH, Tol, WA, Kohrt, BA, Luitel, NP, Macy, RD, et al. Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial. J Child Psychol Psychiatry 2010; 51: 818–26.
31 Layne, CM, Saltzman, WR, Poppleton, L, Burlingame, GM, Pasalic, A, Durakovic, E, et al. Effectiveness of a school-based group psychotherapy program for war-exposed adolescents: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry 2008; 47: 1048–62.
32 McMullen, J, O'Callaghan, P, Shannon, C, Black, A, Eakin, J. Group trauma-focused cognitive-behavioural therapy with former child soldiers and other war-affected boys in the DR Congo: a randomised controlled trial. J Child Psychol Psychiatry 2013; 54: 1231–41.
33 Murray, LK, Skavenski, S, Kane, JC, Mayeya, J, Dorsey, S, Cohen, JA, et al. Effectiveness of trauma-focused cognitive behavioral therapy among trauma-affected children in Lusaka, Zambia: a randomized clinical trial. JAMA Pediatr 2015; 169: 761–9.
34 O'Callaghan, P, McMullen, J, Shannon, C, Rafferty, H, Black, A. A randomized controlled trial of trauma-focused cognitive behavioral therapy for sexually exploited, war-affected Congolese girls. J Am Acad Child Adolesc Psychiatry 2013; 52: 359–69.
35 O'Callaghan, P, Branham, L, Shannon, C, Betancourt, TS, Dempster, M, McMullen, J. A pilot study of a family focused, psychosocial intervention with war-exposed youth at risk of attack and abduction in North-Eastern Democratic Republic of Congo. Child Abuse Negl 2014; 38: 1197–207.
36 O'Callaghan, P, McMullen, J, Shannon, C, Rafferty, H. Comparing a trauma focused and non trauma focused intervention with war affected Congolese youth: a preliminary randomised trial. Intervention 2015; 13: 28–44.
37 Peltonen, K, Qouta, S, El Sarraj, E, Punamaki, R. Effectiveness of school-based intervention in enhancing mental health and social functioning among war-affected children. Traumatology 2012; 18: 37–46.
38 Qouta, SR, Palosaari, E, Diab, M, Punamaki, R. Intervention effectiveness among war-affected children: a cluster randomized controlled trial on improving mental health. J Trauma Stress 2012; 25: 288–98.
39 Schaal, S, Elbert, T, Neuner, F. Narrative exposure therapy versus interpersonal psychotherapy. A pilot randomized controlled trial with Rwandan genocide orphans. Psychother Psychosom 2009; 78: 298–306.
40 Tol, WA, Komproe, IH, Susanty, D, Jordans, MJD, Macy, RD, De Jong, JTVM. School-based mental health intervention for children affected by political violence in Indonesia – a cluster randomized trial. JAMA 2008; 300: 655–62.
41 Tol, WA, Komproe, IH, Jordans, MJD, Vallipuram, A, Sipsma, H, Sivayokan, S, et al. Outcomes and moderators of a preventive school-based mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial. World Psychiatry 2012; 11: 114–22.
42 Tol, WA, Komproe, IH, Jordans, MJD, Ndayisaba, A, Ntamutumba, P, Sipsma, H, et al. School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial. BMC Med 2014; 12: 56.
43 Khamis, V, Macy, R, Coignez, V. The Impact of the Classroom/Community/Camp-Based Intervention (CBI) Program on Palestinian Children. Save the Children, 2004.
44 Schauer, M. Trauma Treatment for Children in War: Build-up of an Evidence-Based Large-scale Mental Health Intervention in North-Eastern Sri Lanka [Doctoral thesis]. University of Konstanz, 2008.
45 Miller, KE, Rasmussen, A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med 2010; 70: 7–16.
46 De Jong, JT, Komproe, IH, Van Ommeren, M, El Masri, M, Araya, M, Khaled, N, et al. Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA 2001; 286: 555–62.
47 Hesser, H, Weise, C, Rief, W, Andersson, G. The effect of waiting: a meta-analysis of wait-list control groups in trials for tinnitus distress. J Psychosom Res 2011; 70: 378–84.
48 Kohrt, BA, Rasmussen, A, Kaiser, BN, Haroz, EE, Maharjan, SM, Mutamba, BB, et al. Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology. Int J Epidemiol 2014; 43: 365–406.
49 Tol, WA, Patel, V, Tomlinson, M, Baingana, F, Galappatti, A, Panter-Brick, C, et al. Research priorities for mental health and psychosocial support in humanitarian settings. PLoS Med 2011; 8: e1001096.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *

CAPTCHA *

Skip to the audio challenge
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 63 *
Loading metrics...

Abstract views

Total abstract views: 110 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 23rd April 2018. This data will be updated every 24 hours.

  • Cited by 4
  • Cited by
    Crossref Citations
    Crossref logo
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Fazel, Mina and Betancourt, Theresa S 2017. Preventive mental health interventions for refugee children and adolescents in high-income settings. The Lancet Child & Adolescent Health,

    Dawson, Katie Joscelyne, Amy Meijer, Catherine Steel, Zachary Silove, Derrick and Bryant, Richard A 2017. A controlled trial of trauma-focused therapy versus problem-solving in Islamic children affected by civil conflict and disaster in Aceh, Indonesia. Australian & New Zealand Journal of Psychiatry, p. 000486741771433.

    Fazel, M. 2017. Psychological and psychosocial interventions for refugee children resettled in high-income countries. Epidemiology and Psychiatric Sciences, p. 1.

    Nocon, Agnes Eberle-Sejari, Rima Unterhitzenberger, Johanna and Rosner, Rita 2017. The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis. European Journal of Psychotraumatology, Vol. 8, Issue. sup2, p. 1388709.

    ×
  • Access

Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: Meta-analysis

  • Nexhmedin Morina (a1), Mina Malek (a2), Angela Nickerson (a3) and Richard A. Bryant (a3)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *

Cancel
Confirm
×