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 24
  • 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.
    Sim, Amanda Fazel, Mina Bowes, Lucy and Gardner, Frances 2018. Pathways linking war and displacement to parenting and child adjustment: A qualitative study with Syrian refugees in Lebanon. Social Science & Medicine, Vol. 200, Issue. , p. 19.
    Kane, J. C. Luitel, N. P. Jordans, M. J. D. Kohrt, B. A. Weissbecker, I. and Tol, W. A. 2018. Mental health and psychosocial problems in the aftermath of the Nepal earthquakes: findings from a representative cluster sample survey. Epidemiology and Psychiatric Sciences, Vol. 27, Issue. 03, p. 301.
    Dowling, Alison Enticott, Joanne and Russell, Grant 2017. Measuring self-rated health status among resettled adult refugee populations to inform practice and policy – a scoping review. BMC Health Services Research, Vol. 17, Issue. 1,
    Jayawickreme, Nuwan Mootoo, Candace Fountain, Christine Rasmussen, Andrew Jayawickreme, Eranda and Bertuccio, Rebecca F. 2017. Post-conflict struggles as networks of problems: A network analysis of trauma, daily stressors and psychological distress among Sri Lankan war survivors. Social Science & Medicine, Vol. 190, Issue. , p. 119.
    Tay, A K Jayasuriya, R Jayasuriya, D and Silove, D 2017. Twelve-month trajectories of depressive and anxiety symptoms and associations with traumatic exposure and ongoing adversities: a latent trajectory analysis of a community cohort exposed to severe conflict in Sri Lanka. Translational Psychiatry, Vol. 7, Issue. 8, p. e1200.
    Miller, K. E. and Rasmussen, A. 2017. The mental health of civilians displaced by armed conflict: an ecological model of refugee distress. Epidemiology and Psychiatric Sciences, Vol. 26, Issue. 02, p. 129.
    Riley, Andrew Varner, Andrea Ventevogel, Peter Taimur Hasan, M. M. and Welton-Mitchell, Courtney 2017. Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh. Transcultural Psychiatry, Vol. 54, Issue. 3, p. 304.
    Miller, Kenneth E. and Jordans, Mark J. D. 2016. Determinants of Children’s Mental Health in War-Torn Settings: Translating Research Into Action. Current Psychiatry Reports, Vol. 18, Issue. 6,
    Budosan, Boris Aziz, Sabah Benner, Marie Theres and Abras, Batoul 2016. Perceived needs and daily stressors in an urban refugee setting. Intervention, Vol. 14, Issue. 3, p. 293.
    Alfadhli, Khalifah and Drury, John 2016. Psychosocial support among refugees of conflict in developing countries. Intervention, Vol. 14, Issue. 2, p. 128.
    Shing, Elaine Z. Jayawickreme, Eranda and Waugh, Christian E. 2016. Contextual Positive Coping as a Factor Contributing to Resilience After Disasters. Journal of Clinical Psychology, Vol. 72, Issue. 12, p. 1287.
    Hassan, G. Ventevogel, P. Jefee-Bahloul, H. Barkil-Oteo, A. and Kirmayer, L. J. 2016. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiology and Psychiatric Sciences, Vol. 25, Issue. 02, p. 129.
    De Schryver, Maarten Vindevogel, Sofie Rasmussen, Andrew E. and Cramer, Angélique O. J. 2015. Unpacking Constructs: A Network Approach for Studying War Exposure, Daily Stressors and Post-Traumatic Stress Disorder. Frontiers in Psychology, Vol. 6, Issue. ,
    Tay, Alvin Kuowei Rees, Susan Chan, Jack Kareth, Moses and Silove, Derrick 2015. Examining the broader psychosocial effects of mass conflict on PTSD symptoms and functional impairment amongst West Papuan refugees resettled in Papua New Guinea (PNG). Social Science & Medicine, Vol. 132, Issue. , p. 70.
    Ayazi, Touraj Swartz, Leslie Eide, Arne H Lien, Lars and Hauff, Edvard 2015. Perceived current needs, psychological distress and functional impairment in a war-affected setting: a cross-sectional study in South Sudan. BMJ Open, Vol. 5, Issue. 8, p. e007534.
    Tay, Alvin Kuowei Rees, Susan Chen, Jack Kareth, Moses Mohsin, Mohammed and Silove, Derrick 2015. The Refugee-Mental Health Assessment Package (R-MHAP); rationale, development and first-stage testing amongst West Papuan refugees. International Journal of Mental Health Systems, Vol. 9, Issue. 1,
    Tol, W. A. Purgato, M. Bass, J. K. Galappatti, A. and Eaton, W. 2015. Mental health and psychosocial support in humanitarian settings: a public mental health perspective. Epidemiology and Psychiatric Sciences, Vol. 24, Issue. 06, p. 484.
    Tay, Alvin Kuowei Rees, Susan Chen, Jack Kareth, Moses and Silove, Derrick 2015. Pathways from conflict-related trauma and ongoing adversity to posttraumatic stress disorder symptoms amongst West Papuan refugees: The mediating role of anxiety and panic-like symptoms. Comprehensive Psychiatry, Vol. 63, Issue. , p. 36.
    Jordans, M. J. D. and Tol, W. A. 2015. Mental health and psychosocial support for children in areas of armed conflict: call for a systems approach. BJPsych. International, Vol. 12, Issue. 03, p. 72.
    Tay, Alvin Kuowei Rees, Susan Chen, Jack Kareth, Moses and Silove, Derrick 2015. The coherence and correlates of intermittent explosive disorder amongst West Papuan refugees displaced to Papua New Guinea. Journal of Affective Disorders, Vol. 177, Issue. , p. 86.
    Download full list
    ×
  • Access

Role of current perceived needs in explaining the association between past trauma exposure and distress in humanitarian settings in Jordan and Nepal

  • Mark J. D. Jordans (a1), Maya Semrau (a2), Graham Thornicroft (a2) and Mark van Ommeren (a3)
Abstract
Background

Attention is increasingly shifting towards the role of daily stressors in explaining mental health outcomes in humanitarian emergencies.

 Aims

To assess the role of current perceived needs in explaining the association between past traumatic exposure and distress in humanitarian settings.

 Method

A series of mediator analyses were conducted, using data from Jordan (displaced Iraqi people) and Nepal (Bhutanese refugees). The General Health Questionnaire (GHQ-12), the newly developed Humanitarian Emergency Settings Perceived Needs Scale (HESPER) and the traumatic events list of the Composite International Diagnostic Interview (CIDI) were used as measures of distress, current perceived needs and past traumatic events respectively.

 Results

Current perceived needs were found to mediate the association between past traumatic exposure and distress in Jordan and, less strongly, in Nepal.

 Conclusions

An integrated approach that includes a focus on daily stressors should be adopted to mitigate the impact of traumatic exposure in humanitarian settings.
      • 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.

      Role of current perceived needs in explaining the association between past trauma exposure and distress in humanitarian settings in Jordan and Nepal
      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.

      Role of current perceived needs in explaining the association between past trauma exposure and distress in humanitarian settings in Jordan and Nepal
      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.

      Role of current perceived needs in explaining the association between past trauma exposure and distress in humanitarian settings in Jordan and Nepal
      Available formats
      ×
Copyright
COPYRIGHT: © Royal College of Psychiatrists, 2012 
Corresponding author
Mark J. D. Jordans, PhD, Health Net TPO, Lizzy Ansinghstraat 163, 1072 RG, Amsterdam, The Netherlands. Email: mark.jordans@hntpo.org
Footnotes
Hide All
∗

Joint first authors

∗∗

joint last authors.

Declaration of interest

None.

Data collection in Jordan was funded by the Jordanian Nursing Council, WHO Jordan, and the University of London Central Research Fund. Data collection in Nepal was funded by WHO Geneva and United Nation High Commissioner for Refugees Nepal; WHO Nepal providing further support. M.S. is funded by a PhD studentship grant of the Medical Research Council (UK). G.T. is funded by a National Institute for Health Research (NIHR) Applied Programme grant awarded to the South London and Maudsley NHS Foundation Trust and is affiliated with the NIHR Specialist Mental Health Biomedical Research Centre at the Institute of Psychiatry, King's College London and the South London and Maudsley NHS Foundation Trust.

Footnotes
References
Hide All
1 de Jong, JTVM, Komproe, IH, van Ommeren, M. Common mental disorders in postconflict settings. Lancet 2003; 361: 2128–30.
2 Inter-Agency Standing Committee (IASC). IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. IASC, 2007.
3 Mollica, RF, Lopes Cardozo, B, Osofsky, HJ, Raphael, B, Ager, A, Salama, P. Mental health in complex emergencies. Lancet 2004; 364: 2058–67.
4 Foa, EB, Stein, DJ, McFarlane, AC. Symptomatology and psychopathology of mental health problems after disaster. J Clin Psychiatr 2006; 67 (suppl 2): 15–25.
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. JAMA 2009; 302: 537–49.
6 de Jong, JTVM, 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.
7 Mollica, RF, Caridad, KR, Massagli, MP. Longitudinal study of posttraumatic stress disorder, depression, and changes in traumatic memories over time in Bosnian refugees. J Nerv Ment Dis 2007; 195: 572–9.
8 Karunakara, UK, Neuner, F, Schauer, M, Singh, K, Hill, K, Elbert, T, et al. Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese Nationals, refugees and Ugandans in the West Nile. Afr Health Sci 2004; 4: 83–93.
9 Medicins Sans Frontieres (MSF). Mental Health Guidelines – A Handbook for Implementing Mental Health Programmes in Areas of Mass Violence. Lightning Source UK, 2005.
10 van Ommeren, M, Saxena, S, Saraceno, B. Mental and social health during and after acute emergencies: emerging consensus? Bull World Health Organ 2005; 83: 71–6.
11 Weiss, MG, Saraceno, B, Saxena, S, van Ommeren, M. Mental health in the aftermath of disasters: consensus and controversy. J Nerv Ment Dis 2003; 191: 611–5.
12 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.
13 van Ommeren, M, Saxena, S, Saraceno, B. Aid After disasters - needs as long term public mental health perspective. BMJ 2005; 330: 1160–1.
14 Jordans, MJD, Tol, WA, Komproe, IH, Susanty, D, Vallipuram, A, Ntamatumba, P, et al. Development of a multi-layered psychosocial care system for children in areas of political violence. Int J Ment Health Syst 2010; 4: 15.
15 Semrau, M, van Ommeren, M, Blagescu, M, Griekspoor, A, Howard, LM, Jordans, MJD, et al. The development and psychometric properties of the Humanitarian Emergency Settings Perceived Needs (HESPER) Scale. Am J Public Health 2012; in press.
16 Miller, KE, Rasmussen, A. Mental health and armed conflict: the importance of distinguishing between war exposure and other sources of adversity: a response to Neuner. Soc Sci Med 2010; 71: 1385–9.
17 Neuner, F. Assisting war-torn populations – should we prioritize reducing daily stressors to improve mental health? Comment on Miller and Rasmussen (2010). Soc Sci Med 2010; 71: 1381–4.
18 Ager, A. Psychosocial needs in complex emergencies. Lancet 2002; 360: s43–4.
19 Goldberg, D. General Health Questionnaire (GHQ-12). GL Assessment Limited, 1978.
20 World Health Organization, King's College London. The Humanitarian Emergency Settings Perceived Needs Scale (HESPER): Manual with Scale. WHO, 2011.
21 World Health Organization. Composite International Diagnostic Interview (CIDI) 3.0. WHO, 2004.
22 Daradkeh, TK, Ghubash, R, El-Rufaie, OEF. Reliability, validity, and factor structure of the Arabic version of the 12-Item General Health Questionnaire. Psychol Rep 2001; 89: 85–94.
23 Koirala, NR, Regmi, SK, Sharma, VD, Khalid, A, Nepal, MK. Sensitivity and validity of the General Health Questionnaire-12 (GHQ-12) in a rural community setting in Nepal. Nepalese J Psychiatry 1999; 1: 34–40.
24 Harvard School of Medicine. The World Mental Health Survey Initiative. Harvard School of Medicine, 2005 (http://www.hcp.med.harvard.edu/wmh/index.php).
25 World Health Organization, The WHOQOL-Group, Division of Mental Health. WHOQOL-100. WHO, 1995.
26 Kish, L. A procedure for objective respondent selection within the household. J Am Stat Assoc 1949; 44: 380–7.
27 Frazier, PA, Tix, AP, Barron, KE. Testing moderator and mediator effects in counseling psychology research. J Couns Psychol 2004; 51: 115–34.
28 Baron, RM, Kenny, DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986; 51: 1173–82.
29 Preacher, KJ, Hayes, AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 2008; 40: 879–91.
30 MacKinnon, DP, Lockwood, CM, Hoffman, JM, West, SG, Sheets, V. A comparison of methods to test mediation and other intervening variable effects. Psychol Methods 2002; 7: 83–104.
31 Preacher, KJ, Hayes, AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 2008; 40: 879–91.
32 MacKinnon, DP, Lockwood, CM, Williams, J. Confidence limits for the indirect effect: distribution of the product and re-sampling methods. Multivariate Behav Res 2004; 39: 99–128.
33 Kohrt, BA, Speckman, RA, Kunz, RD, Baldwin, JL, Upadhaya, N, Acharya, NR, et al. Culture in psychiatric epidemiology: using ethnography and multiple mediator models to assess the relationship of caste with depression and anxiety in Nepal. Ann Hum Biol 2009; 36: 261–80.
34 Betancourt, TS, Brennan, RT, Rubin-Smith, J, Fitzmaurice, GM, Gilman, SE. Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health. J Am Acad Child Adolesc Psychiatry 2010; 49: 606–15.
35 Miller, KE, Omidian, P, Rasmussen, A, Yaqubi, A, Daudzai, H. Daily stressors, war experiences, and mental health in Afghanistan. Transcult Psychiatry 2008; 45: 611–38.
36 Laban, CJ, Gernaat, HBPE, Komproe, IH, Schreuders, BA, de Jong, JTVM. Impact of a long asylum procedure on the prevalence of psychiatric disorders in Iraqi Asylum seekers in the Netherlands. J Nerv Ment Dis 2004; 192: 843–51.
37 Miller, KE, Weine, SM, Ramic, A, Brkic, N, Bjedic, ZD, Smajkic, A, et al. The relative contribution of war experiences and exile-related stressors to levels of psychological distress among Bosnian refugees. J Trauma Stress 2002; 15: 377–87.
38 Porter, M, Haslam, N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 2005; 294: 602–12.
39 Brewin, CR, Andrews, B, Valentine, JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 2000; 68: 748–66.
40 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: 16 *
Loading metrics...

Abstract views

Total abstract views: 69 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 12th June 2018. This data will be updated every 24 hours.

  • Cited by 24
  • 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.
    Sim, Amanda Fazel, Mina Bowes, Lucy and Gardner, Frances 2018. Pathways linking war and displacement to parenting and child adjustment: A qualitative study with Syrian refugees in Lebanon. Social Science & Medicine, Vol. 200, Issue. , p. 19.
    Kane, J. C. Luitel, N. P. Jordans, M. J. D. Kohrt, B. A. Weissbecker, I. and Tol, W. A. 2018. Mental health and psychosocial problems in the aftermath of the Nepal earthquakes: findings from a representative cluster sample survey. Epidemiology and Psychiatric Sciences, Vol. 27, Issue. 03, p. 301.
    Dowling, Alison Enticott, Joanne and Russell, Grant 2017. Measuring self-rated health status among resettled adult refugee populations to inform practice and policy – a scoping review. BMC Health Services Research, Vol. 17, Issue. 1,
    Jayawickreme, Nuwan Mootoo, Candace Fountain, Christine Rasmussen, Andrew Jayawickreme, Eranda and Bertuccio, Rebecca F. 2017. Post-conflict struggles as networks of problems: A network analysis of trauma, daily stressors and psychological distress among Sri Lankan war survivors. Social Science & Medicine, Vol. 190, Issue. , p. 119.
    Tay, A K Jayasuriya, R Jayasuriya, D and Silove, D 2017. Twelve-month trajectories of depressive and anxiety symptoms and associations with traumatic exposure and ongoing adversities: a latent trajectory analysis of a community cohort exposed to severe conflict in Sri Lanka. Translational Psychiatry, Vol. 7, Issue. 8, p. e1200.
    Miller, K. E. and Rasmussen, A. 2017. The mental health of civilians displaced by armed conflict: an ecological model of refugee distress. Epidemiology and Psychiatric Sciences, Vol. 26, Issue. 02, p. 129.
    Riley, Andrew Varner, Andrea Ventevogel, Peter Taimur Hasan, M. M. and Welton-Mitchell, Courtney 2017. Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh. Transcultural Psychiatry, Vol. 54, Issue. 3, p. 304.
    Miller, Kenneth E. and Jordans, Mark J. D. 2016. Determinants of Children’s Mental Health in War-Torn Settings: Translating Research Into Action. Current Psychiatry Reports, Vol. 18, Issue. 6,
    Budosan, Boris Aziz, Sabah Benner, Marie Theres and Abras, Batoul 2016. Perceived needs and daily stressors in an urban refugee setting. Intervention, Vol. 14, Issue. 3, p. 293.
    Alfadhli, Khalifah and Drury, John 2016. Psychosocial support among refugees of conflict in developing countries. Intervention, Vol. 14, Issue. 2, p. 128.
    Shing, Elaine Z. Jayawickreme, Eranda and Waugh, Christian E. 2016. Contextual Positive Coping as a Factor Contributing to Resilience After Disasters. Journal of Clinical Psychology, Vol. 72, Issue. 12, p. 1287.
    Hassan, G. Ventevogel, P. Jefee-Bahloul, H. Barkil-Oteo, A. and Kirmayer, L. J. 2016. Mental health and psychosocial wellbeing of Syrians affected by armed conflict. Epidemiology and Psychiatric Sciences, Vol. 25, Issue. 02, p. 129.
    De Schryver, Maarten Vindevogel, Sofie Rasmussen, Andrew E. and Cramer, Angélique O. J. 2015. Unpacking Constructs: A Network Approach for Studying War Exposure, Daily Stressors and Post-Traumatic Stress Disorder. Frontiers in Psychology, Vol. 6, Issue. ,
    Tay, Alvin Kuowei Rees, Susan Chan, Jack Kareth, Moses and Silove, Derrick 2015. Examining the broader psychosocial effects of mass conflict on PTSD symptoms and functional impairment amongst West Papuan refugees resettled in Papua New Guinea (PNG). Social Science & Medicine, Vol. 132, Issue. , p. 70.
    Ayazi, Touraj Swartz, Leslie Eide, Arne H Lien, Lars and Hauff, Edvard 2015. Perceived current needs, psychological distress and functional impairment in a war-affected setting: a cross-sectional study in South Sudan. BMJ Open, Vol. 5, Issue. 8, p. e007534.
    Tay, Alvin Kuowei Rees, Susan Chen, Jack Kareth, Moses Mohsin, Mohammed and Silove, Derrick 2015. The Refugee-Mental Health Assessment Package (R-MHAP); rationale, development and first-stage testing amongst West Papuan refugees. International Journal of Mental Health Systems, Vol. 9, Issue. 1,
    Tol, W. A. Purgato, M. Bass, J. K. Galappatti, A. and Eaton, W. 2015. Mental health and psychosocial support in humanitarian settings: a public mental health perspective. Epidemiology and Psychiatric Sciences, Vol. 24, Issue. 06, p. 484.
    Tay, Alvin Kuowei Rees, Susan Chen, Jack Kareth, Moses and Silove, Derrick 2015. Pathways from conflict-related trauma and ongoing adversity to posttraumatic stress disorder symptoms amongst West Papuan refugees: The mediating role of anxiety and panic-like symptoms. Comprehensive Psychiatry, Vol. 63, Issue. , p. 36.
    Jordans, M. J. D. and Tol, W. A. 2015. Mental health and psychosocial support for children in areas of armed conflict: call for a systems approach. BJPsych. International, Vol. 12, Issue. 03, p. 72.
    Tay, Alvin Kuowei Rees, Susan Chen, Jack Kareth, Moses and Silove, Derrick 2015. The coherence and correlates of intermittent explosive disorder amongst West Papuan refugees displaced to Papua New Guinea. Journal of Affective Disorders, Vol. 177, Issue. , p. 86.
    Download full list
    ×
  • Access

Role of current perceived needs in explaining the association between past trauma exposure and distress in humanitarian settings in Jordan and Nepal

  • Mark J. D. Jordans (a1), Maya Semrau (a2), Graham Thornicroft (a2) and Mark van Ommeren (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
×