nach oben

Quality of Life Research

Erschienen in:

01.08.2007 | Original Paper

Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians

verfasst von: Mesfin Araya, Jayanti Chotai, Ivan H. Komproe, Joop T. V. M. de Jong

Erschienen in: Quality of Life Research | Ausgabe 6/2007

Einloggen, um Zugang zu erhalten

Abstract

Objective

An understanding of how quality of life is affected by severe trauma and mental distress may facilitate better intervention strategies for postconflict internally displaced persons, by identifying mediators, moderators, and independent risk factors. We investigate the pathways involved in this process and also study the moderating roles of coping strategies and perceived social support.

Method

A random sample of 1193 (62% women) internally displaced Ethiopian adults living in shelters in Addis Ababa were interviewed with instruments capturing the relevant concepts, including SCL-90-R and WHOQOL-BREF. Path analysis was employed to elaborate the mediating and moderating effects. Self-reported living conditions were also assessed.

Results

Mental distress increased and quality of life decreased with age. Mental distress mediated the effects of trauma in reducing the quality of life, and some trauma also reduced quality of life directly. These effects remained after adjusting for living conditions. Living conditions were related to quality of life also on their own. Coping strategies and perceived social support influenced mental distress and quality of life directly as well as indirectly by moderation, in part gender specific.

Conclusions

Intervention strategies aimed at reducing mental distress, modifying coping strategies, and encouraging social support may turn out to be useful in increasing the overall quality of life in postconflict situations, and are worth considering as complements to strategies that improve the living conditions.

Nur mit Berechtigung zugänglich

UNHCR. Internally displaced persons: questions and answers. Retrieved January 2007, from http://www.unhcr.org/basics/BASICS/405ef8c64.pdf.

de Jong, J. T. V. M, Komproe, I. H., & van Ommeren, M. et al. (2001). Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA, 286, 55–562.CrossRef

de Jong, J. T. V. M. (2002). Public mental health, traumatic stress and human rights violations in low-income countries. A culturally appropriate model in times of conflict, disaster and peace. In J. de Jong (Ed.), Trauma, war, and violence: public mental health in socio-cultural context (pp. 1–91). New York: Kluwer Academic/Plenum Publishers.

Mollica, R. F., Cui, X., & McInnes, K. et al. (2002). Science-based policy for psychosocial interventions in refugee camps: A Cambodian example. Journal of Nervous and Mental Disease, 190, 158–166.PubMedCrossRef

de Jong, J. T. V. M., Komproe, I. H., & van Ommeren, M. et al. (2003) Common mental disorders in postconflict settings. Lancet, 361, 2128–2130.PubMedCrossRef

Araya, M., Chotai, J., Komproe, I. H., de Joop, J. T. V. M. Gender differences in traumatic life events, coping strategies, perceived social support and sociodemographics among postconflict displaced persons in Ethiopia. Social Psychiatry And Psychiatric Epidemiology (in press).

Mollica, R. F., Lopes Cardozo B., & Osofsky, H. J. et al. (2004). Mental health in complex emergencies. Lancet, 364, 2058–2067.PubMedCrossRef

Aptekar, L., & Giel, R. (2002). Walks in Kaliti, life in a destitute shelter for the displaced. In J. de Jong (Ed.), Trauma, war, and violence: public mental health in socio-cultural context (pp. 337–366). New York: Kluwer Academic/Plenum Publishers.

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.PubMedCrossRef

10.

Kraemer, H. C., Stice E., & Kazdin, A. et al. (2001) How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. The American Journal of Psychiatry, 158, 848–856.PubMed

11.

Mollica, R. F., Caspi-Yavin, Y., & Bollini, P. et al. (1998). The Harvard Trauma Questionnaire – validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disease, 180, 111–116.

12.

Mollica, F., McInnes, K., & Pham, T. et al. (1998). The dose-effect relationships between torture and psychiatric symptoms in Vietnamese ex-political detainees and a comparison group. Journal of Nervous and Mental Disease, 186, 543–553.PubMedCrossRef

13.

Derogatis, L. R. (1994). SCL-90-R: symptom checklist-90-R. Administration, scoring and procedures manual. Minneapolis, MN: National Computer Systems.

14.

Schmitz, N., Hartkamp, N., & Kiuse, J. et al. (2000). The Symptom Check-List-90-R (SCL-90-R): A German study. Quality of Life Research, 9, 185–193.PubMedCrossRef

15.

Olsen, L. R., Mortensen, E. L., & Bech, P. (2006). Mental distress in the Danish general population. Acta Psychiatrica Scandinavica, 113, 477–484.PubMedCrossRef

16.

Lev-Wiesel, R., & Amir, M. (2000). Posttraumatic stress disorder symptoms, psychological distress, personal resources, and quality of life in four groups of Holocaust child survivors. Family Process, 39, 445–459.PubMedCrossRef

17.

Wang, X., Gao, L., & Shinfuku, N. et al. (2000). Longitudinal study of earthquake-related PTSD in a randomly selected community sample in North China. The American Journal of Psychiatry, 157, 1260–1266.PubMedCrossRef

18.

Punamäki, R. L., Komproe, I., & Qouta, S. et al. (2005). The deterioration and mobilization effects of trauma on social support: Childhood maltreatment and adulthood military violence in a Palestinian community sample. Child Abuse & Neglect, 29, 351–373.CrossRef

19.

Skevington, S. M., Lotfy, M., & O’Connell, O. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL Group. Quality of Life Research, 13, 299–310.PubMedCrossRef

20.

Trompenaars, F. J., Masthoff, E. D., & Van Heck, G. L. et al. (2005). Content validity, construct validity, and reliability of the WHOQOL-Bref in a population of Dutch adult psychiatric outpatients. Quality of Life Research, 14, 151–160.PubMedCrossRef

21.

Endler, N. S., & Parker, J. D. A. (1990). Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology, 58, 844–854.PubMedCrossRef

22.

Endler, N. S., & Parker, J. D. A. (1994). Assessment of multidimensional coping: task, emotion, and avoidance strategies. Psychological Assessment, 6, 50–60.CrossRef

23.

Rafnsson, F. D., Smari, J., & Windle, M. et al. (2006). Factor structure and psychometric characteristics of the Icelandic version of the Coping Inventory for Stressful Situations (CISS). Personality and Individual Differences, 40, 1247–1258.CrossRef

24.

Cutrona, C. E., & Russell, D. (1987). The provisions of social relationships and adaptation to stress. In W. H. Jones, & D. Perlman (Eds.), Advances in personal relationships (Vol. 1., pp. 37–68). Greenwich, CT: JAI Press.

25.

SPSS Inc. SPSS Base 14.0 & AMOS 6.0 for Windows. Chicago, IL, 2005.

26.

Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–606.CrossRef

27.

Carlsson, J. M., Mortensen, E. L., & Kastrup, M. (2006). Predictors of mental health and quality of life in male tortured refugees. Nordic Journal of Psychiatry, 60, 51–57.PubMedCrossRef

28.

Emmelkamp, J., Komproe, I. H., & Van Ommeren, M. et al. (2002). The relation between coping, social support and psychological and somatic symptoms among torture survivors in Nepal. Psychological Medicine, 32, 1465–1470.PubMedCrossRef

29.

Ahern, J., Galea, S., & Fernandes, W. G. et al. 2004). Gender, social support, and posttraumatic stress in postwar Kosovo. Journal of Nervous and Mental Disease, 192, 762–770.PubMedCrossRef

30.

Schweitzer, R., Melville, F., & Steel, Z. et al. (2006) Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. The Australian and New Zealand Journal of Psychiatry, 40, 179–187.PubMedCrossRef

31.

Kaspersen, M., Matthiesen, S. B., & Götestam, K. G. (2003). Social network as a moderator in the relation between trauma exposure and trauma reaction: a survey among UN soldiers and relief workers. Scandinavian Journal of Psychology, 44, 415–423.PubMedCrossRef

32.

Kitaoka-Higashiguchi, K., Nakagawa, H., & Morikawa, Y. et al. (2003). Social support and individual styles of coping in the Japanese workplace: an occupational stress model by structural equation analysis. Stress Health, 19, 37–43.CrossRef

33.

McWilliams, L. A., Cox, B. J., & Enns, M. W. (2003). Use of the Coping inventory for Stressful Situations in a clinically depressed sample: factor structure, personality correlates, and prediction of distress. Journal of Clinical Psychology, 59, 423–437.PubMedCrossRef

Titel: Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians
verfasst von: Mesfin Araya
Jayanti Chotai
Ivan H. Komproe
Joop T. V. M. de Jong
Publikationsdatum: 01.08.2007
Verlag: Springer Netherlands
Erschienen in: Quality of Life Research / Ausgabe 6/2007
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-007-9201-9

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Effect of trauma on quality of life as mediated by mental distress and moderated by coping and social support among postconflict displaced Ethiopians

Abstract

Objective

Method

Results

Conclusions

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objective

Method

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2007

Reliability, validity, and minimally important differences of the SF-6D in systemic sclerosis

Measurement of overall quality of life in nursing homes through self-report: the role of cognitive impairment

Rod O’Connor: Measuring quality of life in health

Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report

A further investigation of health-related quality of life over time among men with HIV infection in the HAART era

Responsiveness to change to change due to supportive-expressive group therapy, improvement in mood and disease progression in women with metastatic breast cancer