Background
Mental Health Research after war and displacement
Long-term mental health consequences of the Yugoslav wars
Study goal
Method
Setting and participants
Characteristic | Total sample (N = 98) | |
---|---|---|
Baseline | Follow-up | |
Female, % (n) | 62.2 (61) | 62.2 (61) |
Mean age (SD) | 36.5 (12.1) | 47.5 (12.2) |
Education, % (n) | ||
Primary | 20.4 (20) | 15.3 (15) |
Secondary | 65.3 (64) | 60.2 (59) |
Tertiary | 12.2 (12) | 23.5 (23) |
Marital status, % (n) | ||
Married/long-term relationship | 68.4 (67) | 66.3 (65) |
Single/divorced/separated/widowed | 31.6 (31) | 33.7 (33) |
Employment status, % (n) | ||
Employed | 26.5 (26) | 51.0 (50) |
Unemployed | 35.7 (35) | 15.3 (15) |
Retired | 8.2 (8) | 16.3 (16) |
In training/education | 10.2 (10) | 1.0 (1) |
Other | 19.3 (19) | 14.2 (14) |
Monthly income, % (n) | ||
No income | 16.2 (16) | 23.5 (23) |
< 500 KM | 36.7 (36) | 22.4 (22) |
500–1000 KM | 6.1 (6) | 32.7 (32) |
> 1000 KM | 4.0 (4) | 18.4 (18) |
Mental health care use, % (n)a | 0.0 (0) | 12.2 (12) |
Number of traumatic events, mean (SD) | ||
Prewar traumatic events | 1.01 (1.93) | 0.34 (0.78) |
Traumatic events during the war | 19.54 (11.58)b | 2.38 (2.20)c |
Postwar traumatic events | – | 0.48 (0.96) |
Number of current stressors, mean (SD) | 2.48 (2.47)d | 2.26 (1.82)e |
Stayers (n = 33) | Displaced (n = 27) | Returnee (n = 38) | ||||
---|---|---|---|---|---|---|
Baseline | Follow-up | Baseline | Follow-up | Baseline | Follow-up | |
Number of years in war zone, mean (SD) | – | 2.93 (1.88) | 1.99 (1.73) | |||
Number of years in displacement setting, mean (SD) | – | 0.95 (1.87) | 4.21 (1.59) | |||
Loss of possessions, % (n) | 39.3 (13) | 81.40 (22) | 68.4 (26) | |||
Damage to home, % (n) | 54.5 (18) | 48.10 (13) | 78.9 (30) | |||
Repatriation-related variables, mean (SD)a | ||||||
Material satisfaction | – | −0.01 (1.05) | −0.19 (1.12) | |||
Identification with home country | – | 0.11 (0.57) | 0.86 (0.59) | |||
Community feeling | – | 0.51 (1.01) | −0.67 (1.19) | |||
Type of current stressor, % (n)bc | ||||||
Bad living conditions | – | 27.2 (9) | 59.2 (16) | 18.5 (5) | 52.6 (20) | 21.1 (8) |
Worries about stay in accommodation | – | 9.1 (3) | 74.1 (20) | 11.1 (3) | 28.9 (11) | 13.1 (5) |
Lack of identity papers | – | 12.1 (4) | 14.8 (4) | 7.4 (2) | 7.8 (3) | 10.5 (4) |
Unemployment | – | 15.1 (5) | 25.9 (7) | 40.7 (11) | 36.8 (14) | 13.1 (5) |
Bad job conditions | – | 18.2 (6) | 14.8 (4) | 14.8 (4) | 13.1 (5) | 10.5 (4) |
Little help with welfare | – | 18.2 (6) | 7.4 (2) | 18.5 (5) | 10.5 (4) | 18.4 (7) |
Debts | – | 12.1 (4) | 48.1 (13) | 11.1 (3) | 47.3 (18) | 15.7 (6) |
Serious health problems | – | 48.4 (16) | 44.4 (12) | 55.5 (15) | 39.4 (18) | 36.8 (14) |
Poor access to medical care | – | 24.2 (8) | 22.2 (6) | 37.1 (10) | 15.7 (6) | 10.5 (4) |
Family problems | – | 9.1 (3) | 11.1 (3) | 11.1 (3) | 5.2 (2) | 10.5 (4) |
Loved ones missingd | – | 12.1 (4) | 48.1 (13) | 70.3 (19) | 21.1 (8) | 28.9 (11) |
Separation from loved onesd | – | – | 29.6 (8) | – | 47.3 (18) | – |
Study procedure
Measures
Sociodemographic and war-related characteristics
Psychological distress
Traumatic experiences
Current stress factors
Data analysis
Results
Sample characteristics
Trauma exposure
Exposure to current stressors
Change in psychological symptoms
BSI | Stayers (n = 33) | Displaced (n = 27) | Returnee (n = 38) | ||||||
---|---|---|---|---|---|---|---|---|---|
Baseline | Follow-up |
t
| Baseline | Follow-up |
t
| Baseline | Follow-up |
t
| |
Somatization | 1.26 (1.02) | 1.10 (0.97) | −1.08 | 1.11 (0.95) | 0.96 (0.80) | −0.88 | 0.70 (0.91) | 1.08 (1.02) | 2.65** |
Obsessive-compulsive disorder | 1.46 (1.18) | 1.09 (0.86) | −2.23* | 1.24 (1.06) | 1.13 (0.83) | −0.61 | 0.75 (0.76) | 1.16 (0.98) | 2.62** |
Interpersonal sensitivity | 1.18 (0.83) | 0.81 (0.74) | −2.43* | 1.03 (1.0) | 0.83 (0.69) | −1.17 | 0.78 (0.68) | 0.79 (0.69) | 0.09 |
Depression | 0.98 (1.08) | 0.73 (0.65) | −1.74 | 0.80 (0.86) | 0.74 (0.52) | −0.38 | 0.64 (0.73) | 0.99 (0.93) | 2.58* |
Anxiety | 1.18 (1.15) | 0.87 (0.74) | −1.68 | 1.11 (0.95) | 1.07 (0.96) | −0.22 | 0.73 (0.78) | 1.14 (1.01) | 2.44* |
Hostility | 0.99 (0.71) | 0.68 (0.61) | −1.85 | 0.82 (0.73) | 0.90 (0.71) | 0.41 | 0.67 (0.79) | 1.06 (0.99) | 2.51* |
Phobic anxiety | 0.85 (1.12) | 0.46 (0.79) | −2.80** | 0.70 (0.83) | 0.51 (0.63) | −1.26 | 0.49 (0.68) | 0.51 (0.50) | 0.13 |
Paranoid ideation | 1.28 (1.13) | 1.19 (0.93) | −0.58 | 0.97 (0.76) | 1.28 (0.95) | 1.78 | 0.84 (0.75) | 1.29 (0.95) | 3.08** |
Psychoticism | 0.59 (0.69) | 0.47 (0.64) | −0.89 | 0.39 (0.78) | 0.48 (0.74) | 0.61 | 0.48 (0.63) | 0.55 (0.70) | 0.53 |
Factors predicting general psychological distress
Predictor | Baseline | Follow-up | ||||
---|---|---|---|---|---|---|
β | ∆R2/∆F | R2/F | β | ∆R2/∆F | R2/F | |
Step 1 | ||||||
Control variablesa | .08/2.86* | .22/6.48*** | ||||
Step 2 | ||||||
Prewar traumatic events Married/long-term relationship | .25* | .10/11.18** | .18/5.18*** | .02 | .02/2.32 | .24/5.73*** |
Step 3 | ||||||
Traumatic events during the war | .23* | .21* | ||||
Group statusb | ||||||
Stayer | .24 | .02 | ||||
Returnee | .01 | .08/3.30* | .26/4.60*** | .23* | .08/3.62* | .33/5.26*** |
Step 4 | ||||||
Postwar traumatic events | – | .20* | ||||
Current stressors | .19 | .02/2.09 | .28/4.33*** | .33** | .12/9.10*** | .45/6.84*** |