A systematic review and meta-analysis of psychological interventions to improve mental wellbeing

Nature Human Behaviour, Год журнала: 2021, Номер 5(5), С. 631 - 652

Опубликована: Апрель 19, 2021

Язык: Английский

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Effectiveness of a brief group behavioral intervention for common mental disorders in Syrian refugees in Jordan: A randomized controlled trial

PLoS Medicine, Год журнала: 2022, Номер 19(3), С. e1003949 - e1003949

Опубликована: Март 17, 2022

Common mental disorders are frequently experienced by refugees. This study evaluates the impact of a brief, lay provider delivered group-based psychological intervention [Group Problem Management Plus (gPM+)] on health refugees in camp, as well parenting behavior and children's health.In this single-blind, parallel, randomized controlled trial, 410 adult Syrian (300 females, 110 males) Azraq Refugee Camp (Jordan) were identified through screening distress (≥16 Kessler Psychological Distress Scale) impaired functioning (≥17 WHO Disability Assessment Schedule). Participants randomly allocated to gPM+ or enhanced usual care (EUC) involving referral information for psychosocial services 1:1 ratio. aware treatment allocation, but assessors blinded condition. Primary outcomes scores Hopkins Symptom Checklist-25 (HSCL; depression anxiety scales) assessed at baseline, 6 weeks, 3 months follow-up primary outcome time point. It was hypothesized that would result greater reductions HSCL than EUC. Secondary disability, posttraumatic stress, personally problems, prolonged grief, prodromal psychotic symptoms, behavior, health. Between October 15, 2019 March 2, 2020, 624 screened eligibility, 462 (74.0%) positive, whom 204 assigned 206 There 168 (82.4%) participants 189 (91.7%) EUC follow-up. Intent-to-treat analyses indicated follow-up, showed reduction scale those receiving (mean difference, 3.69 [95% CI 1.90 5.48], p = .001; effect size, 0.40). no difference between conditions -0.56, 95% -2.09 0.96; .47; -0.03). Relative EUC, had severity problems 0.88, 0.07 1.69; .03), inconsistent disciplinary 1.54, 1.03 2.05; < .001). significant differences changes PTSD, childhood outcomes. Mediation analysis change associated with reduced attentional (β 0.11, SE .07; .003 .274) internalizing 0.08, .05; 0.19) children. No adverse events attributable interventions trial. Major limitations included only one-quarter being male, measures have not been validated Syrians.In camp-based refugees, brief group behavioral led depressive compared care, may indirect benefits refugees' The limited capacity reduce points need development more effective treatments camp settings.Prospectively registered Australian New Zealand Clinical Trials Registry: ACTRN12619001386123.

Язык: Английский

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Parenting Interventions for Refugees and Forcibly Displaced Families: A Systematic Review

Clinical Child and Family Psychology Review, Год журнала: 2022, Номер 25(2), С. 395 - 412

Опубликована: Янв. 10, 2022

Язык: Английский

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Effectiveness of a brief group behavioural intervention on psychological distress in young adolescent Syrian refugees: A randomised controlled trial

PLoS Medicine, Год журнала: 2022, Номер 19(8), С. e1004046 - e1004046

Опубликована: Авг. 12, 2022

Millions of young adolescents in low- and middle-income countries (LMICs) affected by humanitarian crises experience elevated rates poor mental health. There is a need for scalable programs that can improve the health adolescents. This study evaluated effectiveness nonspecialist delivered group-based intervention (Early Adolescent Skills Emotions (EASE)) to adolescents' health.In this single-blind, parallel, controlled trial, Syrian refugees aged 10 14 years Jordan were identified through screening psychological distress as defined scores ≥15 on Paediatric Symptom Scale. Participants randomised either EASE or enhanced usual care (EUC) involving referral local psychosocial services (on 1:1.6 ratio). aware treatment allocation but assessors blinded. Primary outcomes Checklist (PSC; internalising, externalising, attentional difficulty scales) assessed at week 0, 9 weeks, 3 months after (primary outcome time point). It was hypothesised would result greater reductions internalising symptoms than EUC. Secondary depression, posttraumatic stress, well-being, functioning, school belongingness, caregivers' parenting Between June 2019 January 2020, 1,842 adolescent screened eligibility basis distress. 520 (28.2%) who positive, whom 471 (90.6%) agreed enter trial. Overall, 185 assigned 286 EUC, 169 254 retained respectively. Intent-to-treat analyses indicated months, resulted reduction PSC-internalising scale EUC (estimated mean difference 0.69, 95% CI 0.19 1.19; p = 0.007; effect size, 0.38) there no differences PSC-externalising 0.24, -0.43 0.91; 0.49; -0.10), PSC-attentional problem -0.01, -0.51 0.54; 0.97; -0.01) scores, belongingness. Relative caregivers had less 1.95, 0.71 3.19; 0.002) inconsistent disciplinary (mean 1.54, 1.03 2.05; < 0.001). (a) focused with probable disorders; (b) completed 3-month assessment; (c) trauma exposure did not alter primary results. Mediation analysis condition, associated reduced (β 0.11, SE 0.07; 0.003, 0.274) problems their children. No adverse events attributable intervention. A limitation matched terms facilitator attention group involvement.EASE led refugee caregivers. has potential mitigate emotional difficulties LMIC.Prospectively registered Australian New Zealand Clinical Trials Registry: ACTRN12619000341123.

Язык: Английский

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Adverse childhood experiences and global mental health: avenues to reduce the burden of child and adolescent mental disorders

Epidemiology and Psychiatric Sciences, Год журнала: 2022, Номер 31

Опубликована: Янв. 1, 2022

Abstract Mental disorders are one of the largest contributors to burden disease globally, this holds also for children and adolescents, especially in low- middle-income countries. The prevalence severity these influenced by social determinants, including exposure adversity. When occurring early life, latter events referred as adverse childhood experiences (ACEs). In editorial, we provide an overview literature on role ACEs determinants mental health through lenses global health. While relation between has been extensively explored, most research was centred higher income contexts. We argue that findings from realm should be integrated into ACEs, e.g. preventative responsive psychosocial interventions children, adolescents their caregivers. field undertake active efforts better address its initiatives, all with goal reducing among globally.

Язык: Английский

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Non-clinical Psychosocial Mental Health Support Programmes for People with Diverse Language and Cultural Backgrounds: A Critical Rapid Review

Culture Medicine and Psychiatry, Год журнала: 2025, Номер unknown

Опубликована: Янв. 29, 2025

Язык: Английский

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A call for greater conceptual clarity in the field of mental health and psychosocial support in humanitarian settings

Epidemiology and Psychiatric Sciences, Год журнала: 2021, Номер 30

Опубликована: Янв. 1, 2021

Abstract Aims When the Interagency Standing Committee (IASC) adopted composite term mental health and psychosocial support (MHPSS) published its guidelines for MHPSS in emergency settings 2007, it aimed to build consensus strengthen coordination among relevant humanitarian actors. The offered an inclusive tent by welcoming different terminologies, explanatory models intervention methods of diverse actors across several sectors (e.g., health, protection, education, nutrition). Since introduction, has become well-established within global system. However, also been critiqued papering over substantive differences priorities conceptual frameworks that inform wide range interventions described as MHPSS. Our aims are clarify those frameworks, argue their essential complementarity illustrate perils failing adequately consider causal theories change underlie our interventions. Methods We describe historical backdrop against which IASC were developed, well impact on improving relations aid sectors. fuzziness field lack clear articulation guide approaches two primary MHPSS, we label clinical social-environmental . Using examples intimate partner violence compromised parenting settings, these challenges can arise when either framework is inappropriately applied. Results Clinical prioritise role intrapersonal variables, biological and/or psychological, mediators treatment distress. Social-environmental emphasise social determinants distress target factors material environments order lower increase resilience face adversity. Both play a critical settings; however, rationale adopting one or other approach commonly insufficiently articulated should be based thorough assessment processes at multiple levels ecology. Conclusions Greater attention ‘why’ choices more explicit decisions (i.e., ‘how’), may effects minimise risk applying inappropriate actions particular problem.

Язык: Английский

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Supporting parenting among Syrian refugees in Lebanon: a randomized controlled trial of the caregiver support intervention

Journal of Child Psychology and Psychiatry, Год журнала: 2022, Номер 64(1), С. 71 - 82

Опубликована: Июль 15, 2022

Background Parenting interventions in humanitarian settings have prioritized the acquisition of parenting knowledge and skills, while overlooking adverse effects stress distress on parenting—a key mediator refugee children's mental health. We evaluated effectiveness Caregiver Support Intervention (CSI), which emphasizes caregiver wellbeing together with training positive parenting. Methods conducted a two‐arm randomized controlled trial CSI Syrian refugees Lebanon, an intent‐to‐treat design, from September 2019–December 2020. A total 480 caregivers 240 families were to or waitlist control group (1:1). Retention baseline endline was 93%. Data psychological collected at baseline, endline, three‐month follow‐up. Prospective registration: ISRCTN22321773. Results did not find significant change overall skills (primary outcome endpoint) ( d = .11, p .126) follow‐up (Cohen's .15, .054). effect among participants receiving full intervention—the sub‐sample interrupted by (COVID‐19) 0.25, < .05). The showed beneficial sample harsh − .17, .05; .19, .05), .63, .001; .50, .001), .33, .23, .01). found no parental warmth responsiveness, psychosocial wellbeing, stress, management. Changes partially mediated impact parenting, accounting for 37% reduction Conclusions reduced distress, demonstrated value addressing as pathway strengthening adversity. These achieved despite pandemic‐related lockdown that impacted implementation, severe economic crisis, widespread social unrest. Replication under less extreme conditions may more accurately demonstrate intervention's potential.

Язык: Английский

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Cochrane library, Год журнала: 2023, Номер 2023(10)

Опубликована: Окт. 24, 2023

Язык: Английский

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The effectiveness of parenting interventions in reducing violence against children in humanitarian settings in low- and middle-income countries: A systematic review and meta-analysis

Child Abuse & Neglect, Год журнала: 2024, Номер unknown, С. 106850 - 106850

Опубликована: Июнь 1, 2024

Violence against children is a global phenomenon, yet living in humanitarian settings are at elevated risk of experiencing violent parenting. Parenting interventions recommended prevention strategy. To conduct systematic review and meta-analysis on the effectiveness parenting preventing violence related parent child outcomes. Primary caregivers low- middle-income countries (LMICs). A highly sensitive multi-language search electronic grey-literature database. Studies were appraised for bias, summary effects by certainty effect, effect estimates pooled using robust variance estimation. Twenty-three randomized trials meta-analyzed finding small physical psychological (n = 14, k 21, d −0.36, 95 % CI [−0.69, −0.04]), positive 16, 43, 0.48, [0.29, 0.67]), negative 17, 37, −0.42, [−0.67, −0.16]), parental poor mental health 9, 15, −0.34, [−0.66, −0.02]), internalizing behaviors 11, 29, −0.38, [−0.70, −0.05]); non-significant externalizing −0.12, [−0.50, 0.27]). Too few studies reported intimate partner violence, sexual stress Our findings suggest that LMICs may be an effective strategy to reduce numerous However, need interpreted light limited number available imprecise statistical significance selected

Язык: Английский

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