From Crisis to Reconciliation : Feasibility and Effectiveness of School-Based Interventions Promoting Trauma Rehabilitation and Reconciliation After the War in Uganda

Winkler, Nina

From Crisis to Reconciliation : Feasibility and Effectiveness of School-Based Interventions Promoting Trauma Rehabilitation and Reconciliation After the War in Uganda

Dateien

Winkler_0-420065.pdfGröße: 6.92 MBDownloads: 2903

Datum

2017

Open Access-Veröffentlichung

Open Access Green

Sammlungen

Psychologie

Publikationstyp

Dissertation

Publikationsstatus

Published

Zusammenfassung

After more than three decades of civil war in Northern Uganda waged by the rebel army the Lords’ Resistance Army (LRA) using large numbers of forced child soldiers within their ranks, the current research focuses on the psychological impact of war, displacement and rebel abductions on war-affected youths now placed in educational programs, and it focuses on understanding ways to foster psychological recovery and enhanced psychosocial support. In our first study, trained local screeners assessed the mental health status of male and female students in Northern Ugandan schools. The study aimed to disclose potential differences in mental health-related impairment in two groups, former child soldiers (n = 354) and other war-affected youth (n = 489), as well as to separate factors predicting mental suffering in learners. Almost all respondents had been displaced at least once in their life. Thirty percent of the girls and 50% of the boys in the study reported past abduction history. Trauma exposure was notably higher in the group of abductees. The post-traumatic stress disorder (PTSD) rate in former child soldiers, 32%, was remarkably higher than that in non-abductees (12%). A path-analytic model for developing PTSD and potential depression revealed both previous trauma exposure and duration of abduction to have significant influences on trauma-related mental suffering. Findings suggest that in Northern Ugandan schools, trauma spectrum disorders are common among war-affected learners, and we have therefore recommended the school context to be further utilized and researched to provide mental health support for war-affected youth. In our second study, trained local screeners assessed the mental health status of male and female students in vocational training centers in Northern Uganda. The study aimed to explore the applicability and measurability of the newly emerging concepts of openness to reconciliation and revenge in the context of Northern Uganda and to understand their interplay with measures of PTSD, depression, aggression and stigmatization. In the study sample of war-affected learners (N = 406), we found that the two sub-scales “openness to reconciliation” and “revenge” were applicable to the majority of respondents (n = 325). Factor analysis and internal consistency supported this finding. Correlations revealed strong associations between the measures of psychopathology and maladjustment across genders. Respondents with a PTSD diagnosis (n = 94) had lower scores in openness to reconciliation and higher scores in vengeful feelings, aggression, and stigmatization. The results underline that mental health status, particularly PTSD diagnosis, among Ugandan youths is strongly interrelated with measures of openness to reconciliation, revenge, aggression and stigmatization. While we acknowledge that more research is needed with regards to the nature and direction of the found associations among the variables, it appears that suffering from PTSD diagnosis is a potential obstacle for reconciliation and peace-building attempts. In our third study, we tested the feasibility and efficacy of delivering group-based trauma and reconciliation education (n = 135), group-based conflict resolution and social competence training (n = 136), and individual teacher counseling (n = 135) carried out by local lay counselors in a randomized controlled research design. We assessed the intervention groups prior to the start of the interventions, at five months after the interventions, and at nine months after the interventions, with very low drop-out rates. In intention-to-treat (I-T-T) and treatment-completer (T-C) analysis of variance, we obtained the main effects for time for all three treatment conditions on all dependent variables, but no meaningful interaction effects between treatment conditions and times. We obtained medium effect sizes (Cohen’s d) for PTSD as an outcome measure, while we found high effect sizes for outcomes of depression, as well as for all post-war reconciliation measures. The study provides preliminary support for the feasibility and effectiveness of all three culturally and contextually adapted classroom-based interventions when implemented with former child soldiers and other war-affected learners in Northern Ugandan schools. The study further provides evidence that in randomized controlled trial (RCT) research designs, tailored mental health and psychosocial support (MHPSS) programs not only have beneficial effects on strained psychological health of war-affected learners, but also on societal post-war reconciliation and peace building after crisis. We discuss our findings’ implications for future research needs and the further development of group-based psychosocial interventions in LRA-affected areas, for the reintegration of former child soldiers, such as in (child) disarmament, demobilization and reintegration (DDR) programs, and for MHPSS programs using curriculum-based intervention (CBI) in educational settings.

Fachgebiet (DDC)

150 Psychologie

Schlagwörter

PTSD, depression, child soldiers, war-affected youth, post-conflict, MHPSS, psychosocial support, reconciliation, curriculum-based intervention, CBI, trauma, reconciliation, reintegration, LRA, displacement, school context, abductees, trauma treatment, aggression, stigmatization, DDR, trauma and reconciliation education, teacher training, conflict resolution, social competence, treatment manuals

Zitieren

ISO 690

WINKLER, Nina, 2017. From Crisis to Reconciliation : Feasibility and Effectiveness of School-Based Interventions Promoting Trauma Rehabilitation and Reconciliation After the War in Uganda [Dissertation]. Konstanz: University of Konstanz

BibTex

@phdthesis{Winkler2017Crisi-39889,
  year={2017},
  title={From Crisis to Reconciliation : Feasibility and Effectiveness of School-Based Interventions Promoting Trauma Rehabilitation and Reconciliation After the War in Uganda},
  author={Winkler, Nina},
  address={Konstanz},
  school={Universität Konstanz}
}

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    <dcterms:abstract xml:lang="eng">After more than three decades of civil war in Northern Uganda waged by the rebel army the Lords’ Resistance Army (LRA) using large numbers of forced child soldiers within their ranks, the current research focuses on the psychological impact of war, displacement and rebel abductions on war-affected youths now placed in educational programs, and it focuses on understanding ways to foster psychological recovery and enhanced psychosocial support. In our first study, trained local screeners assessed the mental health status of male and female students in Northern Ugandan schools. The study aimed to disclose potential differences in mental health-related impairment in two groups, former child soldiers (n = 354) and other war-affected youth (n = 489), as well as to separate factors predicting mental suffering in learners. Almost all respondents had been displaced at least once in their life. Thirty percent of the girls and 50% of the boys in the study reported past abduction history. Trauma exposure was notably higher in the group of abductees. The post-traumatic stress disorder (PTSD) rate in former child soldiers, 32%, was remarkably higher than that in non-abductees (12%). A path-analytic model for developing PTSD and potential depression revealed both previous trauma exposure and duration of abduction to have significant influences on trauma-related mental suffering. Findings suggest that in Northern Ugandan schools, trauma spectrum disorders are common among war-affected learners, and we have therefore recommended the school context to be further utilized and researched to provide mental health support for war-affected youth. In our second study, trained local screeners assessed the mental health status of male and female students in vocational training centers in Northern Uganda. The study aimed to explore the applicability and measurability of the newly emerging concepts of openness to reconciliation and revenge in the context of Northern Uganda and to understand their interplay with measures of PTSD, depression, aggression and stigmatization. In the study sample of war-affected learners (N = 406), we found that the two sub-scales “openness to reconciliation” and “revenge” were applicable to the majority of respondents (n = 325). Factor analysis and internal consistency supported this finding. Correlations revealed strong associations between the measures of psychopathology and maladjustment across genders. Respondents with a PTSD diagnosis (n = 94) had lower scores in openness to reconciliation and higher scores in vengeful feelings, aggression, and stigmatization. The results underline that mental health status, particularly PTSD diagnosis, among Ugandan youths is strongly interrelated with measures of openness to reconciliation, revenge, aggression and stigmatization. While we acknowledge that more research is needed with regards to the nature and direction of the found associations among the variables, it appears that suffering from PTSD diagnosis is a potential obstacle for reconciliation and peace-building attempts. In our third study, we tested the feasibility and efficacy of delivering group-based trauma and reconciliation education (n = 135), group-based conflict resolution and social competence training (n = 136), and individual teacher counseling (n = 135) carried out by local lay counselors in a randomized controlled research design. We assessed the intervention groups prior to the start of the interventions, at five months after the interventions, and at nine months after the interventions, with very low drop-out rates. In intention-to-treat (I-T-T) and treatment-completer (T-C) analysis of variance, we obtained the main effects for time for all three treatment conditions on all dependent variables, but no meaningful interaction effects between treatment conditions and times. We obtained medium effect sizes (Cohen’s d) for PTSD as an outcome measure, while we found high effect sizes for outcomes of depression, as well as for all post-war reconciliation measures. The study provides preliminary support for the feasibility and effectiveness of all three culturally and contextually adapted classroom-based interventions when implemented with former child soldiers and other war-affected learners in Northern Ugandan schools. The study further provides evidence that in randomized controlled trial (RCT) research designs, tailored mental health and psychosocial support (MHPSS) programs not only have beneficial effects on strained psychological health of war-affected learners, but also on societal post-war reconciliation and peace building after crisis. We discuss our findings’ implications for future research needs and the further development of group-based psychosocial interventions in LRA-affected areas, for the reintegration of former child soldiers, such as in (child) disarmament, demobilization and reintegration (DDR) programs, and for MHPSS programs using curriculum-based intervention (CBI) in educational settings.</dcterms:abstract>
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Prüfungsdatum der Dissertation

May 30, 2017

Hochschulschriftenvermerk

Konstanz, Univ., Diss., 2017

Universitätsbibliographie

Nein