Verduin Femke, Smid Geert E, Wind Tim R, Scholte Willem F
Academic Medical Center, Dept. of Psychiatry, University of Amsterdam, Amsterdam, Netherlands; Equator Foundation, Diemen, Netherlands.
Foundation Centrum '45, Diemen, Netherlands; Arq Psychotrauma Expert Group, Research Program, Diemen, Netherlands.
Soc Sci Med. 2014 Nov;121:1-9. doi: 10.1016/j.socscimed.2014.09.054. Epub 2014 Oct 2.
To date, reviews show inconclusive results on the association between social capital and mental health. Evidence that social capital can intentionally be promoted is also scarce. Promotion of social capital may impact post-conflict recovery through both increased social cohesion and better mental health. However, studies on community interventions and social capital have mostly relied on cross-sectional study designs. We present a longitudinal study in Rwanda on the effect on social capital and mental health of sociotherapy, a community-based psychosocial group intervention consisting of fifteen weekly group sessions. We hypothesized that the intervention would impact social capital and, as a result of that, mental health. We used a quasi-experimental study design with measurement points pre- and post-intervention and at eight months follow-up (2007-2008). Considering sex and living situation, we selected 100 adults for our experimental group. We formed a control group of 100 respondents with similar symptom score distribution, age, and sex from a random community sample in the same region. Mental health was assessed by use of the Self Reporting Questionnaire, and social capital through a locally adapted version of the short Adapted Social Capital Assessment Tool. It measures three elements of social capital: cognitive social capital, support, and civic participation. Latent growth models were used to examine whether effects of sociotherapy on mental health and social capital were related. Civic participation increased with 7% in the intervention group versus 2% in controls; mental health improved with 10% versus 5% (both: p < 0.001). Linear changes over time were not significantly correlated. Support and cognitive social capital did not show consistent changes. These findings hint at the possibility to foster social capital and simultaneously impact mental health. Further identification of pathways of influence may contribute to the designing of psychosocial interventions that effectively promote recovery in war-affected populations.
Nederlands Trial Register 1120.
迄今为止,关于社会资本与心理健康之间的关联,综述显示结果尚无定论。关于社会资本可有意促进的证据也很稀少。促进社会资本可能通过增强社会凝聚力和改善心理健康来影响冲突后恢复。然而,关于社区干预与社会资本的研究大多依赖横断面研究设计。我们在卢旺达开展了一项纵向研究,以探讨社会心理治疗(一种基于社区的心理社会小组干预,包括十五次每周一次的小组会议)对社会资本和心理健康的影响。我们假设该干预将影响社会资本,并进而影响心理健康。我们采用了准实验研究设计,在干预前、干预后以及八个月随访(2007 - 2008年)时进行测量。考虑到性别和生活状况,我们为实验组选取了100名成年人。我们从同一地区的随机社区样本中选取了100名症状评分分布、年龄和性别相似的受访者组成对照组。使用自我报告问卷评估心理健康,通过当地改编版的简短社会资本评估工具测量社会资本。该工具测量社会资本的三个要素:认知社会资本、支持和公民参与。使用潜在增长模型来检验社会心理治疗对心理健康和社会资本的影响是否相关。干预组的公民参与增加了7%,而对照组增加了2%;心理健康改善了10%,而对照组改善了5%(两者:p < 0.001)。随时间的线性变化没有显著相关性。支持和认知社会资本没有显示出一致的变化。这些发现暗示了促进社会资本并同时影响心理健康的可能性。进一步确定影响途径可能有助于设计能有效促进受战争影响人群恢复的心理社会干预措施。
荷兰试验注册1120。