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针对受战争影响青年的青年准备干预措施。

The Youth Readiness Intervention for war-affected youth.

作者信息

Newnham Elizabeth A, McBain Ryan K, Hann Katrina, Akinsulure-Smith Adeyinka M, Weisz John, Lilienthal Grace M, Hansen Nathan, Betancourt Theresa S

机构信息

François-Xavier Bagnoud Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; School of Psychology, The University of Western Australia, Crawley, Western Australia, Australia.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

出版信息

J Adolesc Health. 2015 Jun;56(6):606-11. doi: 10.1016/j.jadohealth.2015.01.020.

Abstract

PURPOSE

Mental disorders are among the largest contributors to the global burden of disease. Since the cessation of the Sierra Leonean civil war in 2002, there have been few mental health resources available for war-affected youth. Co-occurring psychological problems are commonly reported by youth in the post-conflict setting, suggesting a need for evidence-based interventions that cater to comorbid psychological difficulties. This feasibility study outlines the implementation and evaluation of a mixed-methods approach for developing and piloting a culturally grounded group mental health treatment-the Youth Readiness Intervention (YRI)-for war-affected Sierra Leonean youth.

METHODS

Participating youth (N = 32; 50% female; ages, 15-24 years) were allocated to one of four gender- and age-stratified groups, facilitated by gender-matched Sierra Leonean interventionists. The intervention comprised adapted cognitive behavioral therapy techniques to address issues pertinent to war-affected youth. Analyses comprised assessments of reliable symptom change, mental health, functional adaptation, and interventionist fidelity outcomes.

RESULTS

The YRI was found to be acceptable, feasible and associated with reliable changes in internalizing and externalizing symptoms and improvements in functional impairments and emotion regulation (mean effect size, d = .64).

CONCLUSIONS

Youth struggling with the mental health consequences of past trauma due to war merit special attention. The YRI presents a feasible and acceptable intervention for use in this low resource setting. A randomized controlled trial is planned to further test intervention effectiveness and scalability.

摘要

目的

精神障碍是全球疾病负担的最大促成因素之一。自2002年塞拉利昂内战结束以来,受战争影响的青年可获得的心理健康资源很少。冲突后环境中的青年普遍报告存在并发的心理问题,这表明需要有基于证据的干预措施来应对共病的心理困难。这项可行性研究概述了一种混合方法的实施和评估,该方法用于开发和试点一种基于文化的团体心理健康治疗方法——青年准备干预(YRI),用于受战争影响的塞拉利昂青年。

方法

参与研究的青年(N = 32;50%为女性;年龄在15 - 24岁之间)被分配到四个按性别和年龄分层的组中的一组,由性别匹配的塞拉利昂干预人员提供协助。干预措施包括采用经过调整的认知行为疗法技术,以解决与受战争影响青年相关的问题。分析包括对可靠症状变化、心理健康、功能适应和干预人员忠诚度结果的评估。

结果

发现青年准备干预(YRI)是可接受的、可行的,并且与内化和外化症状的可靠变化以及功能障碍和情绪调节的改善相关(平均效应大小,d = 0.64)。

结论

因战争而在心理健康方面受过去创伤影响的青年值得特别关注。青年准备干预(YRI)为在这种资源匮乏的环境中使用提供了一种可行且可接受的干预措施。计划进行一项随机对照试验,以进一步测试干预效果和可扩展性。

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