Cherewick Megan, Doocy Shannon, Tol Wietse, Burnham Gilbert, Glass Nancy
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205 USA.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH 863, Baltimore, MD 21205 USA.
Glob Health Res Policy. 2016 Jul 21;1:8. doi: 10.1186/s41256-016-0007-6. eCollection 2016.
Youth in conflict and post-conflict settings are exposed to a variety of potentially-traumatic events that impact their mental health and well-being. The purposes of this study were to examine coping strategies among conflict-affected youth exposed to potentially-traumatic events and the relationship to psychological symptoms and well-being in the Democratic Republic of Congo (DRC).
A total of 434 male and female youth (ages 10-15 years) completed data collection with a trained Congolese interviewer. The survey instrument included measures of exposure to potentially traumatic events, an adapted coping strategies checklist, and measures of psychosocial distress and well-being. Exploratory factor analyses was used to identify coping strategies and Hierarchical regression was used to assess how coping strategies were associated with psychological symptoms including internalizing and externalizing problems and well-being outcomes including prosocial behavior and self-esteem.
Exploratory Factor analysis suggested four coping strategies; problem-focused, emotion-focused, avoidance and faith-based strategies. Problem-focused coping strategies were associated with greater internalizing and externalizing problems and lower prosocial behavior in both boys and girls. However, when problem-focused strategies were used with emotion-focused coping strategies, the result was fewer internalizing problems in girls and fewer externalizing problems in boys and girls. Emotion-focused, avoidance and faith based strategies were associated with better self-esteem.
These results suggest a complex relationship between coping strategies, psychological symptoms and well-being and contradict evidence that problem-focused strategies benefit mental health while emotion-focused strategies harm mental health, particularly in conflict and post-conflict settings. The results suggest coping flexibility, or use of multiple coping strategies may be particularly useful to improving mental health and well-being. The need for context specific understandings of coping strategies in conflict-affected populations is highlighted by the results of the study.
处于冲突和冲突后环境中的青少年会接触到各种可能造成创伤的事件，这些事件会影响他们的心理健康和幸福。本研究的目的是调查接触过可能造成创伤事件的受冲突影响青少年的应对策略，以及这些策略与刚果民主共和国（DRC）青少年心理症状和幸福之间的关系。
共有434名年龄在10至15岁之间的青少年男女，在一名训练有素的刚果采访员的协助下完成了数据收集。调查工具包括接触可能造成创伤事件的测量、一份经过改编的应对策略清单，以及心理社会困扰和幸福的测量。探索性因素分析用于确定应对策略，层次回归用于评估应对策略如何与心理症状（包括内化和外化问题）以及幸福结果（包括亲社会行为和自尊）相关联。
探索性因素分析表明有四种应对策略：以问题为中心、以情绪为中心、回避和基于信仰的策略。以问题为中心的应对策略与男孩和女孩更多的内化和外化问题以及更低的亲社会行为相关。然而，当以问题为中心的策略与以情绪为中心的应对策略一起使用时，结果是女孩的内化问题减少，男孩和女孩的外化问题减少。以情绪为中心、回避和基于信仰的策略与更好的自尊相关。
这些结果表明应对策略、心理症状和幸福之间存在复杂的关系，这与以下证据相矛盾：以问题为中心的策略有益于心理健康，而以情绪为中心的策略则损害心理健康，特别是在冲突和冲突后环境中。结果表明应对灵活性，即使用多种应对策略，可能对改善心理健康和幸福特别有用。研究结果强调了对受冲突影响人群的应对策略进行具体情境理解的必要性。
