GISAME, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, calle 62 Nº 52 - 59, Medellín, Colombia.
SISTEMIC, Facultad de Ingeniería, Universidad de Antioquia UdeA, calle 70 No 52-21, Medellín, Colombia.
BMC Psychol. 2021 Aug 27;9(1):127. doi: 10.1186/s40359-021-00626-2.
Populations exposed to Armed Conflict Experiences (ACE) show different levels of impact in their mental health (i.e. clinical and positive components); however, there is limited evidence related to mental health of general population (civilians not classified as victims) exposed to ACE. Government guided mental health assessments exclude this population. The use of a newly validated Extreme Experiences Scale (EX) seems appropriate to classify victims, ex-combatants, and civilians for their mental health assessment.
Here, we propose a novel approach to identify relationships between individuals classified with different levels of ACE exposure-independent of their legal role in the armed conflict, and mental health outcomes. According to the cut-off points derived from the scores of EX, we classified the sample in low and high exposure to ACE.
The high-level ACE group (scores > 2.5) included 119 subjects, and the low-level ACE was constituted by 66 subjects. Our results evidence that people with high exposure to ACE experiment higher odds to present anxiety disorders, risk of suicide, or post-traumatic stress disorder, as well as increased cognitive empathy (i.e., fantasy dimension).
These findings allowed us to identify the influence of ACE on mental health outcomes beyond the conventional frame (victim or ex-combatant), and to discuss effective interventions and implementation of mental health strategies in these communities. We expect to help the health system to focus on key vulnerable subjects by including civilians not recognized as victims, which are neglected from most of the public health screening, assessment, and interventions.
暴露于武装冲突经历（ACE）的人群在心理健康方面表现出不同程度的影响（即临床和积极成分）；然而，对于暴露于 ACE 的普通人群（未被归类为受害者的平民）的心理健康，相关证据有限。政府主导的心理健康评估将这些人群排除在外。使用新验证的极端经历量表（EX）似乎适合对受害者、前战斗人员和平民进行心理健康评估。
在这里，我们提出了一种新方法，用于识别不同 ACE 暴露水平的个体之间的关系，而与他们在武装冲突中的法律角色无关，以及与心理健康结果的关系。根据 EX 得分的临界点，我们将样本分为 ACE 低暴露组和高暴露组。
高水平 ACE 组（得分>2.5）包括 119 名受试者，低水平 ACE 组由 66 名受试者组成。我们的结果表明，高 ACE 暴露的人更有可能出现焦虑障碍、自杀风险或创伤后应激障碍，以及增加的认知同理心（即幻想维度）。
这些发现使我们能够超越传统框架（受害者或前战斗人员）来识别 ACE 对心理健康结果的影响，并讨论在这些社区中实施有效的干预措施和心理健康策略。我们希望通过包括未被认定为受害者的平民，帮助卫生系统关注关键弱势群体，这些平民在大多数公共卫生筛查、评估和干预中被忽视。
