Dissanayake Lasith, Jabir Sameeha, Shepherd Thomas, Helliwell Toby, Selvaratnam Lavan, Jayaweera Kaushalya, Abeysinghe Nihal, Mallen Christian, Sumathipala Athula
Institute for Research and Development in Health & Social Care, Off Robert Gunawardena Mawatha, Battaramulla, 10120, Sri Lanka.
School of Medicine, Keele University, Staffordshire, ST5 5BG, United Kingdom.
Child Adolesc Psychiatry Ment Health. 2023 Aug 31;17(1):101. doi: 10.1186/s13034-023-00648-1.
Armed conflicts impact on the health and well-being of everyone, but its effect on adolescent mental health is a significant, yet under-explored area in global health. Mental health disorders which develop during adolescence often lead to behavioural problems, risky decision-making, under-age substance use and can adversely impact on educational attainment. This study aimed to estimate the prevalence of common mental disorders, substance use and their correlates with social support and resilience among adolescents (age 12-19 years) in Vavuniya; a post-conflict region of Sri Lanka.
A population-based cross-sectional study was conducted, with a modified cluster sampling method used for participant selection. Eight culturally adapted instruments were used for data collection. A total of 585 adolescents participated in the study. Analyses were performed using SPSS Version 23 statistical software package. All statistical tests were two-sided (p < 0.05) and p-values less than 0.05 were considered significant. Chi-square tests were used to explore associations between variables of interest. Spearman rank order correlation was used to examine correlations among depression, hopelessness, quality of life, social support, and resilience.
The mean age of participants was 15.02 (± 2.13) years. Ninety-one (15.6%) participants reported being exposed to one or more war-related events, and 85 (93.4%) participants in this group reported being internally displaced due to war. Fifty-two (8.9%) had dropped out of school and the prevalence of depression (3.9%) and substance use (7%) were low. Correlational analyses revealed that depression and hopelessness were significantly negatively correlated with social support, resilience, and quality of life (p < 0.01). Linear regression analysis suggested that 40% of the variance in resilience of the participants can be explained by perceived social support.
The low prevalence of hopelessness and depression highlights the resilience of this group in the face of adversity. Furthermore, significant negative correlations between hopelessness and depression with perceived social support and resilience suggest that social support and resilience could be protective factors against mental health issues in these adolescents. However, the prevalence of school dropouts calls for a focus on academic attainment to promote better educational outcomes in the adolescents of this conflict-affected region.
武装冲突影响着每个人的健康和福祉，但其对青少年心理健康的影响在全球健康领域是一个重要但尚未充分探索的领域。青少年时期出现的心理健康障碍往往会导致行为问题、冒险决策、未成年人使用毒品，并且会对学业成绩产生不利影响。本研究旨在估计斯里兰卡冲突后地区瓦武尼亚12至19岁青少年中常见精神障碍、物质使用情况及其与社会支持和心理韧性的相关性。
开展了一项基于人群的横断面研究，采用改良整群抽样方法选择参与者。使用了八份经过文化调适的工具进行数据收集。共有585名青少年参与了该研究。使用SPSS 23版统计软件包进行分析。所有统计检验均为双侧检验（p < 0.05），p值小于0.05被视为具有统计学意义。卡方检验用于探索感兴趣变量之间的关联。Spearman等级相关用于检验抑郁、绝望、生活质量、社会支持和心理韧性之间的相关性。
参与者的平均年龄为15.02（±2.13）岁。91名（15.6%）参与者报告曾经历过一次或多次与战争相关的事件，该组中有85名（93.4%）参与者报告因战争而流离失所。52名（8.9%）青少年辍学，抑郁患病率（3.9%）和物质使用率（7%）较低。相关性分析显示，抑郁和绝望与社会支持、心理韧性和生活质量显著负相关（p < 0.01）。线性回归分析表明，参与者心理韧性40%的变异可由感知到的社会支持来解释。
绝望和抑郁的低患病率凸显了该群体在面对逆境时的心理韧性。此外，绝望和抑郁与感知到的社会支持和心理韧性之间的显著负相关表明，社会支持和心理韧性可能是这些青少年心理健康问题的保护因素。然而，辍学率较高，需要关注学业成绩，以促进这一受冲突影响地区青少年获得更好的教育成果。
