Browsing by Author "Abbott, Rosemary"

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    Cohort profile: mental health following extreme trauma in a northern Ugandan cohort of War-Affected Youth Study (The WAYS Study)
    (SpringerPlus, 2013) Amone-P’Olak, Kennedy; Jones, Peter B.; Abbott, Rosemary; Meiser-Stedman, Richard; Ovuga, Emilio; Croudace, Tim J.
    War experiences are associated with the risk of long-term mental health problems. The War-affected Youths (WAYS) Study comprises a cohort of 539 youths (61% male) aged between 18 to 25 (at baseline) randomly sampled from the population of war-affected youths in northern Uganda. The study aims to chart the trajectory of long-term mental health consequences of war and the roles of individual, family, and community contextual risk and protective factors in influencing the course of mental health using Social Ecology Model, thus, addressing both the individual and its social ecology. Knowledge of postwar contexts may inform policy and guide interventions on postwar psychosocial adjustment and reintegration in conflict-prone Great Lakes region of Africa (Rwanda, Burundi, DR Congo, Uganda, Central African Republic, and South Sudan). Two waves of data collection have been conducted and more data collection is planned. At baseline, information on demographic characteristics, pre-war experiences, psychosocial outcomes, coping, stigma/discrimination, family and community acceptance and relationship, family functioning, and post-war experiences were obtained. At follow-up, information on general health, gender-based violence, PTSD, social skills, trauma memory quality, rumination, self-esteem, and psychosocial outcomes were collected. Approval to access the data can be obtained on application to the Principal Investigator upon submission of a research proposal with ethical approval from the applicant's institution. This research is funded by Wellcome Trust and Gulu University.
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    The influence of different types of war experiences on depression and anxiety in a Ugandan cohort of war-affected youth: the WAYS study
    (Social psychiatry and psychiatric epidemiology, 2014) Amone-P’Olak, Kennedy; Ovuga, Emilio; Croudace, Tim J.; Jones, Peter B.; Abbott, Rosemary
    Background War experiences (WE) are frequently associated with mental health problems. Whether different types of WE vary in predicting which problem, or how severe, in former child soldiers (FCS) remains unknown. Methods Using data from the first wave of an on-going longitudinal cohort study (the WAYS study), we investigated relations between types of WE and symptoms of depression/anxiety among FCS in Northern Uganda (N = 539, baseline age = 22.39; SD = 2.03, range 18–25). Using robust Maximum Likelihood estimation in SEM, regression analyses were performed to relate binary indicators of types of WE to a single latent factor capturing symptoms of depression/anxiety. Results SEM results showed that ‘‘direct personal harm’’, ‘‘witnessing violence’’, ‘‘deaths’’, ‘‘threat to loved ones’’, ‘‘involvement in hostilities’’, and ‘‘sexual abuse’’ indicators were related to reported symptoms of depression/anxiety irrespective of gender and age. Multivariable models revealed independent associations of ‘‘witnessing violence’’ (b = 0.29, SE = 0.09, p\0.001) and ‘‘deaths’’ (b = 0.14, SE = 0.05, p\0.001) with symptoms of depression/anxiety in both sexes. ‘‘Sexual abuse’’ (b = 0.32, SE = 0.16, p\0.001) independently predicted symptoms of depression/anxiety for female but not male youths whilst ‘‘threat to loved ones’’ (b = 0.13, SE = 0.07, p\0.05) independently predicted symptoms of depression/anxiety in male but not female youths. Conclusions Dimensions of WE predicted symptoms of depression/anxiety differently, but it is hard to establish their causal status. Our findings suggest that it might be fruitful to consider such exposure variations of WE when designing interventions to mitigate the symptoms of depression/anxiety on male and female FCS.
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    Postwar environment and long-term mental health problems in former child soldiers in Northern Uganda: the WAYS study
    (J Epidemiol Community Health, 2014) Amone-P’Olak, Kennedy; Stochl, Jan; Ovuga, Emilio; Abbott, Rosemary; Meiser-Stedman, Richard; Croudace, Tim J.; Jones, Peter B.
    War experiences (WE) and postwar environments (PWE) are associated with mental ill-health. The present study aims to investigate the pathways from WE and PWE to mental ill-health and to define opportunities for intervention through analysis of the war-affected youths study (WAYS) cohort study. Method WAYS is an ongoing study of a large cohort of former child soldiers being conducted in Uganda. Mental health problems, subjective WE and PWE contexts were assessed by local adaptations of internationally developed measures for use with former child soldiers at least 6 years after the end of the war. Structural equation modeling was used to test two mediation hypotheses: (1) the ‘trauma model’ in which WE directly influence long-term mental health and (2) the ‘psychosocial path’ in which WE influence long-term mental health through PWE stressors. Results WE were linked to depression/anxiety (β=0.15 (95% CI 0.01 to 0.30)) through PWE (accounting for 44% of the variance in the relationship between these variables) and to conduct problems (β=0.23 (95% CI 0.03 to 0.43); (accounting for 89% of the variance, ie, near complete mediation)). The direct relation between WE and depression/anxiety attenuated but remained statistically significant. For conduct problems, the direct relationship was no longer significant after accounting for PWE. Conclusions PWE are a key determinant of continued mental health problems in former child soldiers. Interventions to reduce long-term mental problems should address both PWE stressors (psychosocial model) and specialised mental healthcare (trauma model) and consider both models of intervention as complementary.
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    War experiences, general functioning and barriers to care among former child soldiers in Northern Uganda: the WAYS study
    (Journal of Public Health, 2014) Amone-P’Olak, Kennedy; Jones, Peter; Meiser-Stedman, Richard; Abbott, Rosemary; Stephen Ayella-Ataro, Paul; Amone, Jackson; Ovuga, Emilio
    Exposure to war is associated with considerable risks for long-term mental health problems (MHP) and poor functioning. Yet little is known about functioning and mental health service (MHS) use among former child soldiers (FCS).We assessed whether different categories of war experiences predict functioning and perceived need for, sources of and barriers to MHS among FCS. Methods Data were drawn from an on-goingWar-affected Youths (WAYS) cohort study of FCS in Uganda. Participants completed questionnaires about war experiences, functioning and perceived need for, sources of and barriers to MHS. Regression analyses and parametric tests were used to assess between-group differences. Results Deaths, material losses, threat to loved ones and sexual abuse significantly predicted poor functioning. FCS who received MHS function better than those who did not. Females reported more emotional and behavioural problems and needed MHS more than males. FCS who function poorly indicated more barriers to MHS than those who function well. Stigma, fear of family break-up and lack of health workers were identified as barriers to MHS. Conclusions Various war experiences affect functioning differently. A significant need for MHS exists amidst barriers to MHS. Nevertheless, FCS are interested in receiving MHS and believe it would benefit them