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    Jan 26, 2021
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    Trauma in the Kashmir Valley and the mediating effect of stressors of daily life on symptoms of posttraumatic stress disorder, depression and anxiety

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    Housen et al 2019 Trauma in the ...
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    Authors
    Housen, T
    Lenglet, A
    Shah, S
    Sha, H
    Richardson, A
    Pintaldi, G
    Shabnum, A
    Affiliation
    MSF OCA and MSF India
    Issue Date
    2019-12-12
    Submitted date
    2019-12
    
    Metadata
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    Journal
    Conflict and Health
    Abstract
    Background The negative psychological impact of living in a setting of protracted conflict has been well studied, however there is a recognized need to understand the role that non-conflict related factors have on mediating exposure to trauma and signs of psychological distress. Methods We used data from the 2015 Kashmir Mental Health Survey and conducted mediation analysis to assess the extent to which daily stressors mediated the effect of traumatic experiences on poor mental health outcomes. Outcomes of interest were probable diagnosis of anxiety, depression, or PTSD; measured using the pre-validated Hopkins Symptoms Checklist (HSCL-25) and the Harvard Trauma Questionnaire (HTQ). Results Total effect mediated were statistically significant but the proportions of effect mediated were found to be small in practical terms. Financial stress mediated 6.8% [95% Confidence Interval (CI) 6∙0–8∙4], 6.7% [CI 6.2–7∙7] and 3.6% [CI 3∙4–4∙0] of the effect of experiencing multiple traumaticogenic events on symptoms of anxiety, depression and PTSD, respectively. Family stress mediated 11.3% [CI 10.3–13.8], 10.3% [CI 9.5–11.9] and 6.1% [CI 5.7–6.7] of the effect of experiencing multiple traumatogenic events on symptoms of anxiety, depression and PTSD, respectively. Poor physical health mediated 10.0% [CI 9.1–12∙0], 7.2% [CI 6.6–8.2] and 4.0% [CI 3.8,4.4] of the effect of experiencing more than seven traumatic events on symptoms of anxiety, depression and PTSD, respectively. Conclusion Our findings highlight that not only do we need to move beyond a trauma-focussed approach to addressing psychological distress in populations affected by protracted conflict but we must also move beyond focussing on daily stressors as explanatory mediators.
    Publisher
    Springer Science and Business Media LLC
    URI
    http://hdl.handle.net/10144/619559
    DOI
    10.1186/s13031-019-0245-6
    Type
    journal-article
    Language
    en
    ISSN
    1752-1505
    ae974a485f413a2113503eed53cd6c53
    10.1186/s13031-019-0245-6
    Scopus Count
    Collections
    Mental Health

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