BackgroundInternational humanitarian aid workers providing care in emergencies are subjected to numerous chronic and traumatic stressors.ObjectivesTo examine consequences of such experiences on aid workers' mental health and how the impact is influenced by moderating variables.MethodologyWe conducted a longitudinal study in a sample of international non-governmental organizations. Study outcomes included anxiety, depression, burnout, and life and job satisfaction. We performed bivariate regression analyses at three time points. We fitted generalized estimating equation multivariable regression models for the longitudinal analyses.ResultsStudy participants from 19 NGOs were assessed at three time points: 212 participated at pre-deployment; 169 (80%) post-deployment; and 154 (73%) within 3–6 months after deployment. Prior to deployment, 12 (3.8%) participants reported anxiety symptoms, compared to 20 (11.8%) at post-deployment (p = 0·0027); 22 (10.4%) reported depression symptoms, compared to 33 (19.5%) at post-deployment (p = 0·0117) and 31 (20.1%) at follow-up (p = .00083). History of mental illness (adjusted odds ratio [AOR] 4.2; 95% confidence interval [CI] 1·45–12·50) contributed to an increased risk for anxiety. The experience of extraordinary stress was a contributor to increased risk for burnout depersonalization (AOR 1.5; 95% CI 1.17–1.83). Higher levels of chronic stress exposure during deployment were contributors to an increased risk for depression (AOR 1·1; 95% CI 1·02–1.20) comparing post- versus pre-deployment, and increased risk for burnout emotional exhaustion (AOR 1.1; 95% CI 1.04–1.19). Social support was associated with lower levels of depression (AOR 0·9; 95% CI 0·84–0·95), psychological distress (AOR = 0.9; [CI] 0.85–0.97), burnout lack of personal accomplishment (AOR 0·95; 95% CI 0·91–0·98), and greater life satisfaction (p = 0.0213).ConclusionsWhen recruiting and preparing aid workers for deployment, organizations should consider history of mental illness and take steps to decrease chronic stressors, and strengthen social support networks.

Expatriate aid workers (n = 214) representing 19 nongovernmental organizations (NGOs) completed a predeployment survey, including measures of mental health (depression, anxiety, and posttraumatic stress disorder [PTSD]); risk factors (childhood trauma, family risk, and adult trauma exposure); and resilience factors (coping, social support, and healthy lifestyle) to assess their baseline mental health during preparation for deployment. Multiple regression analysis indicated that childhood trauma/family risk was not significantly related to depression, anxiety, or PTSD symptoms when controlling for report of prior mental illness; yet, adult trauma exposure was significantly related to all three. Social support contributed significant variance to depression and PTSD. NGOs can help applicants recognize the effects of recent trauma and the resilience provided by a healthy social network.

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This research aims to characterize the psychosocial aspects of well-being among youth-headed households (YHH) in Gikongoro, Rwanda, through examination of social support and marginalization. Data is presented on perceived availability of support from relatives, an unidentified adult, peers, and other community members and an index of social marginalization. A total of 692 interviews were completed with YHH age 13-24 who are beneficiaries of a basic needs program. Sixteen percent of youth reported there was no one they felt they could go to with a problem. In times of need, only 24% felt relatives would help them, while 57% felt neighbors would offer assistance. Most youth reported significant caring relationships: 73% reported access to trusted adult who offers them advice and guidance, and most indicated close peer relationships. However, many youth also perceived a lack of community support, with 86% feeling rejected by the community and 57% feeling the community would rather hurt them than help them. Social support is a low-cost critical resource for the care of vulnerable youth and an understanding of existing social support networks would enhance the design and implementation of psychosocial and community-based care initiatives.

Children and youth affected by AIDS typically face a wide range of stressful events and circumstances, including poverty, the loss of caregivers and loved ones, having to drop out of school, the burden of adultlike responsibilities, and social isolation. Increasingly programs for orphans and vulnerable children are addressing not only their material and educational needs, but their psychosocial needs as well. Yet there has been little research on how to evaluate psychosocial support (PSS) programs and the impact of these programs on vulnerable youth's psychosocial well-being. This report presents findings from an exploratory study by the Regional Psychosocial Support Initiative (REPSSI) and Catholic Relief Services' Support to Replicable, Innovative Village/Community-level Efforts (STRIVE) Program of vulnerable youth living in and around Bulawayo, Zimbabwe. It describes their demographic characteristics, exposure to stress and trauma, and psychosocial well-being. The report also highlights the relationships between psychosocial well-being outcomes and exposure to stress and trauma, and the differences in psychosocial well-being between males and females, orphaned and nonorphaned youth, and younger and older adolescents. In addition, the report explores the relationships between exposure to different psychosocial support programs and measures of psychosocial well-being and distress. The report concludes with program and research implications. Methods First, formative qualitative research was conducted with youth and adults working with youth to determine local concepts, manifestations, and domains of well-being among youth. These findings, together with input from local youth and international research experts and psychologists, were used to draft a quantitative survey. After pre-testing and finalizing the survey, the researchers administered it to a cross-sectional sample of 1,258 orphans and vulnerable youth, ages 14 to 20. All of the youth fell into one of three intervention groups, or into a fourth comparison group. The intervention groups included (1) youth exposed to community PSS, (2) youth exposed to the Salvation Army Masiye Camp, a residential PSS program, and (3) youth who attended Masiye Camp and went on to become youth peer leaders. Youth in the comparison group had not been exposed to any known PSS program. Data analysis was conducted in three stages to: (1) produce a profile of the sample, (2) determine relationships between psychosocial measures and demographic characteristics of the sample, and (3) explore associations between participation by youth in PSS interventions and psychosocial outcomes. The cross-sectional design of the study does not allow for establishing a causal relationship between program exposure and psychosocial well-being measures. But, using multiple regression analysis, the researchers were able to explore differences in select psychosocial well-being variables (e.g., self-Despite widespread trauma, daily stress, and psychosocial distress, many youth maintained selfconfidence,...