Improving reports of health risks: Life history calendars and measurement of potentially traumatic experiences

Axinn, William G.; Chardoul, Stephanie

doi:10.1002/mpr.1853

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…Our measures of timing are also limited to annual precision to reduce the consequences of imprecise recall on our results and age-related recall bias is much less likely to be operating in the youngest cohort whose AUD onset would have happened quite recently (relative to assessment). In part, our confidence in these measures of relative timing comes from the success of the life history calendar approach to the measurement of the timing of symptom onset, as documented in a previously published largescale randomized experiment [14,18]. Second, we focus solely on neighborhood beatings.…”

Section: Discussionmentioning

confidence: 99%

“…One decade after the armed conflict ended (2016-2018), CVFS added one of the most rigorous measures of lifetime history of AUD and other mental disorders, including timing, ever conducted in settings like Nepal [14,15]. The specially designed CVFS mixed-method event history calendars provide the timing of AUD onset relative to other events [14,[16][17][18], allowing us to estimate the association between violent events near the neighborhood during the armed conflict and subsequent onset of AUD, both during and after the armed conflict.…”

Section: Data Sources and Respondentsmentioning

confidence: 99%

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Community exposure to armed conflict and subsequent onset of alcohol use disorder

Bruffaerts,

Axinn,

Ghimire

et al. 2023

Addiction

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AimsTo measure the independent consequences of community‐level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000–2006 conflict.DesignA population‐representative panel study from Nepal, with precise measures of community‐level violent events and subsequent individual‐level AUD in males. Females were not included because of low AUD prevalence.SettingChitwan, Nepal.ParticipantsFour thousand eight hundred seventy‐six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15–59 were eligible (response rate 93%).MeasurementsMeasures of beatings in the community during the conflict (2000–2006), including the date and distance away, were gathered through neighborhood reports, geo‐location and official resources, then linked to respondents' life histories of AUD (collected in 2016–2018) using the Nepal‐specific Composite International Diagnostic Interview with life history calendar. Beatings nearby predict the subsequent onset of AUD during and after the armed conflict. Data were analyzed in 2021–2022.FindingsCohort‐specific, discrete‐time models revealed that within the youngest cohort (born 1992–2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods (odds ratio = 1.66; 95% confidence interval = 1.02–2.71). In this cohort, a multilevel matching analysis designed to simulate a randomized trial showed the post‐conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings.ConclusionsAmong male children living in Chitwan, Nepal during the 2000–2006 armed conflict, living in a neighborhood where armed conflict beatings occurred is associated with increased odds of developing subsequent alcohol use disorder. This association was independent of personal exposure to beatings and other mental disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Data Sources and Respondentsmentioning

confidence: 99%

Community exposure to armed conflict and subsequent onset of alcohol use disorder

Bruffaerts,

Axinn,

Ghimire

et al. 2023

Addiction

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“…Frameworks of vulnerability and resilience should more explicitly model these challenges associated with compounded and enduring effects of multiple displacements. Life history calendars have excellent potential as tools for the systematic data collection on such repeated events and can be adapted to focus on events that are unique to an individual respondent as well as events that affect the entire community (Axinn and Chardoul 2021).…”

Section: Need More Attention and Emphasis On Multiple Displacementsmentioning

confidence: 99%

Resilience within Communities of Forced Migrants: Updates and the Path Forward

Pendley

VanLandingham

Pham

et al. 2021

Journal on Migration and Human Security

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We explore the current state of the principal literature relevant to resilience and vulnerability within and among communities of forced migrants. We highlight strengths, gaps, and weaknesses in these literatures, utilizing a case study to illustrate the importance of what we deem to be essential omitted variables. We make recommendations for moving these literatures—and their associated underlying conceptual frameworks—forward.

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“…High-stress settings are high-priority demonstration contexts for depression prevention through promotion of social support. Nepal is a setting with a general population exposed to high levels of stress, including widespread poverty and a 6-year, medium-intensity armed conflict, with the majority of people experiencing 2 or more potentially traumatic experiences in their lifetime . Otherwise, Nepal’s population is similar to agrarian populations throughout Asia .…”

Section: Introductionmentioning

confidence: 99%

“…Nepal is a setting with a general population exposed to high levels of stress, including widespread poverty and a 6-year, medium-intensity armed conflict, 9,10 with the majority of people experiencing 2 or more potentially traumatic experiences in their lifetime. 11 Otherwise, Nepal's population is similar to agrarian populations throughout Asia. [12][13][14] Serendipitously, this setting also provides a natural experiment with exogenously introduced community-level cooperative programs that promote social support through both social capital and social cohesion.…”

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confidence: 99%

Community-Level Social Support Infrastructure and Adult Onset of Major Depressive Disorder in a South Asian Postconflict Setting

et al. 2022

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Individual-level social support protects against major depressive disorder (MDD) among adults exposed to trauma. Little is known about the consequences of community-level interventions in the general population.OBJECTIVE To determine the potential consequences of neighborhood social infrastructure on incident MDD in a high-risk general population. DESIGN, SETTING, AND PARTICIPANTSThis longitudinal, multilevel study estimated associations between a neighborhood-level program in a case-control design and subsequent individual outcomes across 10 years (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) in a cohort of young adults. Exogenously placed social programs simulate natural experiment conditions in a high-poverty population experiencing armed conflict (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). The western Chitwan valley in Nepal has a general population at high risk of MDD, with neighborhoods exposed to interventions to improve social support. From a random sample (response rate 93%) selected to represent the general population in 2016, participants aged 25 to 34 years in 2006 were studied. These individuals resided within 149 neighborhoods that varied in their availability of active social support programs. The analyses were conducted between October 2020 and November 2021.EXPOSURES The Small Farmers Development Program (SFDP) uses shared, joint liability financial credit among neighbors to build social capital and cohesion within neighborhoods. MAIN OUTCOMES AND MEASURES Onset of DSM-IV MDD after the conflict, assessed by the Nepal-specific, clinically validated World Mental Health Composite International DiagnosticInterview with a life history calendar. The hypothesis tested was that exposure to SFDP reduced adult onset of MDD. RESULTSOf the 1917 survey participants, 886 (46.2%) were women, and 856 (44.7%) were of Brahmin or Chhetri ethnicity. Of the 149 neighborhoods, 21 had an active SFDP group, and 156 of 1917 (8.1%) participants experienced MDD between 2006 and 2015. Discrete-time hazard models showed participants living in neighborhoods with an SFDP experienced incident MDD at nearly half the rate as others (odds ratio = 0.55; 95% CI, 0.30-1.02; P = .06). A multivariate, multilevel matching analysis showed the incidence of MDD among adults living in neighborhoods with an SFDP was 19 of 256 (7.4%), compared with 33 of 256 (12.9%) in the matched sample with no SFDP (z = 2.05; P = .04). CONCLUSIONS AND RELEVANCELiving in a neighborhood with community-level social support infrastructure was associated with reduced subsequent rates of adult-onset MDD, even in this high-risk population. Investments in such infrastructure may reduce population-level MDD, supporting clinical focus on potentially unpreventable cases.

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Improving reports of health risks: Life history calendars and measurement of potentially traumatic experiences

Cited by 7 publications

References 22 publications

Community exposure to armed conflict and subsequent onset of alcohol use disorder

Community exposure to armed conflict and subsequent onset of alcohol use disorder

Resilience within Communities of Forced Migrants: Updates and the Path Forward

Community-Level Social Support Infrastructure and Adult Onset of Major Depressive Disorder in a South Asian Postconflict Setting

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