Mental health outcomes in communities exposed to Armed Conflict Experiences

Abstract

Background Populations exposed to Armed Conflict Experiences (ACE) show different levels of impact in their mental health (i.e. clinical and positive components); however, there is limited evidence related to mental health of general population (civilians not classified as victims) exposed to ACE. Government guided mental health assessments exclude this population. The use of a newly validated Extreme Experiences Scale (EX2) seems appropriate to classify victims, ex-combatants, and civilians for their mental health assessment. Methods Here, we propose a novel approach to identify relationships between individuals classified with different levels of ACE exposure—independent of their legal role in the armed conflict, and mental health outcomes. According to the cut-off points derived from the scores of EX2, we classified the sample in low and high exposure to ACE. Results The high-level ACE group (scores > 2.5) included 119 subjects, and the low-level ACE was constituted by 66 subjects. Our results evidence that people with high exposure to ACE experiment higher odds to present anxiety disorders, risk of suicide, or post-traumatic stress disorder, as well as increased cognitive empathy (i.e., fantasy dimension). Conclusion These findings allowed us to identify the influence of ACE on mental health outcomes beyond the conventional frame (victim or ex-combatant), and to discuss effective interventions and implementation of mental health strategies in these communities. We expect to help the health system to focus on key vulnerable subjects by including civilians not recognized as victims, which are neglected from most of the public health screening, assessment, and interventions.

Profiles of Suicide Attempted in Children and Adolescents in Cauca, Colombia 2016-2019

“…The department of Cauca has been one of the most affected by this phenomenon, with 20 of 42 towns prioritized for the Colombian armed post-con ict [20]. The literature describes a higher frequency of SA in people exposed to armed con ict, military population and adults displaced by violence [21][22][23]. In the child and adolescent population, information is scarce, although, in Middle Eastern countries, a higher frequency of depression and suicidal ideation is reported in those exposed to terrorist attacks [24].…”

A mini-review on safeguarding global health amidst a “Pandemic” of armed conflicts

“…Also, collaboration with local authorities ensures safe security for healthcare workers, aiding the provision of needed medical services in affected areas. [ 39 ]…”

Imprints of war: An analysis of implicit prejudice among victims, ex-combatants, and communities in Colombia.

“…Violent conflict experiences not only affect ex-combatants', victims', and communities' mental health (Trujillo, Trujillo, Ugarriza, et al, 2017;Trujillo et al, 2021), but also their attitudes toward one another in the longer term (Aiken, 2008;Harris & Fiske, 2006;Northrup, 1989;Volkan, 1999Volkan, , 2009.…”

“…This approval includes individual signed consent forms that were used before each session on the field.6 The Extreme Experiences scale comprised 18 items that ask participants about whether they were subjected to war-related traumatic experiences, either in a direct or indirect way, such as threats, beating, kidnapping, sexual abuse, firing, bombing, repression, assaults, homicide of close persons, invalidating disease or condition, or personal life disruption. A recent application of this instrument can be found atTrujillo et al (2021).IMPRINTS OF WAR…”