Preventive interventions among children exposed to trauma of armed conflict: a literature review

Abstract

Increasing research is available on the preconditions for child mental health and optimal development in traumatic conditions, whereas less is known how to translate the findings into effective interventions to help traumatized children. This literature review analyses the effectiveness of psychosocial preventive interventions and treatments and their theoretical bases among children traumatized in the context of armed conflicts (war, military violence, terrorism and refugee). The first aim is to evaluate the effectiveness of preventive interventions in preventing emotional distress and impairment and promoting optimal emotional-cognitive and social development. The second task is to analyze the nature of the underlying mechanisms for the success of preventive interventions, and the theoretical premises of the choice of intervention techniques, procedures and tools. We found 16 relevant published studies, but an examination of them revealed that only four of them had experimental designs strong enough that they could be included in the meta-analysis. While the subjective reports of the researchers suggested that systematic preventive interventions were effective in decreasing PTSD and depressive symptoms among children traumatized due to armed conflict, the more objective results of the meta-analysis and the weaknesses in designs uncovered during the meta-analysis undermine such a conclusion. Additionally, a majority of the reported preventive interventions focused only on children's biased cognitive processes and negative emotions, while only a few aimed at influencing multiple domains of child development and improving developmental functioning on emotional, social and psychophysiological levels. It is concluded that substantial additional work needs to be done in developing effective preventive interventions and treatments for children traumatized by exposure to war and violence.

Peritraumatic dissociation predicts posttraumatic stress disorder symptoms via dysfunctional trauma-related memory among war-affected children

“…Cognitive behavioural therapy (CBT) approaches aim to integrate shattered psychic processes, including trauma memories, into integrated and controllable life histories (Peltonen & Punamäki, 2010). However, treatment for dissociation is not a routine element in these treatments (Schauer & Elbert, 2015).…”

Refugees and Mental Health - Hosting, Understand and Treat

“…Embora a maioria das crianças experimentem sofrimento intenso após a vivência de acontecimentos traumáticos apenas uma minoria desenvolve sintomas que sejam critérios para diagnóstico de PTSD (Peltonen & Punamaki, 2010). A perda de um dos progenitores está associada a maior incidência de PTSD e de depressão sendo as crianças que vivem com ambos os progenitores as que apresentam menos problemas psicológicos (Levy & Sidel, 2009).…”

“…A relação entre os fatores de riscos e os fatores protetores, em crianças que estiveram submetidas a conflitos armados, joga-se não só nelas mas também nas suas relações familiares e no suporte social. A importância de melhorar o envolvimento da criança, a participação parental e os serviços multidisciplinares integrados são enfatizados como formas de intervenção pela maioria dos autores (Peltonen & Punamaki, 2010). O apoio à paternidade e à maternidade, a restauração da narrativa e da simbolização são fundamentais no processo psicoterapêutico com os pais e os filhos.…”

Assessing Resilience in War-Affected Children and Adolescents: A Critical Review

“…For the critical analysis of the two quantitative studies, the set of evaluation criteria was primarily compiled from the method sections of three literature reviews on psychosocial outcomes and trauma in conflict settings -Hollifield et al (2002), Peltonen and Punamaki (2010), and Theron and Theron (2010). Given the multidimensional nature of the concept of resilience described above and its implications for the methodological plurality in the field, the operational definition of resilience utilized in each study will first be considered including its rationale and relationship with extant conceptual models.…”