Testimony method to ameliorate post-traumatic stress symptoms

Igreja, Victor; Kleijn, Wim Chr.; Schreuder, Bas J. N.; Dijk, Janie A. van; Verschuur, Margot J.

doi:10.1192/bjp.184.3.251

Cited by 66 publications

(36 citation statements)

References 19 publications

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“…The empirical results of these methods exhibit diverse effects in refugees. Although Igreja et al (2004) was unable to detect a significant effect of this approach in contrast to the comparison group, and Weine et al (1998) described positive effects within an uncontrolled study, Neuner et al (2004) documented moderate effects immediately after the therapy, which then increased significantly in the one-year follow up.…”

Section: Discussionmentioning

confidence: 63%

“…However, our approach contrasts significantly with the narrative exposure therapy (Neuner et al, 2004(Neuner et al, , 2008 and the testimony psychotherapy (Igreja, Kleijn, Schreuder, van Dijk, & Verschuur, 2004;Weine et al, 1998), which aim at confronting refugees with their traumatic experiences in a very short span of time. The empirical results of these methods exhibit diverse effects in refugees.…”

Section: Discussionmentioning

confidence: 95%

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Effects of trauma‐focused psychotherapy upon war refugees

Kruse

Joksimovic²,

Cavka³

et al. 2009

Journal of Traumatic Stress

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The aim of this study is to evaluate the effects of a trauma-focused psychotherapy upon war refugees from Bosnia. Seventy refugees who met the criteria for posttraumatic stress disorder (PTSD) and somatoform disorders were included. The first 35 refugees were offered psychotherapy and the following 35 refugees received usual care. Outcome variables were changes in self-reported PTSD symptoms, psychological symptoms, and health status. At 12-month follow-up, participants in the intervention group reported significantly lower scores on the PTSD scale and the measure of psychological symptoms than the comparison group participants. Our results suggest that psychotherapy reduces symptoms of PTSD and somatoform disorders among war refugees even in the presence of insecure residence status.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 95%

Effects of trauma‐focused psychotherapy upon war refugees

Kruse

Joksimovic²,

Cavka³

et al. 2009

Journal of Traumatic Stress

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“…In addition to our previous trial of IPT-G in southwestern Uganda, 8 are RCTs by Patel et al in India, 7 Araya et al in Chile, 6 and Igreja et al 5 in Mozambique; all focusing on adults. Two of these studies used individual-based psychotherapy treatments 5,7 and reported no effectiveness, whereas the 2 group-based studies found active treatment superior to controls. The current study also supports the potential of group-based therapies.…”

Section: Study Limitationsmentioning

confidence: 99%

Interventions for Depression Symptoms Among Adolescent Survivors of War and Displacement in Northern Uganda

Bolton

Bass

Betancourt

et al. 2007

JAMA

514

424

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Context Prior qualitative work with internally displaced persons in war-affected northern Uganda showed significant mental health and psychosocial problems.Objective To assess effect of locally feasible interventions on depression, anxiety, and conduct problem symptoms among adolescent survivors of war and displacement in northern Uganda. Design, Setting, and ParticipantsA randomized controlled trial from May 2005 through December 2005 of 314 adolescents (aged 14-17 years) in 2 camps for internally displaced persons in northern Uganda. Interventions Locally developed screening tools assessed the effectiveness of interventions in reducing symptoms of depression and anxiety, ameliorating conduct problems, and improving function among those who met study criteria and were randomly allocated (105, psychotherapy-based intervention [group interpersonal psychotherapy]; 105, activity-based intervention [creative play]; 104, wait-control group [individuals wait listed to receive treatment at study end]). Intervention groups met weekly for 16 weeks. Participants and controls were reassessed at end of study.Main Outcome Measures Primary measure was a decrease in score (denoting improvement) on a depression symptom scale. Secondary measures were improvements in scores on anxiety, conduct problem symptoms, and function scales. Depression, anxiety, and conduct problems were assessed using the Acholi Psychosocial Assessment Instrument with a minimum score of 32 as the lower limit for clinically significant symptoms (maximum scale score, 105).Results Difference in change in adjusted mean score for depression symptoms between group interpersonal psychotherapy and control groups was 9.79 points (95% confidence interval [CI], 1.66-17.93). Girls receiving group interpersonal psychotherapy showed substantial and significant improvement in depression symptoms compared with controls (12.61 points; 95% CI, 2.09-23.14). Improvement among boys was not statistically significant (5.72 points; 95% CI, −1.86 to 13.30). Creative play showed no effect on depression severity (−2.51 points; 95% CI, −11.42 to 6.39). There were no statistically different improvements in anxiety in either intervention group. Neither intervention improved conduct problem or function scores.Conclusions Both interventions were locally feasible. Group interpersonal psychotherapy was effective for depression symptoms among adolescent girls affected by war and displacement. Other interventions should be investigated to assist adolescent boys in this population who have symptoms of depression.

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“…Designed for ease of administration, it consists of 20 items covering symptoms of anxiety and mood disorders with a binary (yes/no) response scale. The SRQ-20 has been assessed across a wide range of contexts, including conflict and refugee settings in Colombia [30], Guinea Bissau [31], Mozambique [32], Rwanda [33], Uganda [34], Iran [35], Pakistan [36], and Afghanistan [37,38]. In Afghanistan, the psychometric properties of a Pashto SRQ-20 were examined by Ventevogel and colleagues [39], who reported reasonable psychometric properties but large differences across gender.…”

Section: Introductionmentioning

confidence: 99%

Comparing the validity of the self reporting questionnaire and the Afghan symptom checklist: dysphoria, aggression, and gender in transcultural assessment of mental health

et al. 2014

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BackgroundThe relative performance of local and international assessment instruments is subject to ongoing discussion in transcultural research on mental health and psychosocial support. We examined the construct and external validity of two instruments, one developed for use in Afghanistan, the other developed by the World Health Organization for use in resource-poor settings.MethodsWe used data collected on 1003 Afghan adults (500 men, 503 women) randomly sampled at three sites in Afghanistan. We compared the 22-item Afghan Symptom Checklist (ASCL), a culturally-grounded assessment of psychosocial wellbeing, with Pashto and Dari versions of the 20-item Self-Reporting Questionnaire (SRQ-20). We derived subscales using exploratory and confirmatory factor analyses (EFA and CFA) and tested total and subscale scores for external validity with respect to lifetime trauma and household wealth using block model regressions.ResultsEFA suggested a three-factor structure for SRQ-20 - somatic complaints, negative affect, and emotional numbing - and a two-factor structure for ASCL - jigar khun (dysphoria) and aggression. Both factor models were supported by CFA in separate subsamples. Women had higher scores for each of the five subscales than men (p < 0.001), and larger bivariate associations with trauma (rs .24 to .29, and .10 to .19, women and men respectively) and household wealth (rs -.27 to -.39, and .05 to -.22, respectively). The three SRQ-20 subscales and the ASCL jigar khun subscale were equally associated with variance in trauma exposures. However, interactions between gender and jigar khun suggested that, relative to SRQ-20, the jigar khun subscale was more strongly associated with household wealth for women; similarly, gender interactions with aggression indicated that the aggression subscale was more strongly associated with trauma and wealth.ConclusionsTwo central elements of Afghan conceptualizations of mental distress - aggression and the syndrome jigar khun – were captured by the ASCL and not by the SRQ-20. The appropriateness of the culturally-grounded instrument was more salient for women, indicating that the validity of instruments may be gender-differentiated. Transcultural validation processes for tools measuring mental distress need to explicitly take gender into account. Culturally relevant measures are worth developing for long-term psychosocial programming.

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Testimony method to ameliorate post-traumatic stress symptoms

Abstract: A remarkable drop in symptoms could not be linked directly to the intervention. Feasibility of the intervention was good, but controlling the intervention in a small rural community appeared to be a difficult task to accomplish.

Cited by 66 publications

References 19 publications

Effects of trauma‐focused psychotherapy upon war refugees

Effects of trauma‐focused psychotherapy upon war refugees

Interventions for Depression Symptoms Among Adolescent Survivors of War and Displacement in Northern Uganda

Comparing the validity of the self reporting questionnaire and the Afghan symptom checklist: dysphoria, aggression, and gender in transcultural assessment of mental health

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