Abstract
BackgroundArmed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim).MethodsWe conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention.ResultsNo main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes.ConclusionsGiven inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings.Trial registrationThe study was registered as ISRCTN42284825
Highlights
Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents
These may range from resilience, that is, maintained mental health in the face of adversity, to increased psychological distress and heightened prevalence of mental disorders including post-traumatic stress disorder (PTSD), depression, and anxiety disorders [3]
The school-based intervention was aimed both at reducing psychological symptoms, as well as improving strengths and functioning in children with heightened symptomatology
Summary
Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. Epidemiological studies have shown that armed conflicts are associated with a wide range of child mental health outcomes These may range from resilience, that is, maintained mental health in the face of adversity, to increased psychological distress and heightened prevalence of mental disorders including (symptoms of) post-traumatic stress disorder (PTSD), depression, and anxiety disorders [3]. The current study concerns a school-based mental health intervention implemented within a multi-layered package of services [6,7] Within this package, the school-based intervention was aimed both at reducing psychological symptoms (treatment aim), as well as improving strengths and functioning in children with heightened symptomatology (preventive aim)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
