Abstract
Conflict-affected populations are exposed to stressful events during and after war, and it is well established that both take a substantial toll on individuals’ mental health. Exactly how exposure to events during and after war affect mental health is a topic of considerable debate. Various hypotheses have been put forward on the relation between stressful war exposure (SWE), daily stressors (DS) and the development of post-traumatic stress disorder (PTSD). This paper seeks to contribute to this debate by critically reflecting upon conventional modeling approaches and by advancing an alternative model to studying interrelationships between SWE, DS, and PTSD variables. The network model is proposed as an innovative and comprehensive modeling approach in the field of mental health in the context of war. It involves a conceptualization and representation of variables and relationships that better approach reality, hence improving methodological rigor. It also promises utility in programming and delivering mental health support for war-affected populations.
Highlights
Factoranalytic techniques are applied to determine the presence of each symptom cluster (Yule, 1997; Morina et al, 2010, 2011) and internal-consistency is calculated (Bayer et al, 2007; Miller et al, 2008; Fernando et al, 2010; Mels et al, 2010; Ertl et al, 2014). This practice reflects the underlying view that mental health constructs such as post-traumatic stress disorder (PTSD) are latent variables that cause manifest symptoms, which is the basic premise of the reflective model (Borsboom et al, 2003; Schmittmann et al, 2013)
Researchers have mainly relied on the reflective measurement model, which is characterized by the conception of these constructs as latent variables (Netland, 2005)
Based on the assumption of a dose-effect relationship, these constructs have been combined into structural models to study the impact of stress accumulation on PTSD
Summary
While SWE and DS are not usually conceptualized as a latent construct, they are often operationalized as latent variables in the process of measure construction and data analysis. Factoranalytic techniques are applied to determine the presence of each symptom cluster (Yule, 1997; Morina et al, 2010, 2011) and internal-consistency is calculated (Bayer et al, 2007; Miller et al, 2008; Fernando et al, 2010; Mels et al, 2010; Ertl et al, 2014) This practice reflects the underlying view that mental health constructs such as PTSD are latent variables that cause manifest symptoms, which is the basic premise of the reflective model (Borsboom et al, 2003; Schmittmann et al, 2013). We scrutinize these limitations and introduce the network approach as an alternative way to conceptualize and operationalize stress exposure and mental health in the context of armed conflict
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