Original articleModerators of Treatment Effectiveness for War-Affected Youth With Depression in Northern Uganda
Section snippets
Participants
The RCT was conducted in two IDP camps near the town of Gulu, northern Uganda. Study inclusion criteria consisted of ability to understand and speak Acholi Luo and having lived in either of the two camps for at least 1 month before the baseline screening interview. Eligible adolescents were aged 14–17 years, scored above a predetermined threshold of depression symptom severity based on the Acholi Psychosocial Assessment Instrument (APAI) Depression Problems Subscale [26], and reported some
Results
The IPT-G, CP, and wait-list control groups had similar mean age and gender distributions (Table 1). The trial arms did not differ significantly in baseline characteristics, including rates of LRA abduction; however, male subjects reported a significantly higher rate of abduction (n = 68, 52%) compared with female subjects (n = 59, 34%) (p < .01). There were no significant differences in baseline depression scores across groups. Further sociodemographic details are provided elsewhere [8].
Discussion
We found that the effect of IPT-G on depression symptoms was different among youth with a history of abduction compared with never abducted youth. Importantly, both male and female former child soldiers benefited from IPT-G. The intervention was most effective among war-affected adolescent girls without a history of abduction by rebel forces; however, in contrast to our hypotheses, those least likely to benefit from IPT-G were male subjects with no history of abduction. These findings are
Conclusions
These findings contribute to a growing, yet nascent, evidence base on mental health interventions for war-affected youth, including former child soldiers [39]. The present study indicates that the effectiveness of IPT-G for war-affected youth may vary according to the joint effects of abduction status and gender. These findings raise the possibility that the effectiveness of other treatments might also vary by similar factors, and that such treatment moderators should be explicitly investigated
Acknowledgments
The authors are grateful to the project staff, local leaders, and the communities for their warm welcome and professional engagement with the study. They thank Ista Zahn and Sidney Atwood for their assistance with data management and analysis. This study was supported by funding from World Vision, War Child Holland, grant 1K01MH077246-01A2 from the National Institute of Mental Health, grant P60 MD002261 from the National Center for Minority Health and Disparities, the American Australian
References (40)
- et al.
The risk of return: Intimate partner violence in Northern Uganda's armed conflict
Soc Sci Med
(2010) - et al.
Post-traumatic stress in former Ugandan child soldiers
Lancet
(2004) - et al.
Effectiveness of a school-based group psychotherapy program for war-exposed adolescents: A randomized controlled trial
J Am Acad Child Adolesc Psychiatry
(2008) - et al.
Sierra Leone's former child soldiers: A longitudinal study of risk, protective factors, and mental health
J Am Acad Child Adolesc Psychiatry
(2010) - et al.
Past horrors, present struggles: The role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone
Soc Sci Med
(2010) - et al.
Group interpersonal psychotherapy for depressed youth in IDP camps in Northern Uganda: Adaptation and training
Child Adolesc Psychiatr Clin N Am
(2008) Attending to the mental health of war-affected children: The need for longitudinal and developmental research perspectives
J Am Acad Child Adolesc Psychiatry
(2011)- et al.
Bridging the gap between best evidence and best practice in mental health
Clin Psychol Rev
(2010) Child soldiers: Global report 2004
(2004)The Paris Principles: Principles and guidelines on children associated with armed forces or armed conflict
(2007)
Psychosocial adjustment and social reintegration of children associated with armed forces and armed groups: The state of the field and future directions
Multiple trauma and mental health in former Ugandan child soldiers
J Trauma Stress
Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: A randomized controlled trial
JAMA
School-based cognitive-behavioural therapy group intervention for refugee children who have experienced war-related trauma
Clin Child Psychol Psychiatry
Community-implemented trauma therapy for former child soldiers in northern Uganda: A randomized controlled trial
JAMA
The impact of structured activities among Palestinian children in a time of conflict
J Child Psychol Psychiatry
School-based mental health intervention for children affected by political violence in Indonesia: A cluster randomized trial
JAMA
Glimpsing the complexity of youth and political violence
A qualitative study of mental health problems among children displaced by war in northern Uganda
Transcult Psychiatry
Cited by (44)
Common factors in psychological treatments delivered by non-specialists in low- and middle-income countries: Manual review of competencies
2020, Journal of Behavioral and Cognitive TherapyEffects of interventions to reduce adolescent depression in low- and middle-income countries: A systematic review and meta-analysis
2020, Journal of Psychiatric ResearchCitation Excerpt :Neshat-Doost et al. (2013) has been excluded from further evaluation as the authors of this review could not reach the authors of the study and gain more specific information of the interventions effectiveness. One study by Betancourt et al. (2012) met the criteria but was excluded from the meta-analysis because it used secondary data. Therefore, total of 28 studies included in the further evaluations.
The impact of abduction and hostage-taking on the mental health of children and adolescents: a scoping review
2024, European Child and Adolescent Psychiatry