Effect of Cognitive Behavioral Intervention Program on Post-Traumatic Stress Disorder Among Syrian Adolescent Refugees in Egypt
DOI:
https://doi.org/10.53555/hsn.v6i7.1377Keywords:
Cognitive Behavioral Intervention, Post Traumatic Stress Disorder, Syrian Adolescent RefugeesAbstract
Abstract: Background: Adolescents' refugee's is directly or indirectly affected by war-related traumas. Many studies had consistently recorded the presence of post-traumatic stress disorder (PTSD) and other psycho-social disorder. However, there is still much discussion about evidence based and sensitive interventions for such problems. Objectives: Assess the prevalence of Post Traumatic Stress Disorder (PTSD) among Syrian adolescents' refugee's students in Egypt and identify the effect of cognitive behavioral intervention program (CBITS) on post-traumatic stress disorder among them. A Quasi experimental research design was adopted to carry out this study. Settings: The study was carried out at 10 schools for Syrian refugees' students at Cairo and Alexandria Governorates. Subjects: All Syrian adolescent refugees' students enrolled in the previously mentioned schools whose age ranged between 11 – 15 years, and was registered in the United Nations High Commissioner for Refugees (UNHCR). Their total number was 613 students in 2014 – 2015 (Appendix 1). b- All students with moderate level of PTSD (206) according to the initial assessment using child PTSD symptom scale (CPSS) were selected to be included in the (CBITS) program. Tools: Two tools were used in this study. Tool I: Students' Personal and Socio- demographic Data Structured Interview Questionnaire. Tool Two: Child PTSD Symptom Scale (CPSS) to assess the frequency of all post-traumatic stress disorder symptoms within the past month among adolescents experienced a traumatic event. The study had four phases. The first was the assessment and preparatory phase were tool (II) used to assess PTSD symptoms frequency and severity among adolescent6s' refugees, the second was the development phase while the third was the implantation phase and Finally the fourth phase was the evaluation phase during which tool (II) was reused for immediate and 3 month follow up evaluation for. Results: Findings of the present study revealed that more than one third (34.75%) of the Syrian adolescent's refugees had mild symptoms of PTSD, one third of them (33.6 %) had moderate symptoms and 4.08% had severe PTSD symptoms. statistically significant difference on PTSD severity either immediately or after three month following the intervention implementing between study and control groups (X2=16.455, P=0.001 and X2=23.486, P=0.01).Conclusion. post-traumatic stress disorder symptoms is prevalent among Syrian adolescent refugees in Egypt. Furthermore, the current study concluded that the cognitive behavioral interventions for trauma in school was promising intervention for reduce of PTSD symptoms among Syrian adolescent refugees' in Egypt. Recommendations: Conduct comprehensive physical and mental health screen and assessment for traumatic adolescent's refugees for PTSD to identify intervention requirements and training for health specialists' practitioners to deliver evidence-based PTSD related interventions
Downloads
References
Al-Hemiary, N. J., Hashim, M. T., Al-Shawi, A. F., & Al-Diwan, J. K. (2016). Effect of post-traumatic stress disorder on school achievement among secondary school students in Baghdad, Iraq. Journal of the Faculty of Medicine, 58(2), 146-148.
Allison, A. C., & Ferreira, R. J. (2017). Implementing Cognitive Behavioral Intervention for Trauma in Schools (CBITS) with Latino Youth. Child and Adolescent Social Work Journal, 34(2), 181-189.
Alpak, G., Unal, A., Bulbul, F., Sagaltici, E., Bez, Y., Altindag, A. . . . & Savas, H. A. (2015). Post-traumatic stress disorder among Syrian refugees in Turkey: a cross-sectional study. International journal of psychiatry in clinical practice, 19(1), 45-50.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). USA: American Psychiatric Association.
Berdal, M. (2017). Building peace after war. New York: Routledge.
Bichescu, D., Schauer, M., Saleptsi, E., Neculau, A., Elbert, T., & Neuner, F. (2005). Long-term consequences of traumatic experiences: an assessment of former political detainees in Romania. Clinical practice and epidemiology in mental health, 1(1), 17.
Blanchet, K., Ramesh, A., Frison, S., Warren, E., Hossain, M., Smith, J. . . . & Woodward, A. (2017). Evidence on public health interventions in humanitarian crises. The Lancet, 390(10109), 2287-2296.
Bogic, M., Njoku, A., & Priebe, S. (2015). Long-term mental health of war-refugees: a systematic literature review. BMC international health and human rights, 15, 29.
Bonanno, G. A., & Mancini, A. D. (2012). Beyond resilience and PTSD: Mapping the heterogeneity of responses to potential trauma. Psychological trauma: Theory, research, practice, and policy, 4(1), 74.
Breslau, N. (2009). The epidemiology of trauma, PTSD, and other posttrauma disorders. Trauma, violence & abuse, 10(3), 198-210.
Bronstein, I., & Montgomery, P. (2011). Psychological distress in refugee children: a systematic review. Clinical child and family psychology review, 14(1), 44-56.
Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C. . . . & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical psychology review, 43, 128-141.
Dyb, G., Jensen, T. K., & Nygaard, E. (2011). Children's and parents' posttraumatic stress reactions after the 2004 tsunami. Clinical child psychology and psychiatry, 16(4), 621-634.
Fazel M, Wheeler J, Danesh J. (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. The Lancet ;365(9467):1309-14.
Fazel, M., Reed, R. V., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. The Lancet, 379(9812), 266-282.
Fazel, M., Reed, R., & Stein, A. (2015). Refugee, asylum-seeking and internally displaced children and adolescents. Rutter's Child and Adolescent Psychiatry. Sixth ed: John Wiley & Sons, Ltd, 573-85.
Figley, C. R. (2013). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Routledge.
Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. (2001). The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties. Journal of clinical child psychology, 30(3), 376-384.
Giannopoulou, I., Dikaiakou, A., & Yule, W. (2006). Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study. Clinical child psychology and psychiatry, 11(4), 543-553.
(Gillies, Taylor, Gray O'Brien & D'Abrew,( 2013). Cochrane database of systematic reviews (Online) 12(12):CD006726.
Goldbeck, L., Muche, R., Sachser, C., Tutus, D., & Rosner, R. (2016). Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: A Randomized Controlled Trial in Eight German Mental Health Clinics. Psychotherapy and psychosomatics, 85(3), 159-170.
Goodkind, J. R., Lanoue, M. D., & Milford, J. (2010). Adaptation and implementation of cognitive behavioral intervention for trauma in schools with American Indian youth. Journal of clinical child and adolescent psychology, 39(6), 858-872.
Hadfield, K., Ostrowski, A., & Ungar, M. (2017). What can we expect of the mental health and well-being of Syrian refugee children and adolescents in Canada? Canadian Psychology/psychologie canadienne, 58(2), 194.
Hapke, U., Schumann, A., Rumpf, H. J., John, U., & Meyer, C. (2006). Post-traumatic stress disorder: the role of trauma, pre-existing psychiatric disorders, and gender. European archives of psychiatry and clinical neuroscience, 256(5), 299-306.
Hariri, A. Y. (2019). Salvation or Suffering? Analyzing the Impact of UN Peacekeeping Operations on Health and Safety of Women in Post-Conflict Environments (Master Thesis). University of Pennsylvania, United States.
Hollon, S. D., & Beck, A. T. (2013). Cognitive and cognitivebehavioral therapies. In M. J. Lambert (Ed.), Handbook of psychotherapy and behavior change (6th ed ed p.p. 393-442). Hoboken, NJ: Wiley & Sons.
Jaycox, L. H., Langley, A. K., & Hoover, S. A. (2018). Cognitive Behavioral Intervention for Trauma in Schools (CBITS) (2nd ed.). Santa Monica, CA: RAND Corporation.
Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J. . . . & Pottie, K. (2011). Common mental health problems in immigrants and refugees: general approach in primary care. Canadian Medical Association Journal, 183(12), E959-E967.
Langley, A. K., Gonzalez, A., Sugar, C. A., Solis, D., & Jaycox, L. (2015). Bounce back: Effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic events. Journal of consulting and clinical psychology, 83(5), 853-865.
Leiler, A., Bjärtå, A., Ekdahl, J., & Wasteson, E. (2019). Mental health and quality of life among asylum seekers and refugees living in refugee housing facilities in Sweden. Social psychiatry and psychiatric epidemiology, 54(5), 543-551.
Littlewood, D. L., Gooding, P. A., Panagioti, M., & Kyle, S. D. (2016). Nightmares and Suicide in Posttraumatic Stress Disorder: The Mediating Role of Defeat, Entrapment, and Hopelessness. Journal of clinical sleep medicine, 12(3), 393-399.
Masten, A. S., & Narayan, A. J. (2012). Child development in the context of disaster, war, and terrorism: pathways of risk and resilience. Annual review of psychology, 63, 227-257.
Merry, S. N., Hetrick, S. E., Cox, G. R., Brudevold‐Iversen, T., Bir, J. J., & McDowell, H. (2012). Cochrane Review: Psychological and educational interventions for preventing depression in children and adolescents. Evidence‐Based Child Health: A Cochrane Review Journal, 7(5), 1409-1685.
Moffitt, T. E. (1993). Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy. In K. M. Beaver & A. Walsh (Eds.), Psychological Review (p.p. 69- 96). New York: Routledge.
Mollica, R. F., Brooks, R. T., Ekblad, S., & McDonald, L. (2015). The New H 5 Model of Refugee Trauma and Recovery. In J. Lindert & I. Levav (Eds.), Violence and Mental Health (p.p. 341-378). Dordrecht: Springer.
Nadorff, M. R., Nazem, S., & Fiske, A. (2013). Insomnia symptoms, nightmares, and suicide risk: duration of sleep disturbance matters. Suicide & life-threatening behavior, 43(2), 139-149.
Njogu, K., & Orchardson-Mazrui, E. (2013). Gender inequality and women’s rights in the Great Lakes: Can culture contribute to women’s empowerment. New York: UNICEF.
Oliveira, R. B., Papa, J. P., Pereira, A. S., & Tavares, J. M. R. (2018). Computational methods for pigmented skin lesion classification in images: review and future trends. Neural Computing and Applications, 29(3), 613-636.
Ooi, C. S., Rooney, R. M., Roberts, C., Kane, R. T., Wright, B., & Chatzisarantis, N. (2016). The Efficacy of a Group Cognitive Behavioral Therapy for War-Affected Young Migrants Living in Australia: A Cluster Randomized Controlled Trial. Frontiers in psychology, 7, 1641.
Osgood, D. W., Foster, E. M., & Courtney, M. E. (2010). Vulnerable populations and the transition to adulthood. The Future of children, 20(1), 209-229.
Özer, S., Sirin, S. R., & Oppedal, B. (2016). Bahçeşehir study of Syrian refugee children in Turkey.
Perkins, J. D., Ajeeb, M., Fadel, L., & Saleh, G. (2018). Mental health in Syrian children with a focus on post-traumatic stress: a cross-sectional study from Syrian schools. Social psychiatry and psychiatric epidemiology, 53(11), 1231-1239.
Rush University Medical Center (2018) Intensive Outpatient Therapy Rapidly Reduces PTSD available at https://www.rush.edu/news/press-releases/intensive-outpatient-therapy-rapidly-reduces-ptsd
Sagle, T. (2013). The Effectiveness of Psychosocial Interventions for Reducing Psychological Harm in Children and Adolescents who have Experienced Trauma: A Systematic Review and Meta-Analysis (Doctoral dissertation). (Master Thesis). The University of Guelph, Guelph, Ontario, Canada.
Santiago, C. D., Pears, G., Baweja, S., Vona, P., Tang, J., & Kataoka, S. H. (2013). Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS. School mental health, 5(4).
Shooshtary, M. H., Panaghi, L., & Moghadam, J. A. (2008). Outcome of cognitive behavioral therapy in adolescents after natural disaster. Journal of Adolescent Health, 42(5), 466–472. https://doi.org/10.1016/j.jadohealth.2007.09.011
Slewa-Younan, S., Uribe Guajardo, M. G., Heriseanu, A., & Hasan, T. (2015). A Systematic Review of Post-traumatic Stress Disorder and Depression Amongst Iraqi Refugees Located in Western Countries. Journal of immigrant and minority health, 17(4), 1231-1239.
Swendsen, J., Conway, K. P., Degenhardt, L., Glantz, M., Jin, R., Merikangas, K. R. . . . & Kessler, R. C. (2010). Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey. Addiction, 105(6), 1117-1128.
SSY Li, BJ Liddell, A Nickerson,(2016) The relationship between post-migration stress and psychological disorders in refugees and asylum seekers. Current psychiatry reports, 2016 - Springer
Tekeli-Yesil, S., Isik, E., Unal, Y., Aljomaa Almossa, F., Konsuk Unlu, H., & Aker, A. T. (2018). Determinants of Mental Disorders in Syrian Refugees in Turkey Versus Internally Displaced Persons in Syria. American journal of public health, 108(7), 938-945.
Thabet, A. A., Abu Tawahina, A., El Sarraj, E., & Vostanis, P. (2008). Exposure to war trauma and PTSD among parents and children in the Gaza strip. European child & adolescent psychiatry, 17(4), 191-199.
Tyrer, R. A., & Fazel, M. (2014). School and community-based interventions for refugee and asylum seeking children: a systematic review. PloS one, 9(2), e89359.
UN High Commission for Refugees (UNHCR). (2019). Voluntary repatriation of refugees' operations strategy. Geneva: UNHCR.
UN High Commission for Refugees [UNHCR]. (2018). Situation Syria Regional Refugee Response. Geneva: UNHCR.
Williams, M. B., & Poijula, S. (2016). The PTSD workbook: Simple, effective techniques for overcoming traumatic stress symptoms. USA: New Harbinger Publications.
World Health Organization [WHO]. (2017). Progress in partnership: 2017 progress report on Every woman every child global strategy for women’s, children’s and adolescents’ health (No. WHO /FWC /NMC/ 17.3). Geneva: WHO.
Yehuda, R., & Bierer, L. M. (2009). The relevance of epigenetics to PTSD: implications for the DSM-V. Journal of traumatic stress, 22(5), 427-434.
Yuodelis-Flores, C., & Ries, R. K. (2015). Addiction and suicide: A review. The American journal on addictions, 24(2), 98-104.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 International Journal For Research In Health Sciences And Nursing (ISSN: 2208-2670)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
In consideration of the journal, Green Publication taking action in reviewing and editing our manuscript, the authors undersigned hereby transfer, assign, or otherwise convey all copyright ownership to the Editorial Office of the Green Publication in the event that such work is published in the journal. Such conveyance covers any product that may derive from the published journal, whether print or electronic. Green Publication shall have the right to register copyright to the Article in its name as claimant, whether separately
or as part of the journal issue or other medium in which the Article is included.
By signing this Agreement, the author(s), and in the case of a Work Made For Hire, the employer, jointly and severally represent and warrant that the Article is original with the author(s) and does not infringe any copyright or violate any other right of any third parties, and that the Article has not been published elsewhere, and is not being considered for publication elsewhere in any form, except as provided herein. Each author’s signature should appear below. The signing author(s) (and, in
