ENTRE POBREZA Y VIOLENCIA: ¿CÓMO AFECTAN LOS ESTRESORES DIARIOS Y LA VIOLENCIA A ADOLESCENTES EN ZONAS DE GUERRA?

Cindy Mels

doi:10.22235/cp.v6i1.69

Autores

Cindy Mels Universidad Católica del Uruguay

DOI:

https://doi.org/10.22235/cp.v6i1.69

Palavras-chave:

depresión, ansiedad, adolescencia, resiliencia, República Democratica del Congo

Resumo

Se ha establecido científicamente que la violencia sufrida en situaciones de guerra afecta negativamente al funcionamiento psicológico de las víctimas, no obstante, se supone que es el conjunto de varios factores de riesgo y factores protectores los que determinan las reacciones concretas. Este artículo se enfocará en dos factores de riesgo –la exposición a eventos violentos y los estresores diarios– y su relación con conductas internalizadas (depresión y ansiedad) en adolescentes viviendo en una zona de guerra. A través de un muestreo por conglomerados comprendiendo 13 colegios en 4 zonas seleccionadas en Ituri, una provincia en el noreste de la República Democrática del Congo, se encuestan 991 alumnos (13 a 21 años) por medio de cuestionarios de auto-informe, revelando datos sobre las variables sexo, edad, exposición a la violencia, estresores diarios, conductas internalizadas y externalizadas. Se encontró que los adolescentes varones resultaron más expuestos a la violencia que las adolescentes mujeres. La exposición a eventos violentos también se diferenció según la edad, en ambos sexos. A su vez, los adolescentes mayores, tanto varones como mujeres, reportaron más estresores diarios que sus pares de menor edad. Un efecto de interacción entre la exposición a la violencia y estresores diarios predijo comportamientos internalizados a medida que ambas variables se acumulaban. Además, las adolescentes mujeres, mostraron más conductas internalizadas bajo la acumulación de estresores diarios que los adolescentes varones. Concluimos que los estresores diarios están asociados con mayores niveles de conductas internalizadas, sobre todo en adolescentes mujeres, y que la exposición a la violencia aumenta el efecto. A pesar de la violencia sufrida, la reducción de estresores diarios en la vida de adolescentes afectados por la guerra, podría promover su resiliencia y minimizar en cierta medida los síntomas psicológicos causados por el estrés acumulado durante la guerra.

Downloads

Não há dados estatísticos.

Referências

Amone-P’Olak, K., Garnefski, N., & Kraaij, V. (2007). Adolescents caught between fires: cognitive emotion regulation in response to war experiences in Northern Uganda. Journal of Adolescence, 30 (4), 655-669.

Autesserre, S. (2009). Hobbes and the Congo: frames, local violence, and international intervention. International Organization, 63 (2), 249-280.

Barenbaum, J., Ruchkin, V., & Schwab-Stone, M. (2004). The psychosocial aspects of children exposed to war: practice and policy initiatives. Journal of Child Psychology & Psychiatry, 45 (1), 41-62.

Bass, J. K., Ryder, R. W., Lammers, M. C., Mukaba, T. N., & Bolton, P. A. (2008). Postpartum depression in Kinshasa, Democratic Republic of Congo: Validation of a concept using a mixed- methods cross-cultural approach. Tropical Medicine and International Health, 13, 1534-1542.

Bean, T., Derluyn, I., Eurelings-Bontekoe, E., Broekaert, E., & Spinhoven, P. (2007). Validation of the multiple language versions of the Hopkins Symptom Checklist-37 for Refugee Adolescents. Adolescence, 42, 51-71.

Betancourt, T., & Khan, K. (2008). The mental health of children affected by armed conflict: protective processes and pathways to resilience. International Review of Psychiatry, 20 (3), 317-328.

Bracken, P., Giller, J., & Summerfield, D. (1995). Psychological responses to war and atrocity: the limitations of current concepts. Social Science & Medicine, 40, 1073-1082.

Bronfenbrenner, U. (1979). The ecology of human development. Cambridge: Harvard University Press.

Derluyn, I., Broekaert, E., Schuyten, G., & De Temmerman, E. (2004). Post-traumatic stress in former Ugandan child soldiers. Lancet, 363 (5), 861-863.

Derluyn, I., Mels, C., & Broekaert, E. (2009). Mental health problems in separated refugee adolescents. Journal of Adolescent Health, 44 (3), 292-297.

Derogatis, L., Lipman, R., Rikels, K., Ulenhoth, E., & Colvi, L. (1974). The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behavioural Science, 19, 1-15.

Ehntholt K., & Yule, W. (2006). Practitioner review: assessment and treatment of refugee children and adolescents who have experienced war-related trauma. Journal of Child Psychology & Psychiatry, 47 (12), 1197-1210.

Ellis, H., MacDonald, H., Lincoln, A., & Cabral, H. (2008). Mental health of Somali adolescent refugees: the role of trauma, stress and perceived discrimination. Journal of Consulting & Clinical Psychology, 76 (2), 184-193.

Heptinstall, E., Sethna, V., & Taylor, E. (2004). PTSD and depression in refugee children – Associations with pre-migration trauma and post-migration stress. European Child & Adolescent Psychiatry, 13 (6), 373-380.

Hollifield, M., Warner, T., Lian, N., Krakow, B., Jenkins, J., Kesler, J.,...Stevenson,J.(2002). Measuring trauma and health status in refugees. A critical review. Journal of the American Medical Association, 288, 611-621.

Human Rights Watch (2003). Covered in blood. Ethnically targeted violence in Northern DRC. New York: HRW Publications. Recuperado de http://www.hrw.org/en/reports/ 2003/07/07/covered-blood-0

International Rescue Committee (2008). Mortality in the Democratic Republic in Congo: an ongoing crisis. New York: International Rescue Committee.

Jones, L., & Kafetsios, K. (2002). Assessing adolescent mental health in war-affected societies: the significance of symptoms. Child Abuse & Neglect, 26 (10), 1059-1080.

Kienzler, H. (2008). Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena. Social Science & Medicine, 67, 218-227.

López-Soler, C., Castro, M., Alcántara, M., Fernández, V., Prieto, M., Puerto, J. C., Daset, L. R. (2008). Consecuencias del maltrato grave intrafamiliar en la infancia: conceptualización u diagnostico de las reacciones postraumáticas complejas. Ciencias Psicológicas, 2 (2), 103-118.

Lynch, M. (2003). Consequences of children’s exposure to community violence. Clinical Child and Family Psychology Review, 6 (4), 265-274.

Macksoud, M., & Aber, J. (1996). The war experiences and psychosocial development of children in Lebanon. Child Development, 67 (1), 70-88.

Mels, C., Derluyn, I., Broekaert, E., & Rosseel, Y. (2009). Screening for traumatic exposure and post-traumatic stress symptoms adolescents in war-affected Eastern Democratic Republic of Congo. Archives of Pediatrics & Adolescent Medicine, 163, 525-530.

Mels, C., Derluyn, I., Broekaert, E., & Rosseel, Y. (2010a). The psychological impact of forced displacement and related risk factors on Eastern Congolese adolescents affected by war. Child Psychology & Psychiatry, 51 (10), 1096-1104.

Mels, C., Derluyn, I., Broekaert, E., & Rosseel, Y. (2010b). Community-based cross-cultural adaptation of mental health measures in emergency settings: validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo. Social Psychiatry & Psychiatric Epidemiology, 45 (9), 899-910.

Mels, C., Derluyn, I., Broekaert, E., & Vlassenroot, K. (2012). Exploring the context for adolescent mental heath and spychosocial assistance in the Eastern Democratic Republic of Congo. In I. Derluyn, C. Mels, S. Parmentier, W. Vandenhole, Re-Member. Rehabilitation, Reintegration and Reconciliation of War-affected Children. Volume 11 of the Series on Transitional Justice. Cambridge/Antwerp/Portland: Intersentia.

Miller, K., Weine, S., Ramic, A., Brkic, N., Djuric Bjedic, Z., Smajkic, A.,... Worthington, G. (2002). The relative contribution of war experiences and exile-related stressors to levels of psychological distress among Bosnian refugees. Journal of Traumatic Stress, 15 (5), 377-387.

Miller, K., Omidian, P., Rasmussen, A., Yaqubi, A., & Daudzai, H. (2008). Daily stressors, war experiences, and mental health in Afghanistan. Transcultural Psychiatry, 45 (4), 611-638.

Miller, K., & Rasmussen, A. (2010). War exposure, daily stressors; and mental health in conflict and post-conflict settings: bridging the divide between trauma-focussed and psychosocial frameworks. Social Science & Medicine, 70, 7-16.

Murthy, R. (2007). Mass violence and mental health – Recent epidemiological findings. International Review of Psychiatry, 19 (3), 183-192.

Panter-Brick, C. (2010). Conflict, violence, and health: setting a new interdisciplinary agenda. Social Science & Medicine, 70, 1-6.

Patel, V., Flisher, A., Nikapota, A., & Malhotra, S. (2008). Promoting child and adolescents mental health in low and middle income countries. Journal of Child Psychology & Psychiatry, 49, 313-334.

Porter, M., & Haslam, N. (2005). Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons. Journal of the American Medical Association, 249, 602-612.

Project Ploughshares (2012). Armed Conflicts Report 2011. Project Ploughshares: Waterloo Ontario Canada. Recuperado de http://www.ploughshares.ca/content/2011-armed-conflicts-report

Sharon, A., Levav, I., Brodsky, J., Shemeh, A.A., & Kohn, R. (2009). Psychiatric disorders and other health dimensions among Holocaust survivors 6 decades later. The British Journal of Psychiatry, 195, 331-335.

United Nations (2012). MONUSCO facts and figures. Recuperado de http://www.un.org/en/peacekeeping/missions/monusco/facts.shtml

Vlassenroot, K., & Raeymaekers, T. (2004). The politics of rebellion and intervention in Ituri: The emergence of a new political complex? African Affairs, 103 (412), 385-412.

Williams, R. (2007). The psychosocial consequences for children of mass violence, terrorism and disasters. International Review of Psychiatry, 19 (3), 263-277.