Exploring exposure to intertwined community violence among Uruguayan adolescents using a mixed-method approach.

Building on the case of adolescents (aged 12-16 years) from underprivileged neighborhoods in Montevideo, two studies explore patterns of exposure to community violence among understudied South American youth. Applying a mixed-methods approach, the first study (n = 117) used principal component analysis to examine response patterns on a self-reported exposure to community violence scale. The second study examined subjective experience, drawing from focus group discussions with adolescents (n = 27) and their teachers (n = 22). Events were clustered into three components: indirect violence, traumatic violence, physical/verbal abuse, and robbery. Participants described the severity of violence in relation to chronic exposure, processes of naturalization, and permeable boundaries among the neighborhood, school, family, and social media networks. Violence chronicity and potential threats to life appear to be central dimensions in community violence reporting. Delimitating the study of community violence based on the setting or perceptual closeness has limited socioecological relevance.

Castigo físico: argumentos y justificaciones de padres y madres para su utilización / Physical punishment: arguments and justifications of parents and mothers for their use

El castigo físico en la crianza conlleva consecuencias negativas sobre el desarrollo infantil. Sin embargo, muchos adultos lo consideran un método adecuado. El presente estudio analiza los argumentos y justificaciones que esgrimen los adultos para su utilización. La muestra constó de 14 madres y 13 padres de niños(as) entre 0 a 3 años. El diseño investigativo tuvo un carácter exploratorio, utilizando un enfoque metodológico cualitativo a través del método de estudio de caso y la aplicación de la técnica el grupo focal. Mediante análisis de contenido se arribó a los siguientes resultados: los argumentos se relacionan con el carácter educativo y la eficacia del castigo físico, la repetición generacional de experiencias disciplinarias, la naturalización del castigo físico, razones de orden cultural y, por último, cansancio y estrés. Estos resultados constituyen un aporte a las políticas públicas en la prevención del castigo físico, particularmente en Uruguay.

Physical punishment during child rearing produces negative consequences for child development. Nonetheless, many adults consider it to be an adequate method. This study analyses the arguments and justifications employed by adults to justify their use. Participants were 14 mothers y 13 fathers of children aged 0 to 3 years. Using a qualitative, exploratory research design, we used a case study methodology to gather data through focus groups. The content analysis yielded the following result: the arguments associated with the educational character of corporal punishment and its presumed efficacy, transgenerational repetition of disciplinary experiences, the naturalization of physical punishment, cultural arguments and, finally, stress and exhaustion. These results contribute to public policies aiming to prevent physical punishment, particularly in Uruguay.

Dataset on maternal attitudes about child maltreatment in nine countries using a Q-sort methodology.

Analyses of the present data are reported in the article "Crossing Boundaries: A Pilot Study of Maternal Attitudes about Child Maltreatment in Nine Countries" [8]. Data were collected during home visits using the Maltreatment Q-Sort (MQS). A total of 466 mothers from nine different countries gave their opinion about child maltreatment by sorting 90 cards with parenting behaviors taken from the literature that reflect four types of child maltreatment, into 9 evenly distributed stacks (with 10 cards each) from least to most harmful for the child. This data article provides an overview of the content of the 90 items, which type of maltreatment they reflect, and the source of the items. The percentage of mothers labelling each of the MQS items as maltreatment is also presented. In addition, instructions are included about the administration of the MQS as well as data-entry and analyses of Q-sort data, accompanied by example datasets and syntaxes. This can serve as a manual for researchers interested in using Q-sort data.

Crossing boundaries: A pilot study of maternal attitudes about child maltreatment in nine countries.

BACKGROUND: Definitions of child maltreatment vary widely between studies, and even more so between different cultural contexts. OBJECTIVE: In this pilot study, we examine between-country variations in maternal notions about what constitutes child maltreatment. PARTICIPANTS AND SETTING: The sample consisted of 466 mothers recruited in Chile, China, Greece, Iran, the Netherlands, Portugal, South Africa, Turkey, and Uruguay. METHODS: All mothers completed a new Q-sort measure, ranking 90 parenting behaviors linked to subtypes of maltreatment (emotional neglect, emotional abuse, physical neglect, and physical abuse) from least to most detrimental to child development. RESULTS: Between-country agreement regarding the harmfulness of the parenting behaviors was high (r = .45), but there were different patterns of reported harmfulness of subtypes of maltreatment (although driven mostly by deviating patterns in the South African sample). Further, there were significant country effects on the number and type of behaviors labeled as maltreatment (pƞ2 = .15), and the number of items labeled as requiring intervention (pƞ2 = .19). CONCLUSIONS: Variations in conceptions of maltreatment need to be studied in larger more representative samples and taken into account in the assessment and treatment of child maltreatment across cultures.

Development and validation of a socio-emotional skills assessment instrument for sixth grade of Primary Education in Uruguay / Desenvolvimento e validação de um instrumento para avaliação de habilidades socioemocionais no sexto ano do Ensino Fundamental no Uruguai

The development and implementation of instruments with high psychometric standards for the assessment and monitoring of socio-emotional skills is considered an important step in the agenda for their promotion in educational contexts. This article describes the process behind the development and validation of a large-scale assessment instrument of socio-emotional skills - including interpersonal and intrapersonal skills and aspects related to motivation and self-regulation -, for sixth grade primary school-children in Uruguay. We present results regarding factor structure and internal consistency obtained in throughout three studies. We conclude that the final instrument presents proper psychometric qualities, including evidence of convergent validity. Nonetheless, it is recognized that the development of assessment instruments of this type requires continued efforts for its improvement based on a longitudinal and iterative review.

O desenvolvimento e a implementação de instrumentos de alta qualidade psicométrica para avaliação e monitoramento das competências socioemocionais são considerados um passo importante na agenda para promover as habilidades no contexto educacional. Este artigo descreve o processo de desenvolvimento e validação de um instrumento de avaliação em larga escala das habilidades socioemocionais - incluindo habilidades inter e intrapessoais, bem como aspectos relevantes da motivação e autorregulação - no sexto ciclo do Ensino Básico no Uruguai. Os resultados são apresentados quanto à sua estrutura fatorial e consistência interna obtidas em três estudos. Conclui-se que o instrumento final demonstra ter características psicométricas satisfatórias e validade convergente; no entanto, reconhece-se que o desenvolvimento instrumental deste tipo requer uma abordagem de melhoria contínua após uma revisão longitudinal e iterativa.

Victims and/or perpetrators? Towards an interdisciplinary dialogue on child soldiers.

BACKGROUND: Worldwide, thousands of children are acting in different roles in armed groups. Whereas human rights activism and humanitarian imperatives tend to emphasize the image of child soldiers as incapable victims of adults' abusive compulsion, this image does not fully correspond with prevailing pedagogical and jurisprudential discourses, nor does it represent all child soldiers' own perceptions of their role. Moreover, contemporary warfare is often marked by fuzzy distinctions between perpetrators and victims. This article deepens on the question how to conceptualize the victim-perpetrator imaginary about child soldiers, starting from three disciplines, children's rights law, psychosocial approaches and transitional justice, and then proceeding into an interdisciplinary approach. DISCUSSION: We argue that the victim-perpetrator dichotomy in relation to child soldiers needs to be revisited, and that this can only be done successfully through a truly interdisciplinary approach. Key to this interdisciplinary dialogue is the growing awareness within all three disciplines, but admittedly only marginally within children's rights law, that only by moving beyond the binary distinction between victim- and perpetrator-hood, the complexity of childhood soldiering can be grasped. In transitional justice, the concept of role reversal has been instructive, and in psychosocial studies, emphasis has been put on the 'agency' of (former) child soldiers, whereby child soldiers sometimes account on how joining the armed force or group was (partially) out of their own free will. Hence, child soldiers' perpetrator-hood is not only part of the way child soldiers are perceived in the communities they return to, but equally of the way they see themselves. These findings plea for more contextualized approaches, including a greater participation of child soldiers, the elaboration of accountability mechanisms beyond criminal responsibility, and an intimate connection between individual, social and societal healing by paying more attention to reconciliation. This article deepens on the question how to conceptualize the victim-perpetrator imaginary about child soldiers through an interdisciplinary dialogue between children's rights law, psychosocial approaches and transitional justice. With this interdisciplinary perspective, we intend to open up narrow disciplinary viewpoints, and contribute to more integrated approaches, beyond a binary distinction between victimhood and perpetrator-hood.

Coping behaviours and post-traumatic stress in war-affected eastern Congolese adolescents.

This study explores coping strategies used by war-affected eastern Congolese adolescents across age and sex, and the association between post-traumatic stress symptoms and engagement and disengagement coping. Cross-sectional data were collected in 11 secondary schools across four areas in the Ituri province, Democratic Republic of Congo. A total of 952 pupils (45.3% girls, 54.7% boys) aged 13-21 years (M = 15.83, standard deviation = 1.81) participated in self-report assessment, using instruments that were either specifically developed (Adolescent Complex Emergency Exposure Scale, assessing traumatic exposure), validated (Impact of Event Scale Revised, assessing post-traumatic stress symptoms) or reviewed (Kidcope, assessing coping strategies) for the study population. Reported coping strategies varied with age, and boys more frequently reported problem solving and resignation as compared with girls. Disengagement coping was associated with lower symptom scores in younger adolescent girls, as was the interaction effect between engagement and disengagement coping. We conclude that disengagement coping is not necessarily a maladaptive reaction to stressful events in war-affected situations and that future research should aim to better understand the heterogeneous patterns of stress and coping responses, including the role of factors such as the nature and appraisal of stressors, available resources for coping and cultural preferences.

The psychological impact of forced displacement and related risk factors on Eastern Congolese adolescents affected by war.

BACKGROUND: While the current knowledge base on the mental health effects of displacement is mainly limited to refugees residing in industrialised countries, this paper examines the impact of war-induced displacement and related risk factors on the mental health of Eastern Congolese adolescents, and compares currently internally displaced adolescents to returnees and non-displaced peers. METHODS: Data were collected from a community sample of 819 adolescents aged 13 to 21 years, attending one of 10 selected schools across the Ituri district in the Democratic Republic of Congo. Respondents completed culturally adapted self-report measures of posttraumatic stress symptoms (using the Impact of Event Scale - Revised) and internalising and externalising behaviour problems (by means of the Hopkins Symptoms Checklist - 37 for Adolescents). Associated factors studied were age, sex, parental death, exposure to war-related violence and daily stressors. RESULTS: Internally displaced persons (IDPs) reported highest mean scores for the IES-R and the HSCL-37A internalising scale, followed by returnees, while non-displaced adolescents scored significantly lower. However, ANCOVA tests showed that posttraumatic stress and internalising symptoms were mainly associated with traumatic exposure and daily stressors and not with displacement status. Externalising problem scores were associated with traumatic exposure, daily stressors and displacement. Remarkably, death of father was associated with fewer externalising problems. Sex was differently associated with internalising and externalising problems through traumatic and daily stressors. CONCLUSIONS: As IDPs are highly exposed to violence and daily stressors, they report most psychological distress, when compared to returnees and non-displaced peers. The distinct mental health outcomes for returned youngsters illustrate how enhancing current socio-economic living conditions of war-affected adolescents could stimulate resilient outcomes, despite former trauma or displacement.

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.

BACKGROUND: This study aims at providing qualitative and quantitative evidence on the relevance of two broadly used mental health self-report measures--Impact of Event Scale Revised (IES-R) and Hopkins Symptom Checklist 37 for Adolescents (HSCL-37A)--for use in Eastern Democratic of Congo, as no psychological assessment instruments were available for this region. We therefore describe an apt procedure to adapt and translate standard screening instruments in close collaboration with the local community, feasible under challenging conditions in emergency settings. METHOD: Focus groups and interviews with community key figures in psychosocial care were employed to ensure local validity of the adaptation and translation process. Consequently, the questionnaires' internal consistency (Cronbach's alpha) and construct validity (principal component analysis, testing of theoretical assumptions) were assessed based on a clustered school-based community survey among 1,046 adolescents (13-21 years) involving 13 secondary schools in the Ituri district in Eastern Democratic Republic of Congo. RESULTS: Key-informant qualitative data confirmed face and construct validity of all IES-R and all HSCL-37A anxiety items. Additional culture-specific symptoms of adolescent mental ill-health were added to enhance local relevance of the HSCL-37A depression and externalizing subscales. Quantitative analysis of the survey data revealed adequate internal consistency and construct validity of both adapted measures, yet weaker results for the externalizing scale. Furthermore, it confirmed the internalizing/externalizing factor structure of the HSCL-37A and the theoretically deviating intrusion/arousal versus active avoidance factor structure for the IES-R. CONCLUSIONS: Community-based adaptation can extend the validity and local relevance of mental health screening in emergency and low-income settings. The availability of adequate Swahili and Congolese French adaptations of the IES-R and HSCL-37A could stimulate the assessment of psychosocial needs in war-exposed Eastern Congolese adolescents.

Screening for traumatic exposure and posttraumatic stress symptoms in adolescents in the war-affected eastern Democratic Republic of Congo.

OBJECTIVE: To explore adolescent mental health in the eastern Democratic Republic of Congo, scene of a complex emergency since 1996. DESIGN: Community cross-sectional data obtained using a cluster sample approach. SETTING: From November 5, 2007, through February 5, 2008, we assessed 13 secondary schools in 4 selected health zones in the Ituri district. PARTICIPANTS: One thousand forty-six adolescents and young adults aged 13 to 21 years completed a self-report questionnaire. MAIN EXPOSURES: War-related traumatic events, posttraumatic stress symptoms, and sociodemographic variables. MAIN OUTCOMES MEASURES: The Adolescent Complex Emergency Exposure Scale, specifically designed for this region, screened for exposure to potentially traumatic events, and the Impact of Event Scale-Revised measured symptoms of posttraumatic stress consistent with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. RESULTS: Among the 477 girls (45.6%) and 569 boys (54.4%) in the study, 95.0% reported at least 1 traumatic event. On average, adolescents were exposed to 4.71 traumatic events, with higher exposure rates reported in boys, older groups, rural and urban areas, and respondents whose mother or father was dead. Of 990 respondents, 52.2% met symptom criteria for posttraumatic stress disorder. Symptom scores were strongly related to cumulative trauma exposure; however, the strength of this relationship differed slightly across living area groups for girls. CONCLUSION: Adolescents in the eastern Democratic Republic of Congo are highly exposed to political violence, putting them at a considerable risk--mediated by living area and sex--to develop posttraumatic stress symptoms.

Mental health problems in separated refugee adolescents.

PURPOSE: As migration and separation from parents are widely recognized as important risk factors for the mental health of adolescents, this study aims to investigate mental health problems in refugee adolescents separated from their parents compared to their accompanied peers, all living in Belgium. METHODS: One thousand two hundred ninety-four adolescents--10% of them refugee adolescents separated from both parents--completed three self-report questionnaires (Hopkins Symptoms Checklist-37A, Stressful Life Events, and Reaction of Adolescents to Traumatic Stress) on the prevalence of traumatic experiences, anxiety, and depression symptoms, externalizing problems, and posttraumatic stress. RESULTS: Refugee adolescents separated from both parents experienced the highest number of traumatic events compared to accompanied refugee adolescents. Risk factors influencing the development of serious mental health problems (anxiety, depression, and posttraumatic stress) are separation from parents, high number of traumatizing events experienced, and gender. Despite the fact that refugee adolescents living only with their mother experienced more traumatizing events compared to adolescents living with both parents, they have fewer mental health problems than refugee adolescents living with their father. CONCLUSIONS: This study confirms the importance of the availability of parents to adolescents who have to deal with migration experiences, because separated refugee adolescents are at higher risk to experience multiple traumatic experiences and to develop severe mental health problems. Reception and care structures should provide more adequate preventive and curative interventions to these at-risk groups, and government policies should consider these adolescents primarily as "minors" rather than just "refugees."