Experiences of grief and moral sentiments in survivors of the armed conflict in Medellín, Colombia.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

Child growth and armed conflict.

BACKGROUND: During armed conflict, the non-combative population, and particularly children, are susceptible to the effects of conflict from a variety of perspectives; psychological stress, loss of food and resources, loss of accommodation, occupation, income, death of family members, etc. The Lancet recently published a special issue entitled 'Maternal and child health and armed conflict' concluding that the ways in which health can be affected by conflict are protean but systematic evidence is sparse, whatever evidence exists is localised and of low to moderate quality, and that data on adolescents are sparse to non-existent. Whilst this may be true of the challenging environments of conflicts in developing countries, historically recent conflicts in Europe provide an alternative viewpoint that is frequently aired in the Auxological literature but is virtually unknown and/or unrecognised in health settings. METHODS: The current paper summarises three previously published studies based on repeated cross-sectional child growth surveys in London, Oslo, and Stuttgart covering the years of the Second World War. Taken together these studies provide extensive evidence of the response of children to armed conflict in the context of secular tends in growth of children living in industrialised nations during the twentieth century. CONCLUSIONS: The conclusions to all three studies may be summarised, with regard to children in industrialised nations, as: (1) armed conflict adversely affects human growth and health, (2) armed conflict affects all age groups but adolescents more so, (3) all age groups recover from poor growth as conditions improve in relation to post-war health and welfare programmes, (4) pre-war differences in size between SES groups diminish during post-war recovery when accompanied by nutritional, welfare and reconstruction programmes.

Transcultural pathways to the will to fight.

In 2022, the "Will to Fight Act" was referred to the US Congress urging attention to measuring and assessing will to fight. That Bill was not enacted, and evaluation efforts within the political and military establishment remain contentious, fragmented, and meager. This likely will persist, along with attendant policy failures and grievous costs, without awareness of research that the social and psychological sciences reveal on the will to fight [S. Atran, Science 373, 1063 (2021)]. We illustrate such research using converging data from a multimethod and multicultural approach, including field and online studies from the Middle East, North Africa, and Europe. These studies reveal specific psychosocial pathways, within a general causal framework, that predict willingness to make costly sacrifices, including to cooperate, fight, and die in war and sustained conflict. From the continuing strife in Iraq to embattled Ukraine, 31 studies were conducted in 9 countries with nearly 12,000 participants. These include people in longstanding conflicts, refugees, imprisoned jihadists and gangs, US military, studies in Ukraine before and during the current war, and rolling studies with a European ally of Ukraine. Results provide evidence for a mediation model of transcultural pathways to the will to fight. Building on our previous behavioral and brain research, on the battlefield in Iraq, with violent extremists, and with US military, the linear mediation yielding the will to fight involves identity fusion, perceived spiritual formidability, and trust. The model, a variation on "The Devoted Actor Framework," applies to primary reference groups, core cultural values, and leaders.

Armed conflict exposure and mental health: examining the role of imperceptible violence.

Armed conflict exposure is associated with multiple mental health problems. However, more needs to be known about the differential effects of particular modalities of armed conflict violence and war methods on mental health. This study a) examined the modalities of violence employed in the Colombian armed conflict and b) assessed their association with mental health problems in armed conflict survivors. Using armed conflict data from the Colombian Armed Conflict Events Information System, we identified three violence modalities: armed confrontations, indiscriminate attacks, and selective violence. Descriptive statistics showed that selective violence generated most (86%) of the 333,219 victims of the Colombian armed conflict between 1996 and 2016. A subsample of armed conflict survivors (n = 551) from the 2015 Colombian Mental Health Survey was used to assess the association of each modality of violence with depression and anxiety, Post Traumatic Stress Disorder (PTSD), and substance abuse. Adjusted Odds Ratios (aOR) (p < .05, 95% CI) showed that survivors of selective violence crimes such as forced disappearance of loved ones, kidnapping, sexual violence, and massacres were at increased risk of experiencing Common Mental Health Disorders, PTSD symptoms, and hazardous drinking. Identifying those at elevated risk for developing mental health problems and substance misuse among survivors of armed conflict may help to use limited resources more effectively.

One-year outcomes of two community-based mental health interventions for Afro-Colombian survivors of the armed conflict and displacement.

The objective of the study is to assess the middle-term effects (1 year after intervention) of two community-based mental health interventions, Common Elements Treatment Approach intervention, CETA, and Narrative Community Group Therapy intervention, NCGT, in two cities of the Colombian Pacific region (Buenaventura and Quibdó). A follow-up study was conducted on a cohort of trial participants. In this trial, the positive effects of two mental health interventions were evaluated; assessment was carried out in separate groups (CETA arm, NCGT arm and a control group) of the reduction of symptoms of anxiety, depression, post-traumatic stress and function impaired mentality. The participants were Afro-Colombian survivors of the armed conflict and displacement living in Buenaventura and Quibdó. They were surveyed using the same instrument used in the original trial. Intent-to-treat analyses were performed, and longitudinal mixed-effects regression models with random effects were used to analyse the middle-term effects of the interventions. At 1-year post-intervention, participants in Buenaventura who received the CETA intervention experienced a decrease in depression (-0.23; p = 0.02), post-traumatic stress symptoms (-0.23; p = 0.02) and total mental health symptoms (-0.14; p = 0.048). In Quibdó, the NCGT intervention significantly improved function impairment (-0.30; p = 0.005). CETA and NCGT interventions have the potential to maintain a reduction of mental health symptoms in participants from the Colombian Pacific region.

The Mental Health Costs of Armed Conflicts-A Review of Systematic Reviews Conducted on Refugees, Asylum-Seekers and People Living in War Zones.

AIMS: Armed conflicts produce a wide series of distressing consequences, including death, all of which impact negatively on the lives of survivors. This paper focuses specifically on the mental health consequences of war on adults and child/adolescent refugees or those living in war zones through a review of all systematic reviews and/or meta-analyses published from 2005 up until the current time. RESULTS: Fifteen systematic reviews and/or meta-analyses conducted in adult populations, and seven relating to children and adolescents, were selected for the purpose of this review. Prevalence rates of anxiety, depression and post-traumatic stress disorder (PTSD) were two- to three-fold higher amongst people exposed to armed conflict compared to those who had not been exposed, with women and children being the most vulnerable to the outcome of armed conflicts. A series of war-related, migratory and post-migratory stressors contribute to short- and long-term mental health issues in the internally displaced, asylum seekers and refugees. CONCLUSION: It should be a required social responsibility for all psychiatrists and psychiatric associations to commit to raising awareness amongst political decision-makers as to the mental health consequences caused by armed conflicts, as part of their duty of care for people experiencing the consequences of war.

The stress of war. Recommendations for the protection of mental health and wellbeing for both Ukrainian refugees as well as Poles supporting them. / Stres wojny. Zalecenia dotyczace ochrony zdrowia psychicznego i dobrostanu zarówno uchodzców ukrainskich, jak i Polaków zaangazowanych w ich wsparcie.

The presence of large numbers of Ukrainians looking for refuge in Poland is a new experience for Poles. The ongoing war and the uncertainty of the situation of those displaced may cause anxiety and lead to stressful reactions, exacerbated by endlessly circulating information on hostilities. Therefore, the sense of security may be threatened not only among Ukrainians who have fled to Poland, but also among people who support Ukrainians, who offer them help and shelter. Prolonged support, if not accompanied by proper selfcare can increase the risk of burnout as well as lead to distressful emotional states, such as a feeling of helplessness, hopelessness, reluctance to provide further help, or even demonstrate hostility. The article presents the situation and current psychosocial needs of Ukrainian refugees in Poland and provides a set of recommendations regarding the organization of mental health care in the face of the ongoing war in Ukraine. There are available tools to use by Polish specialists and lay helpers to support Ukrainian refugees. The Mental Health and Psychosocial Support (MHPSS) Intervention Pyramid, developed by the Inter-Agency Standing Committee, is used to classify suggested interventions. Appropriate care should be available to both refugees as well as the host population involved in their care.

Vínculos, autonomía y salud mental en adultos jóvenes del proceso de reintegración en Colombia / Bonds, autonomy and mental health in young adults of the reintegration process in Colombia

Este artículo busca explorar la construcción de los vínculos, su relación con el desarrollo de la autonomía y las problemáticas de salud mental de adultos jóvenes excombatientes de grupos armados que hacen parte del proceso de reintegración en Colombia. Se analizaron 3977 registros de la Encuesta Multimodal Psicosocial (EMP) correspondientes a adultos jóvenes entre los 18 y 24 años, que fueron aplicadas en desarrollo del proceso de reincorporación. Se aplicaron dos métodos de análisis estadísticos complementarios: el método de Componentes Principales (ACP) y un método Jerárquico aglomerativo. En el análisis de los procesos vinculares se encontró que en un grupo alrededor de un 80 % de los casos registra haber experimentado rupturas vinculares importantes a causa de la violencia, el abandono temprano y/o vivir en contextos de conflicto y violencia. En cuanto al análisis de los procesos de autonomía, se encontró que un grupo correspondiente al 70 % reporta no contar con las capacidades para garantizar su autonomía y calidad de vida, pasando por condiciones de precarización laboral con riesgo a incurrir en redes de delincuencia. Y un 39 % reporta coincidir alta disposición de riesgo en sus procesos vinculares y de autonomía.

This article seeks to explore the construction of bonds, their relation with the development of autonomy and the mental health problems of young adult ex-combatants of armed groups who are part of the reintegration process in Colombia. A total of 3977 records of the Psychosocial Multimodal Questionnaire (PMS) corresponding to young adults between 18 and 24 years old, which were applied in the development of the reincorporation process, were analyzed. Two complementary statistical analysis methods were applied: The Principal Components Method (PCA) and an agglomerative Hierarchical method. In the analysis of bonding processes, it was found that, in one group, about 80% of the cases recorded having experienced significant bonding ruptures due to violence, early abandonment and/or living in contexts of conflict and violence. Regarding the analysis of the processes of autonomy, a group corresponding to 70% reported not having the capacities to guarantee their autonomy and quality of life, going through conditions of job insecurity with the risk of incurring in criminal networks. And 39% report a high risk disposition in their relationship and autonomy processes.

El juego como escenario de construcción de paz en contextos de conflicto armado en Colombia / The game as a peace-building scenario in contexts of armed conflict in Colombia

Introducción: el artículo presenta algunos resultados de una investigación que buscó rescatar y visibilizar las potencias y los recursos de la niñez que se vio afectada por el conflicto armado, preguntando por las maneras en que los niños y las niñas pueden aportar a la construcción de paz desde sus potencialidades y escenarios relacionales, dando prioridad al juego como espacio socializador. Método: la investigación fue de tipo cualitativa y se ubicó desde la hermenéutica crítica comprensiva, empleando estrategias metodológicas como talleres creativos, entrevistas a profundidad y grupos focales. Resultados: algunos de los resultados evidencian que los niños y las niñas aportan a la construcción de paz desde la creatividad, el establecimiento de acuerdo con sus pares y otros agentes, pero, sobre todo, desde el juego como principal escenario en donde despliegan su autonomía y criterio propio para la configuración de sus acuerdos socia-les. Conclusión: se concluye que el juego se convierte en una práctica generativa, donde los niños y las niñas despliegan sus potencialidades y recursos como un aporte a la construcción paz.

Introduction: The article presents some results of a research that sought to rescue and make visible the potencies and resources of children who were affected by the armed conflict, asking about the ways in which children can contribute to peace building from their potentialities and relational scenarios, giving priority to play as a socializing space. Method: The research was qualitative and was based on comprehensive critical hermeneutics, using methodological strategies such as creative workshops, in-depth interviews and focus groups. Results: Some of the results show that children contribute to peace building through creativity, the establishment of agreements with their peers and other agents, but, above all, through play as the main scenario where they deploy their autonomy and own criteria for the configuration of their social agreements. Conclusion: It is concluded that play becomes a generative practice, where children deploy their potential and resources as a contribution to peace building.

Traumatismo e violência: a criança em meio à guerra urbana brasileira / Trauma y violencia: el niño en medio de la guerra urbana brasileña / Traumatism and violence: the child in the middle of the Brazilian urban combat / Traumatisme et violence: l'enfant dans milieu de la guerre urbaine brésilienne

O cotidiano de muitas crianças no Brasil tem sido atravessado por situações violentas extremas, evidenciando um estado de abandono social. Sendo assim, o presente artigo visa compreender, a partir da história de Sandro Barbosa do Nascimento e da psicanálise, a natureza do traumatismo e sua relação ao trauma na experiência da criança que vivencia cenas violentas em seu cotidiano. Compreendemos que o traumatismo se constitui na dimensão singular de cada criança, a partir do modo como lidam com o encontro com o trauma que as cenas violentas comportam, bem como com o gozo que irrompe da proximidade do Outro totalitário. Estes modos podem se constituir do recurso simbólico de cada sujeito, mas também da experiência com o não-sentido

La vida cotidiana de muchos niños en Brasil ha estado atravesada por situaciones de extrema violencia, evidenciando un estado de abandono social. Así, este artículo pretende comprender, a partir del relato de Sandro Barbosa do Nascimento y del psicoanálisis, la naturaleza del traumatismo y su relación con el trauma en la experiencia de los niños que viven escenas violentas en su vida cotidiana. Entendemos que el traumatismo se constituye en la dimensión singular de cada niño, a partir de la forma en que se enfrenta al encuentro con el trauma que suponen las escenas violentas, así como con el goce que brota de la proximidad del Otro totalitario. Estos modos pueden constituirse a partir del recurso simbólico de cada sujeto, pero también de la experiencia con el sinsentido

The daily life of many children in Brazil has been crossed by extreme violent situations, evidencing a state of social abandonment. Thus, this article aims to understand, from the story of Sandro Barbosa do Nascimento and of psychoanalysis, the nature of traumatism and its relation to trauma in the experience of children who experience violent scenes in their daily lives. We understand that traumatism is constituted in the singular dimension of each child, from the way they deal with the encounter with the trauma that can be found at violent scenes, as well as with the jouissance that erupts from the proximity of the totalitarian Other. These ways may be constituted from the symbolic resource of each subject, but also from the experience with non-sense

La vie quotidienne de nombreux enfants au Brésil est traversée par des situations de violence extrême, et témoigne d'un état d'abandon social. Cet article vise à comprendre, à partir de l'histoire de Sandro Barbosa do Nascimento et de la psychanalyse, la nature du traumatisme et sa relation au trauma dans l'expérience des enfants qui vivent des scènes de violence dans leur vie quotidienne. Nous comprenons que le traumatisme se constitue dans la dimension singulière de chaque enfant, à partir de la manière dont il gère la rencontre avec le trauma qu'impliquent les scènes de violence, ainsi qu'avec la jouissance qui jaillit de la proximité avec l'Autre totalitaire. Ces voies peuvent se constituer à partir de la ressource symbolique de chaque sujet, mais aussi à partir de l'expérience du non-sens

War Psychiatry: Identifying and Managing the Neuropsychiatric Consequences of Armed Conflicts.

War refugees and veterans have been known to frequently develop neuropsychiatric conditions including depression, post-traumatic stress disorder (PTSD), and anxiety disorders that tend to leave a long-lasting scar and impact their emotional response system. The shear stress, trauma, and mental breakdown from overnight displacement, family separation, and killing of friends and families cannot be described enough. Victims often require years of mental health support as they struggle with sleep difficulties, recurring memories, anxiety, grief, and anger. Everyone develops their coping mechanism which can involve dependence and long-term addiction to alcohol, drugs, violence, or gambling. The high prevalence of mental health disorders during and after the war indicates an undeniable necessity for screening those in need of treatment. For medical health professionals, it is crucial to identify such vulnerable groups who are prone to developing neuropsychiatric morbidities and associated risk factors. It is pivotal to develop and deploy effective and affordable multi-sectoral collaborative care models and therapy, which primarily depends upon family and primary care physicians in the conflict zones. Herein, we provide a brief overview regarding the identification and management of vulnerable populations, alongside discussing the challenges and possible solutions to the same.