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dc.contributor.authorPanter-Brick, Catherine
dc.contributor.authorDajani, Rana
dc.contributor.authorEggerman, Mark
dc.contributor.authorHermosilla, Sabrina
dc.contributor.authorSancilio, Amelia
dc.contributor.authorAger, Alastair
dc.identifier.citationPanter-Brick, C., Dajani, R., Eggerman, M., Hermosilla, S., Sancilio, A. & Ager, A. (2017) Insecurity, distress and mental health: Experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis. Journal of Child Psychology and Psychiatry, 59(5), pp. 523-541.
dc.descriptionAlastair Ager - ORCID 0000-0002-9474-3563
dc.description.abstractBackground: Strengthening the evidence base for humanitarian interventions that provide psychosocial support to war-affected youth is a key priority. We tested the impacts of an 8-week programme of structured activities informed by a profound stress attunement (PSA) framework (Advancing Adolescents), delivered in group-format to 12-18 year-olds in communities heavily affected by the Syrian crisis. We included both Syrian refugee and Jordanian youth. Methods: We followed an experimental design, comparing treatment youth and wait-list controls over two programme implementation cycles, randomizing to study arm in cycle 2 ( ID: NCT03012451). We measured insecurity, distress, mental health difficulties, prosocial behaviour and post-traumatic stress symptoms at three time-points: baseline (n = 817 youth; 55% Syrian, 43% female), postintervention (n = 463; 54% Syrian, 47% female), and follow-up (n = 212, 58% Syrian, 43% female). Regression models assessed: prospective intervention impacts, adjusting for baseline scores, trauma exposure, age, and gender; differential impacts across levels of trauma exposure and activity-based modality; and sustained recovery 1 year later. We analysed cycle-specific and cycle-pooled data for youth exclusively engaged in Advancing Adolescents and for the intent-to-treat sample. Results: We found medium to small effect sizes for all psychosocial outcomes, namely Human Insecurity (_ = -7.04 (95% CI: -10.90, -3.17), Cohen's d = -0.4), Human Distress (_ = -5.78 (-9.02, -2.54), d = -0.3), and Perceived Stress (_ = -1.92 (-3.05, -0.79), d = -0.3); and two secondary mental health outcomes (AYMH: _ = -3.35 (-4.68, -2.02), d = -0.4; SDQ: _ = -1.46 (-2.42, -0.50), d = -0.2). We found no programme impacts for prosocial behaviour or post-traumatic stress reactions. Beneficial impacts were stronger for youth with exposure to four trauma events or more. While symptoms alleviated for both intervention and control groups over time, there were sustained effects of the intervention on Human Insecurity. Conclusions: Findings strengthen the evidence base for mental health and psychosocial programming for a generation affected by conflict and forced displacement. We discuss implications for programme implementation and evaluation research. 2017 Association for Child and Adolescent Mental Health.
dc.description.sponsorshipThis research was funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme (, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. The R2HC programme is funded equally by the Wellcome Trust and the UK Government.
dc.relation.ispartofJournal of Child Psychology and Psychiatry
dc.rights© 2017 The Authors
dc.titleInsecurity, distress and mental health: Experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis
qmu.authorAger, Alastair
qmu.centreInstitute for Global Health and Development

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