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| 2. |
- Lotzin, Annett, et al.
(författare)
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A longitudinal study of risk and protective factors for symptoms of adjustment disorder during the COVID-19 pandemic
- 2024
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Ingår i: European Journal of Psychotraumatology. - : Taylor & Francis. - 2000-8198 .- 2000-8066. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder.Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment.Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression.Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure.Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.
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| 3. |
- Abdel-Fatah, Dana, et al.
(författare)
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Qualitative Field Study of Host Community/Refugee from Syria Relations in Croatia, Germany, Jordan and Sweden : FOCUS Research Project Deliverable 4.2
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The FOCUS project is undertaking a range of research and piloting tasks which aim to improve understanding of dynamic integration and to assist the implementation of effective practices. As part of this work a detailed programme of qualitative research has been undertaken in four countries. This report presents the country-specific findings of this research, which will be further consolidated in a cross-site analysis to be completed in the coming months. Focus group discussions (FGDs) were held with members of the receiving communities and with members of the arriving communities in a total of 10 site in four countries which have different experiences of migration from Syria in recent years (Sweden, Germany, Jordan, Croatia).
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| 4. |
- Dückers, Michel L. A., et al.
(författare)
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Measuring and modelling the quality of 40 post-disaster mental health and psychosocial support programmes
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, the potentially broad range of support activities include a coherent, high-quality mental health and psychosocial support (MHPSS) programme. We present a theory-driven quantitative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings. The objective is to measure quality domains recognized as relevant in the literature and to empirically test associations. During the EU project “Operationalizing Psychosocial Support in Crisis” (OPSIC) an evaluation survey was designed and developed for this purpose and completed by 40 MHPSS programme coordinators involved in different mass emergencies and disasters. We analysed the survey data in two steps. Firstly, we used the data to operationalize quality domains of a MHPSS programme, tested constructs and assessed their internal consistency reliability. A total of 26 out of 44 survey items clustered into three of the four domains identified within the theoretical framework: “planning and delivery system” (Cronbach’s alpha 0.82); “general evaluation criteria” (Cronbach’s alpha 0.82); and “essential psychosocial principles” (Cronbach’s alpha 0.75). “Measures and interventions applied”, theoretically a potential fourth domain, could not be confirmed to empirically cluster together. Secondly, several models with associations between domains and measures and interventions were tested and compared. The model with the best fit suggests that in MHPSS programmes with a higher planning and delivery systems score, a larger number of measures and interventions from evidence-informed guidelines are applied. In such programmes, coordinators are more positive about general evaluation criteria and the realization of essential psychosocial principles. Moreover, the analyses showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor to coordinator perceptions concerning psychosocial principles and evaluation criteria. Further research is necessary to validate and expand the findings and to learn more about success factors and obstacles for MHPSS programme implementation.
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| 5. |
- Irastorza, Nahikari, et al.
(författare)
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Mapping of Host-community/Refugee Relations in Croatia, Germany, Jordan and Sweden : EU H2020 FOCUS Research Project
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This deliverable consists of five tasks which were designed to gain an in-depth and broad understanding of the state-of-the-art on research, policy and practice on integration of refugees and host community relations. This was undertaken to form a foundation upon which to build Work Packages focusing on the field work (WP 3 and 4), the development of a refugee and host community toolbox (WP5 and 6) and the dissemination of all of these (WP7). To achieve this, WP2 has been divided into five separate, though highly interrelated Tasks. This includes; Task 2.1. a state-of-the-art review of the literature and research on the socio-economic integration of refugees. Task 2.2. a state- of-the-art review of the literature and research on the socio-psychological integration of refugees. Task 2.3 Part I. a comparative analysis of integration policies in Croatia, Germany, Jordan and Sweden. Task 2.3 Part II. a qualitative study of professionals’ views on integration practices in Europe. Task 2.4 a state-of-the-art desk review, interviews with key informants and a workshop with practitioners on the tools and solutions for successful integration of refugees. Finally, Task 2.5, a state-of-the-art review on the flows and patterns of asylum migration from Syria to, and sometimes through, Croatia, Germany, Jordan and Sweden.The findings of these tasks showed the following. First, there are significant gaps in our knowledge about aspects of integration of refugees beyond labour market integration. This is especially apparent with regards to the understanding of socio-psychological integration. In addition, WP 2.4 also highlighted that practitioners noted that they were unable to keep up to date with the latest research on integration of refugees and that while general tools and solutions exist, they were often difficult to navigate anat d implement on the ground in different contexts. Therefore, the challenge is not just to fill this knowledge gaps, but also to disseminate the findings in an impactful way to key stakeholders and end users. Our new understanding of these knowledge gaps has already been drawn on to shape the methodology of the field research (WP 3-4), I the hope of addressing them in part at least. The results of WP3-4 will, in turn, inform the development of the toolbox in WP 5-6, as will the engagement of end users with the research findings.Second, when looking at the integration policies of the four research sites, as well as the views on integration policies more generally by key actors in Europe, we can see there are shared approaches and foci. For example, how integration is understood, and the focus on achieving it by granting access to the labour market in all states, or more activity encouraging and facilitating this access (which can be seen in the European states and Jordan). While EU laws may have an impact here, as identified in WP 2.3 Part II, this is also a result of many organisations reliance on the EU’s AMIF funding, which key stakeholders and practitioners reported as having a significant impact on integration policy and practice.Finally, with the exception of a few cases in Sweden, most of the refugees from Syria have been issued temporary residence permits in the four states. While the nature and duration of these vary considerably, securing permanent residency requires that the refugee has ‘integrated’ to some degree (except in the case of Jordan where acquiring permanent residence is not possible). The demand of the three European states vary, but, for example, all require the refugee has either secured employment or has reached a certain level of language proficiency etc. In general, with the exception of Sweden (who mainstreamed migration in all state activities), there is a lack of state-run public awareness raising initiatives or activities to encourage the host community to fulfil their part of the integration process. Here the findings of WP 2.4 provide a valuable resource in reflecting on small- and large-scale integration policies and the tools that have been used to bridge this gap between the two communities.
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| 6. |
- Kazlauskas, Evaldas, et al.
(författare)
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Psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) in 9230 adults across seven European countries : Findings from the ESTSS ADJUST study
- 2023
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Ingår i: Journal of Affective Disorders. - : ELSEVIER. - 0165-0327 .- 1573-2517. ; 335, s. 18-23
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Tidskriftsartikel (refereegranskat)abstract
- Background: The four-item Patient Health Questionnaire-4 (PHQ-4) is a widely used screening measure for depression and anxiety.Objectives: This study aimed to test factor structure and measurement invariance in an adult sample of the general population across seven European countries.Method: A total sample of 9230 adults, 71.3 % female, Mage = 44.35 (SD = 14.11) from seven countries (Austria, Croatia, Georgia, Germany, Lithuania, Portugal, and Sweden) participated in the study. We applied confirmatory factor analysis (CFA) to examine the factor structure and measurement invariance testing to evaluate mea-surement equivalence across countries, gender, and age groups.Results: The CFA yielded that a two-factor PHQ-4 model with separate depression and anxiety factors had the best fit. Partial scalar measurement invariance was established across different groups based on gender, age, and country.Conclusions: The PHQ-4 is a valid and reliable measure that can be applied to screen for depression and anxiety in the general population.Limitations: The limitation of the study includes the sampling, which resulted in the sample structure with the majority of females, predominantly of high education and from urban communities.
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| 7. |
- Lotzin, Annett, et al.
(författare)
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Risk and protective factors for posttraumatic stress disorder in trauma-exposed individuals during the COVID-19 pandemic - findings from a pan-European study
- 2022
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Ingår i: European Journal of Psychotraumatology. - : Taylor & Francis. - 2000-8198 .- 2000-8066. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD).Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic.Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets.Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3-7 times a week (vs. no contact), and digital social contact less than once a week or 1-7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions.Conclusion: We identified risk and protective factors as well as stressors that may help identify trauma-exposed individuals at risk for PTSD, enabling more efficient and rapid access to care.
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| 8. |
- Lotzin, Annett, et al.
(författare)
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Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic – First results of the ESTSS COVID-19 pan-European ADJUST study
- 2021
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Ingår i: European Journal of Psychotraumatology. - : Taylor & Francis. - 2000-8198 .- 2000-8066. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder.Objective This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic.MethodsData from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression.ResultsThe prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions.ConclusionsWe identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.
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| 9. |
- Lotzin, Annett, et al.
(författare)
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Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic - study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study
- 2020
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Ingår i: European Journal of Psychotraumatology. - : TAYLOR & FRANCIS LTD. - 2000-8198 .- 2000-8066. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: During the current COVID-19 pandemic, the people in Europe are exposed to self-isolation, quarantine, job loss, risk of contracting COVID-19, or grief of loved ones. Such a complex array of stressors may lead to symptoms of adjustment disorder or posttraumatic stress disorder. This research protocol describes a study launched by the European Society of Traumatic Stress Studies (ESTSS) to investigate the impact of the COVID-19 pandemic on symptoms of adjustment disorder across European countries. Objective: The longitudinal online cohort study aims (1) to explore psychosocial reactions to the COVID-19 pandemic across ten European countries; (2) to examine the relationships between risk and resilience factors, stressors and symptoms of adjustment disorder during the pandemic; and (3) to investigate whether these relationships are moderated by coping behaviours. Method: In ten countries (Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden), between 1,000 and 2,000 participants will be recruited, depending on the size of the country. Participants will be assessed at two timepoints with a six-month interval. Following a conceptual framework based on the WHO's social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behaviours will be measured to estimate their contribution to symptoms of adjustment disorder. The Adjustment Disorder New Module 8 (ADNM-8) will be used to assess symptoms of adjustment disorder. As a secondary measure, symptoms of posttraumatic stress disorder will be measure using the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). Data analysis: The relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated using multilevel analysis. To determine the moderating effects of different types of coping behaviours on these relationships, a multilevel mediation analysis will be carried out.
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| 10. |
- Schaefer, Ingo, et al.
(författare)
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Trauma and trauma care in Europe
- 2018
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Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 9:1
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Forskningsöversikt (refereegranskat)abstract
- The European countries have a long history of exposure to large-scale trauma. In the early 1990s the increasing awareness of the consequences of trauma within the mental health community led to the foundation of local societies for psychotraumatology across Europe and the European Society of Traumatic Stress Studies (ESTSS), which celebrated its 25th anniversary in 2018. The focus of this article is to describe the current state of care for survivors of trauma in the 15 European countries where ESTSS member societies have been established. Brief descriptions on the historical burden of trauma in each country are followed by an overview of the care system for trauma survivors in the countries, the state-of-the-art of interventions, current challenges in caring for survivors and the topics that need to be most urgently addressed in the future. The reports from the different countries demonstrate how important steps towards a better provision of care for survivors of trauma have been made in Europe. Given the cultural and economic diversity of the continent, there are also differences between the European countries, for instance with regard to the use of evidence-based treatments. Strategies to overcome these differences, like the new ESTSS training curricula for care-providers across Europe, are briefly discussed.
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