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The impact of coping and social support on the mental health of adolescent victims of sexual violence in Eastern Congo

An Verelst, Sarah Bal UGent, Eric Broekaert and Ilse Derluyn UGent (2017) BMC WOMENS HEALTH.
abstract
Abstract Decades of armed conflict have left a devastating impact on the eastern Congolese population. The widespread use of sexual violence has made Congo home to many women and girls dealing with diverse sequelae of sexual violence. The impact of sexual violence, which is increasingly committed by civilian perpetrators, on the psychosocial well-being of adolescent victims is devastating. Little is known however on the role of avoidant/disengagement coping and family support in determining the mental health impact of sexual violence. These factors have been identified before as potentially protective to the mental health outcomes of trauma. This study therefore investigates the role of avoidant/disengagement coping and family support on the mental health outcomes of sexual violence in adolescent Congolese victims. Methods A cross-sectional, population-based survey design was implemented in 22 secondary schools, randomly selected from a stratified sample, in Bunia, Eastern Congo, a region affected by war for a few decades. A total of 1,305 school-going adolescent girls aged 11 to 23 participated. Self-report measures of mental health symptoms, perceived family support, avoidant/disengagement, war-related traumatic events, and experiences of sexual violence (no sexual violence, rape, non-consensual sexual experience), daily stressors and stigmatization were administered. Chi square and ANOVA analysis were carried out to explore differences for in sociodemographic variables, types of sexual violence, family support, avoidant/disengagement coping, stigmatization, daily stressors, war-related traumatic exposure and mental health outcomes (HSCL-37A and IES-R). Hierarchical multiple regression analysis were carried out with mental health outcomes as dependent variables for different types of sexual violence. Finally, several ANCOVA models were defined to explore, besides the main effects and, possible interaction effects of avoidant/disengagement coping and family support with stigmatization, daily stressors and war-related traumatic exposure. Results Avoidant/disengagement coping has been shown to have a direct negative effect on all psychological symptoms in girls who didn’t report sexual violence. In victims of sexual violence, the interaction effect between avoidance coping and stigmatization on different mental health scales (in particular symptoms of posttraumatic stress and anxiety) showed that when high levels of stigma are reported, avoidant/disengagement coping possibly served as a protective factor. Interestingly, high levels of daily stressors combined with avoidant/disengagement strategies were associated with a strong increase in post-traumatic stress symptoms. Family support did in general not mitigate the mental health outcomes of sexual violence. For girls who reported sexual violence but didn’t label it as rape and had a high level of family support, there was a positive association between stressors (daily stressors, stigma and war-related trauma) and posttraumatic stress symptoms, Conclusions These findings speak to the importance of avoidant/disengagement coping strategies in adolescent victims of sexual violence and the impact it has on their mental health. Furthermore, it inspires further investigation on the role of family support in determining the mental health outcomes of sexual violence. This study also illustrates the complex relationship between risk and protective factors in determing the mental health outcomes of sexual violence. Finally important implications for addressing sexual violence and its consequences in war-affected contexts are discussed.
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author
organization
year
type
journalArticle (original)
publication status
in press
journal title
BMC WOMENS HEALTH
language
English
UGent publication?
yes
classification
A1
id
5708114
handle
http://hdl.handle.net/1854/LU-5708114
date created
2014-09-23 14:39:51
date last changed
2017-01-19 08:20:54
@article{5708114,
  abstract     = {Abstract
Decades of armed conflict have left a devastating impact on the eastern Congolese population. The widespread use of sexual violence has made Congo home to many women and girls dealing with diverse sequelae of sexual violence. The impact of sexual violence, which is increasingly committed by civilian perpetrators, on the psychosocial well-being of adolescent victims is devastating. Little is known however on the role of avoidant/disengagement coping and family support in determining the mental health impact of sexual violence. These factors have been identified before as potentially protective to the mental health outcomes of trauma. This study therefore investigates the role of avoidant/disengagement coping and family support on the mental health outcomes of sexual violence in adolescent Congolese victims. 

Methods
A cross-sectional, population-based survey design was implemented in 22 secondary schools, randomly selected from a stratified sample, in Bunia, Eastern Congo, a region affected by war for a few decades. A total of 1,305 school-going adolescent girls aged 11 to 23 participated. Self-report measures of mental health symptoms, perceived family support, avoidant/disengagement, war-related traumatic events, and experiences of sexual violence (no sexual violence, rape, non-consensual sexual experience), daily stressors and stigmatization were administered.  Chi square and ANOVA analysis were carried out to explore differences for in sociodemographic variables, types of sexual violence, family support, avoidant/disengagement coping, stigmatization, daily stressors, war-related traumatic exposure and mental health outcomes (HSCL-37A and IES-R). Hierarchical multiple regression analysis were carried out with mental health outcomes as dependent variables for different types of sexual violence. Finally, several ANCOVA models were defined to explore, besides the main effects and, possible interaction effects of avoidant/disengagement coping and family support with stigmatization, daily stressors and war-related traumatic exposure.
Results
Avoidant/disengagement coping has been shown to have a direct negative effect on all psychological symptoms in girls who didn{\textquoteright}t report sexual violence. In victims of sexual violence, the interaction effect between avoidance coping and stigmatization on different mental health scales (in particular symptoms of posttraumatic stress and anxiety) showed that when high levels of stigma are reported, avoidant/disengagement coping possibly served as a protective factor. Interestingly, high levels of daily stressors combined with avoidant/disengagement strategies were associated with a strong increase in post-traumatic stress symptoms. Family support did in general not mitigate the mental health outcomes of sexual violence. For girls who reported sexual violence but didn{\textquoteright}t label it as rape and had a high level of family support, there was a positive association between stressors (daily stressors, stigma and war-related trauma) and posttraumatic stress symptoms,

Conclusions
These findings speak to the importance of avoidant/disengagement coping strategies in adolescent victims of sexual violence and the impact it has on their mental health. Furthermore, it inspires further investigation on the role of family support in determining the mental health outcomes of sexual violence. This study also illustrates the complex relationship between risk and protective factors in determing the mental health outcomes of sexual violence. Finally important implications for addressing sexual violence and its consequences in war-affected contexts are discussed.},
  author       = {Verelst, An and Bal, Sarah and Broekaert, Eric and Derluyn, Ilse},
  journal      = {BMC WOMENS HEALTH},
  language     = {eng},
  title        = {The impact of coping and social support on the mental health of adolescent victims of sexual violence in Eastern Congo},
  year         = {2017},
}

Chicago
Verelst, An, Sarah Bal, Eric Broekaert, and Ilse Derluyn. 2017. “The Impact of Coping and Social Support on the Mental Health of Adolescent Victims of Sexual Violence in Eastern Congo.” Bmc Womens Health.
APA
Verelst, An, Bal, S., Broekaert, E., & Derluyn, I. (2017). The impact of coping and social support on the mental health of adolescent victims of sexual violence in Eastern Congo. BMC WOMENS HEALTH.
Vancouver
1.
Verelst A, Bal S, Broekaert E, Derluyn I. The impact of coping and social support on the mental health of adolescent victims of sexual violence in Eastern Congo. BMC WOMENS HEALTH. 2017;
MLA
Verelst, An, Sarah Bal, Eric Broekaert, et al. “The Impact of Coping and Social Support on the Mental Health of Adolescent Victims of Sexual Violence in Eastern Congo.” BMC WOMENS HEALTH (2017): n. pag. Print.