Psychiatry - Research Publications

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Type: Journal Article × Author: Bryant, Richard × Author: Creamer, Mark × Author: Forbes, David × Start date: 2020 × End date: 2021 ×

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    Prolonged grief in refugees, parenting behaviour and children's mental health
    Bryant, RA ; Edwards, B ; Creamer, M ; O'Donnell, M ; Forbes, D ; Felmingham, KL ; Silove, D ; Steel, Z ; McFarlane, AC ; Van Hooff, M ; Nickerson, A ; Hadzi-Pavlovic, D (SAGE PUBLICATIONS LTD, 2021-09)
    BACKGROUND: Many refugees experience bereavement, and as a result they suffer elevated rates of prolonged grief disorder. Evidence also indicates that elevated rates of psychological disturbance in refugee children can be associated with parental mental health. This study examined the extent to which prolonged grief disorder in refugees is associated with their parenting behaviour and in turn with their children's mental health. METHODS: This study recruited participants from the Building a New Life in Australia prospective cohort study of refugees admitted to Australia between October 2013 and February 2014. The current data were collected in 2015-2016 and comprised 1799 adults, as well as 411 children of the adult respondents. Adult refugees were assessed for trauma history, post-migration difficulties, harsh and warm parenting, probable prolonged grief disorder and posttraumatic stress disorder. Children were administered the Strengths and Difficulties Questionnaire. The current analyses on bereaved refugees comprise 110 caregivers and 178 children. RESULTS: In this cohort, 37% of bereaved refugees reported probable prolonged grief disorder. Path analysis indicated that caregivers' grief was directly associated with children's emotional difficulties. Caregiver warmth was associated with reduced emotional problems in children of refugees with minimal grief but associated with more emotional problems in caregivers with more severe grief. More harsh parenting was associated with children's conduct problems, and this was more evident in those with less severe grief. CONCLUSION: Severity of prolonged grief disorder is directly linked to refugee children's mental health. The association between parenting style, grief severity and children's mental health highlights that managing grief reactions in refugees can benefit both refugees and their children.
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    An Open Label Pilot Study of a Brief Psychosocial Intervention for Disaster and Trauma Survivors
    O'Donnell, ML ; Lau, W ; Fredrickson, J ; Gibson, K ; Bryant, RA ; Bisson, J ; Burke, S ; Busuttil, W ; Coghlan, A ; Creamer, M ; Gray, D ; Greenberg, N ; McDermott, B ; McFarlane, AC ; Monson, CM ; Phelps, A ; Ruzek, JI ; Schnurr, PP ; Ugsang, J ; Watson, P ; Whitton, S ; Williams, R ; Cowlishaw, S ; Forbes, D (FRONTIERS MEDIA SA, 2020-06-26)
    BACKGROUND: In the aftermath of disaster, a large proportion of people will develop psychosocial difficulties that impair recovery, but for which presentations do not meet threshold criteria for disorder. Although these adjustment problems can cause high distress and impairment, and often have a trajectory towards mental health disorder, few evidence-based interventions are available to facilitate recovery. OBJECTIVE: This paper describes the development and pilot testing of an internationally developed, brief, and scalable psychosocial intervention that targets distress and poor adjustment following disaster and trauma. METHOD: The Skills fOr Life Adjustment and Resilience (SOLAR) program was developed by an international collaboration of trauma and disaster mental health experts through an iterative expert consensus process. The resulting five session, skills-based intervention, deliverable by community-based or frontline health or disaster workers with little or no formal mental health training (known as coaches), was piloted with 15 Australian bushfire survivors using a pre-post with follow up, mixed-methods design study. RESULTS: Findings from this pilot demonstrated that the SOLAR program was safe and feasible for non-mental health frontline workers (coaches) to deliver locally after two days of training. Participants' attendance rates and feedback about the program indicated that the program was acceptable. Pre-post quantitative analysis demonstrated reductions in psychological distress, posttraumatic stress symptoms, and impairment. CONCLUSIONS: This study provides preliminary evidence that the delivery of the SOLAR program after disaster by trained, frontline workers with little or no mental health experience is feasible, acceptable, safe, and beneficial in reducing psychological symptoms and impairment among disaster survivors. Randomized controlled trials of the SOLAR program are required to advance evidence of its efficacy.