Online Program

Coping strategies and depression among survivors of torture in kurdistan, Iraq

Tuesday, November 5, 2013

Sarah Murray, MSPH, Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD
Jeremy Kane, MPH, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Judith Bass, PhD, MPH, Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD
Laura Murray, PhD, MA, Department of Mental Health and Department of International Health, Johns Hopkins School of Public Health
Paul Bolton, MBBS, DTMH, MPH, Department of International Health, Applied Mental Health Research Group, Center for Refugee and Disaster Response, Johns Hopkins School of Public Health, Baltimore, MD
High levels of mental distress have been documented in northern Iraq decades after the perpetration of torture, genocide, and chemical warfare against Kurdish populations. The nature of coping strategies used by survivors of torture living in Kurdistan and the relationship of these strategies to symptoms of distress has yet to be systematically explored. We assessed symptoms of depression and coping among 206 survivors or witnesses of torture who met symptom severity criteria as part of a randomized evaluation of a community mental health worker led counseling intervention in the Dohuk governate of Kurdistan. Depression was measured using a locally validated version of the Hopkins Symptom Checklist. A coping index was developed based on qualitative findings, with respondents indicating how frequently they used the following strategies: praying, sitting together with others to talk, going for walks, getting advice from others, and participating in recreation or sports activities. At baseline, the mean coping index score ranged from 0 to 14 with a mean 5.79. Praying and asking for advice were the most commonly employed strategies. On average, individuals used 1 to 2 coping strategies, although almost a quarter of respondents reported use of no strategy. Depression symptoms were significantly associated with coping index score at baseline and post-intervention (p value <0.001). Findings on the longitudinal association of depression and coping will also be presented, along with an exploration of the relationship between use of coping strategies and the impact of basic counseling.

Learning Areas:

Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe coping strategies employed by survivors of potentially traumatic events and/or torture in Kurdistan, Iraq Assess the longitudinal impact of coping strategies on depressive symptoms Analyze the relationship of use of coping strategies and treatment effects of a basic counselling intervention

Keyword(s): Coping, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a pre-doctoral student and NIMH funded fellow trained in psychiatric epidemiology, psychosocial measurement, and public health approaches to mental distress. My predominant research interest is global mental health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.