title: Psychosocial Group Intervention Among War-Affected Children: An Analysis of Changes in Posttraumatic Cognitions.
abstract: Cognitive theories point to reduction in dysfunctional posttraumatic cognitions (PTCs) as one mechanism involved in recovery from posttraumatic stress symptoms (PTSS), yet research findings have shown individual differences in the recovery process. We tested the cognitive mediation hypothesis above in a previously published psychosocial group intervention among war-affected children. We also examined heterogeneity in children's PTCs during the intervention. We used a cluster randomized trial of Smith et al.'s (2002) teaching recovery techniques (TRT) intervention among 482 Palestinians 10-13 years of age (n = 242 for intervention group, n = 240 for control group). Children reported PTSS, PTCs, and depressive symptoms at baseline, midpoint, postintervention, and at 6-month follow-up. Path analysis results showed that TRT was not effective in reducing dysfunctional PTCs, and the reductions did not mediate intervention effects on PTSS. Using latent class growth analysis, we chose the model with 3 differing trajectories in the intervention group: high, decreasing, moderate, downward trending, and severe, stable levels of PTCs. Higher PTSS and depressive symptoms at baseline were associated with membership in the severe, stable trajectory. The intervention did not produce the kind of beneficial cognitive change needed in the cognitive mediation conceptualization. Nevertheless, cognitive changes differed substantially across children during the intervention, and were associated with their preintervention mental health status. These findings call for more detailed examination of the process of cognitive mediation.
authors.affiliation: School of Social Sciences and Humanities / Psychology, University of Tampere, Tampere, Finland.
authors.forename: Samuli
authors.initials: S
authors.lastname: Kangaslampi
authors.affiliation: School of Social Sciences and Humanities / Psychology, University of Tampere, Tampere, Finland.
authors.forename: Raija-Leena
authors.initials: RL
authors.lastname: Punamäki
authors.affiliation: Faculty of Education, Islamic University of Gaza, Gaza City, Palestine.
authors.forename: Samir
authors.initials: S
authors.lastname: Qouta
authors.affiliation: Gaza Community Mental Health Programme, Gaza City, Palestine.
authors.forename: Marwan
authors.initials: M
authors.lastname: Diab
authors.affiliation: School of Social Sciences and Humanities / Psychology, University of Tampere, Tampere, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Peltonen
mesh_terms: D000293:Adolescent; D018912:Arabs / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D003863:Depression / Q000150:complications / Q000523:psychology; D018450:Disease Progression; D000069581:Exposure to Violence / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D000072858:Psychosocial Support Systems; D011615:Psychotherapy, Group / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D040921:Stress Disorders, Traumatic / Q000150:complications / Q000523:psychology / Q000628:therapy*; D014857:Warfare