Effect of Trauma on Quality of Life as Mediated by Mental Distress and Moderated by Coping and Social Support among Postconflict Displaced Ethiopians

• Published in: Quality of life research Vol. 16; no. 6; pp. 915 - 927
• Main Authors: Araya, Mesfin, Chotai, Jayanti, Komproe, Ivan H., de Jong, Joop T. V. M.
• Format: Journal Article
• Language: English
• Published: Netherlands Springer 01.08.2007; Springer Nature B.V
• Subjects: Adaptation, Psychological; Adolescent; Adult; Childhood; Clinical and Policy Applications; Cognitive models; Coping strategies; Displaced persons; Ethiopia - epidemiology; Family Relations; Female; Humans; Life Change Events; Life events; Living conditions; Male; Men; Middle Aged; Modeling; Quality of life; Quality of Life - psychology; Refugees - psychology; Risk Factors; Sickness Impact Profile; Social events; Social Support; Starvation - physiopathology; Starvation - psychology; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - rehabilitation; Stress, Psychological - psychology; Stress, Psychological - rehabilitation; Studies; Trauma severity indices; Warfare; Ethiopia
• DOI: 10.1007/s11136-007-9201-9
• ISSN: 0962-9343; 1573-2649

Objective An understanding of how quality of life is affected by severe trauma and mental distress may facilitate better intervention strategies for postconflict internally displaced persons, by identifying mediators, moderators, and independent risk factors. We investigate the pathways involved in this process and also study the moderating roles of coping strategies and perceived social support. Method A random sample of 1193 (62% women) internally displaced Ethiopian adults living in shelters in Addis Ababa were interviewed with instruments capturing the relevant concepts, including SCL-90-R and WHOQOLBREF. Path analysis was employed to elaborate the mediating and moderating effects. Self-reported living conditions were also assessed. Results Mental distress increased and quality of life decreased with age. Mental distress mediated the effects of trauma in reducing the quality of life, and some trauma also reduced quality of life directly. These effects remained after adjusting for living conditions. Living conditions were related to quality of life also on their own. Coping strategies and perceived social support influenced mental distress and quality of life directly as well as indirectly by moderation, in part gender specific. Conclusions Intervention strategies aimed at reducing mental distress, modifying coping strategies, and encouraging social support may turn out to be useful in increasing the overall quality of life in postconflict situations, and are worth considering as complements to strategies that improve the living conditions.