Effectiveness and specificity of a classroom‐based group intervention in children and adolescents exposed to war in Lebanon
Open accessAbstract
The purpose of this study was to examine the effectiveness and specificity of a classroom-based psychosocial intervention after war. All students (n=2500) of six villages in Southern Lebanon designated as most heavily exposed to war received a classroom-based intervention delivered by teachers, consisting of cognitive-behavioural and stress inoculation training strategies. A random sample of treated students (n=101) and a matched control group (n=93) were assessed one month post-war and one year later. Mental disorders and psychosocial stressors were assessed using the Diagnostic Interview for Children and Adolescents - Revised with children and parents. War exposure was measured using the War Events Questionnaire. The prevalence of major depressive disorder (MDD), separation anxiety disorder (SAD) and post-traumatic stress disorder (PTSD) was examined pre-war, one month post-war (pre-intervention), and one year post-war. Specificity of treatment was determined by rating teachers' therapy diaries. The rates of disorders peaked one month post-war and decreased over one year. There was no significant effect of the intervention on the rates of MDD, SAD or PTSD. Post-war MDD, SAD and PTSD were associated with pre-war SAD and PTSD, family violence parameters, financial problems and witnessing war events. These findings have significant policy and public health implications, given current practices of delivering universal interventions immediately post-war.
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A Lebanese cross-sectional follow-up found no positive effects for children in a school-based program that combined cognitive-behavioral strategies with drawing, creative play, and group discussion.
“in a cross-sectional follow-up study comparing intervention participants to community controls in Lebanon, no positive effects were observed among children who received a school-based intervention combining cognitive-behavioral treatment strategies with activities like drawing, creative play, and group discussion.47”
From Interventions for Children Affected by War: An Ecological Perspective on Psychosocial Support and Mental Health Care (2013) · cites this paper as [47]
In a Lebanon trial of a 12-session teacher-delivered classroom intervention for 6-18-year-olds in conflict-affected areas, depression, separation anxiety, and PTSD did not differ between study conditions.
“In another trial of a classroom-based intervention (consisting of 12 daily sessions implemented by teachers) with 6–18-year-olds residing in armed conflict-affected areas in Lebanon, no differences in depression, separation anxiety, and PTSD between study conditions were recorded.”
From Mental health and psychosocial support in humanitarian settings: linking practice and research (2011) · cites this paper as [61]
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- Authors
- KARAM, E. G., FAYYAD, J., KARAM, A. N., TABET, C. C., MELHEM, N., MNEIMNEH, Z., & DIMASSI, H.
- Affiliations
- University of Balamand (LB)
- University of Pittsburgh (US)
- University of Michigan (US)
- Institute for Development, Research, Advocacy and Applied Care (LB)
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2008-06
- Volume
- 7
- Issue
- 2
- Pages
- 103-109
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC2430518
- OpenAlex
- W1723388838
- Cited by
- 115
- References
- 49
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 2 · 2023: 1 · 2022: 6 · 2021: 2 · 2020: 8 · 2019: 3 · 2018: 2 · 2017: 41 · 2016: 3 · 2015: 3 · 2014: 7 · 2013: 7 · 2012: 4
- FWCI
- 7.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- UNICEF
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- war exposure, post-war mental health, classroom intervention, teacher-delivered intervention, cognitive-behavioural intervention, stress inoculation training, major depressive disorder, separation anxiety disorder, post-traumatic stress disorder, children and adolescents, Lebanon, domestic violence, treatment specificity
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