The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Sexual and gender-based violence in areas of armed conflict: a systematic review of mental health and psychosocial support interventions
Open accessAbstract
BACKGROUND: Sexual and other forms of gender-based violence are common in conflict settings and are known risk factors for mental health and psychosocial wellbeing. We present findings from a systematic review of the academic and grey literature focused on the effectiveness of mental health and psychosocial support interventions for populations exposed to sexual and other forms of gender-based violence in the context of armed conflicts. METHODS: We searched the Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PubMed/ Medline, psycINFO, and PILOTS, as well as grey literature to search for evaluations of interventions, without date limitations. RESULTS: Out of 5,684 returned records 189 full text papers were assessed for eligibility. Seven studies met inclusion criteria: 1 non-randomized controlled study; 3 non-controlled pre- post-test designs; 1 retrospective cohort with a matched comparison group; and 2 case studies. Studies were conducted in West and Central Africa; Albania; UK and USA, included female participants, and focused on individual and group counseling; combined psychological, medical, social and economic interventions; and cognitive behavioral therapy (two single case studies). CONCLUSIONS: The seven studies, while very limited, tentatively suggest beneficial effects of mental health and psychosocial interventions for this population, and show feasibility of evaluation and implementation of such interventions in real-life settings through partnerships with humanitarian organizations. Robust conclusions on the effectiveness of particular approaches are not possible on the basis of current evidence. More rigorous research is urgently needed.
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“Although previous studies have evaluated effective treatment strategies with conflict-affected women and girls, 5,16 there remains a paucity of knowledge on how to bring mental health supports to the required scale. 17”
From Guided self-help to reduce psychological distress in South Sudanese female refugees in Uganda: A cluster randomised trial (2020) · cites this paper as [17]
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Citations
Cites
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“In addition, we searched the reference lists of a number of relevant reviews [28-33] and the reference lists of included evaluation studies.”
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BackgroundStatistics Notes: Some examples of regression towards the mean
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“Reported mental disorders include anxiety disorders (including Posttraumatic Stress Disorder [PTSD]), major depressive disorder, medically unexplained complaints, substance use disorders and suicidal ideation [12].”
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Armed Conflict and Its International Dimensions, 1946-2004
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Addressing sexual violence in humanitarian emergencies
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“Rates of sexual and other forms of gender-based violence are reported to be higher in areas of armed conflict than in nonconflict affected settings [4], but establishing exact rates”
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“Despite reports of large amounts of people surviving sexual and other forms of gender-based violence in the context of armed conflicts [8], high levels of psychological distress and mental disorders in this population [9-11], and the increasing popularity of preventive and treatment strategies [7,13], very little is k…”
BackgroundPalermo, T., & Peterman, A. (2011) · Bulletin of the World Health Organization · doi:10.2471/blt.11.089888 · Cited by 64 · cited 1×
“is challenging [5].”
Josse, É. (2010) · International Review of the Red Cross · doi:10.1017/s1816383110000251 · Cited by 55 · cited 2×
“Recorded social impacts include rejection by family and community, strain on marital relations, impaired parenting skills, children born as a result of rape, exclusion from schools and jobs, being perceived as unfit for marriage, further violence, repeated assault, and isolation [9,10].”
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“In addition, we searched the reference lists of a number of relevant reviews [28-33] and the reference lists of included evaluation studies.”
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“Moreover, 6 out of 7 studies [37-42] did not apply a control condition, leaving open the possibility that any decrease in symptoms represents natural recovery or regression to the mean [43].”
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Appraisal of psychosocial interventions in Liberia
Lekskes, J., van Hooren, S., & de Beus, J. (2007) · Intervention · doi:10.1097/wtf.0b013e3280be5b47 · Cited by 31 · cited 7×
“Without randomization, it is possible that the larger decrease reported in the one study [36] that applied a control condition is a result of observed pre-treatment differences.”
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Trauma rehabilitation after war and conflict : community and individual perspectives
Martz, E. (2010) · Cited by 29
Schulz, P. M., Marovic-Johnson, D., & Huber, L. (2006) · Clinical Case Studies · doi:10.1177/1534650103262408 · Cited by 22 · cited 6×
“Scores on the PSS went from 33 (severe PTSD) at pre-treatment, to 11 two months into treatment and 4 at post-treatment [42].”
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Martz (2010) · Cited by 21
Ager, A., Stark, L., Olsen, J., Wessells, M., & Boothby, N. (2010) · Girlhood Studies · doi:10.3167/ghs.2010.030106 · Cited by 13
Yohani, S. C., & Hagen, K. T. (2010) · Intervention · doi:10.1097/wtf.0b013e328341665c · Cited by 13 · cited 1×
“In addition, we searched the reference lists of a number of relevant reviews [28-33] and the reference lists of included evaluation studies.”
Method
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Cited by
Sorted by citations
Tol, W. A., Leku, M. R., Lakin, D. P., Carswell, K., Augustinavicius, J., Adaku, A., Au, T. M., Brown, F. L., Bryant, R. A., Garcia-Moreno, C., et al. (2020) · The Lancet Global Health · doi:10.1016/s2214-109x(19)30504-2 · Cited by 249
“17 Against these challenges, it is clear that addressing the substantive mental health needs in humanitarian settings will require further innovation.”
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Lwamba, E., Shisler, S., Ridlehoover, W., Kupfer, M., Tshabalala, N., Nduku, P. M., Langer, L., Grant, S., Sonnenfeld, A., Anda, D., et al. (2022) · Campbell Systematic Reviews · doi:10.1002/cl2.1214 · Cited by 301
Murray, L. K., Tol, W. A., Jordans, M. J. D., Sabir, G., Amin, A. M., Bolton, P. A., Bass, J., Bonilla-Escobar, F. J., & Thornicroft, G. (2014) · Intervention · doi:10.1097/wtf.0000000000000070 · Cited by 127
Gender-based violence against adolescent girls in humanitarian settings: a review of the evidence
Stark, L., Seff, I., & Reis, C. (2020) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(20)30245-5 · Cited by 90
Metadata
- Authors
- Tol, W. A., Stavrou, V., Greene, M. C., Mergenthaler, C., van Ommeren, M., & García Moreno, C.
- Affiliations
- Johns Hopkins University (US)
- Columbia University (US)
- Yale University (US)
- Corresponding author
- Tol, Wietse A
- Venue
- Conflict and Health
- Published
- 2013-08-05
- Volume
- 7
- Issue
- 1
- Pages
- 16-16
- ISSN
- 1752-1505 (ISSN-L)
- PMC
- PMC3750365
- OpenAlex
- W2158842686
- Cited by
- 137
- References
- 38
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 15 · 2023: 5 · 2022: 15 · 2021: 23 · 2020: 13 · 2019: 6 · 2018: 10 · 2017: 12 · 2016: 5 · 2015: 2 · 2014: 7 · 2013: 1
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Conflict and Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Topics
- Social Sciences › Gender Studies › Gender, Security, and Conflict
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Social Sciences › Sociology and Political Science › Conflict, Peace, and Violence in Colombia
- Keywords
- sexual violence, gender-based violence, armed conflict, mental health interventions, psychosocial support, post-traumatic stress, cognitive behavioral therapy, group counseling, humanitarian organizations, conflict-affected populations
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