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      Secuelas de la violencia colectiva: hablan las víctimas del estudio ISAVIC Translated title: Sequelae of collective violen victims' voices in the ISAVIC study

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          Abstract

          Objetivo: A pesar de la importancia de la violencia colectiva en la salud, aún quedan muchas lagunas sobre la naturaleza de las lesiones que produce y su relación con el bienestar y la calidad de vida de sus víctimas. Durante los años 2005-2008 se realizó en el País Vasco el estudio ISAVIC para estimar los efectos de este tipo de violencia en la salud. El estudio intentó comprender las características de las secuelas de la violencia colectiva en la salud de las víctimas a partir de sus percepciones. Métodos: Se seleccionó una muestra intencional de 36 víctimas primarias, a través de redes de contactos y mediadores. Se realizaron entrevistas en profundidad semiestructuradas, analizadas en función del modelo conceptual del estudio. Resultados: Los testimonios sugieren que las víctimas han experimentado un proceso traumático de gran intensidad que no han superado en su totalidad y que es causa de una importante pérdida de calidad de vida. Se describen las principales limitaciones funcionales observadas en términos físicos, emocionales y sociales. Conclusiones: Los resultados cualitativos son coherentes con los obtenidos mediante instrumentos estandarizados, a los que dotan de mayor sentido al explicar la naturaleza de las limitaciones de la salud. También permiten intuir algunas de las relaciones entre las diferentes limitaciones funcionales y su impacto en la calidad de vida. Conviene verificar los resultados con muestras más amplias de víctimas y profundizar en el estudio de la relación entre violencia y salud, incluyendo el impacto del contexto social.

          Translated abstract

          Objective: Despite the significant influence of collective violence on the health status of its victims, there are still many gaps in our understanding of the nature of the functional limitations this violence produces and its impact on victims' wellbeing and quality of life. The ISAVIC study was carried out in the autonomous region of the Basque Country from 2005-2008 to estimate the effects of collective violence on health. The assessment included victims' perceptions of these sequelae and their impact on health. Methods: A purposive sample of 36 primary victims was selected through contact networks and mediators. The victims' perceptions were collected through semi-structured in-depth interviews, which were later analyzed according to the study's conceptual framework. Results: The victims' testimony suggests that they were profoundly traumatized by the collective violence experienced, which was often not yet completely overcome and significantly impaired their quality of life. The main functional, physical, emotional and social limitations described by the victims were identified. Conclusions: The qualitative results of this study are coherent with those obtained through the parametric phase of the ISAVIC study and provide a more complete overview of the nature of the sequelae of collective violence and its impact on quality of life. These results should be verified in larger studies and the influence of the social context on the relationship between collective violence and health should be analyzed in greater depth.

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          Most cited references44

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          Diagnostic and statistical manual of mental disorders.

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            Diagnostic and statisti-cal manual on mental disorders

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              Prospective study of posttraumatic stress disorder and depression following trauma.

              The purpose of this study was to prospectively evaluate the onset, overlap, and course of posttraumatic stress disorder (PTSD) and major depression following traumatic events. The occurrence of PTSD and major depression and the intensity of related symptoms were assessed in 211 trauma survivors recruited from a general hospital's emergency room. Psychometrics and structured clinical interview (the Structured Clinical Interview for DSM-III-R and the Clinician-Administered PTSD Scale) were administered 1 week, 1 month, and 4 months after the traumatic event. Heart rate was assessed upon arrival at the emergency room for subjects with physical injury. Twenty-three subjects with PTSD and 35 matched comparison subjects were followed for 1 year. Major depression and PTSD occurred early on after trauma; patients with these diagnoses had similar recovery rates: 63 survivors (29.9%) met criteria for PTSD at 1 month, and 37 (17.5%) had PTSD at 4 months. Forty subjects (19.0%) met criteria for major depression at 1 month, and 30 (14.2%) had major depression at 4 months. Comorbid depression occurred in 44.5% of PTSD patients at 1 month and in 43.2% at 4 months. Comorbidity was associated with greater symptom severity and lower levels of functioning. Survivors with PTSD had higher heart rate levels at the emergency room and reported more intrusive symptoms, exaggerated startle, and peritraumatic dissociation than those with major depression. Prior depression was associated with a higher prevalence of major depression and with more reported symptoms. Major depression and PTSD are independent sequelae of traumatic events, have similar prognoses, and interact to increase distress and dysfunction. Both should be targeted by early treatment interventions and by neurobiological research.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Ediciones Doyma, S.L. (Barcelona, Barcelona, Spain )
                0213-9111
                April 2011
                : 25
                : 2
                : 115-121
                Affiliations
                [01] orgnameEquipo ISAVIC (Impacto de SAud de la VIolencia Colectiva) España
                [02] Madrid orgnameUniversidad Complutense orgdiv1Departamento de Psicología Social España
                [03] San Sebastián orgnameUniversidad del País Vasco orgdiv1Facultad de Psicología España
                [04] Bilbao orgnameUniversidad de Deusto orgdiv1Instituto de Derechos Humanos Padre Arrupe España
                Article
                S0213-91112011000200006 S0213-9111(11)02500200006
                10.1016/j.gaceta.2010.11.005
                889ac7ff-2cd6-44c9-b6ab-eaa2e320019b

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 10 November 2010
                : 01 August 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 7
                Product

                SciELO Public Health

                Categories
                Originales

                Investigación cualitativa,Violence,Terrorism,Qualitative research,Violencia,Terrorismo,Estado de salud,Métodos epidemiológicos,Epidemiologic methods,Health status

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