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      Multiple-victimisation due to armed conflict and emotional distress in the State of Magdalena, Colombia Translated title: Polivictimización por el conflicto armado y sufrimiento emocional en el Departamento del Magdalena, Colombia

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          Abstract

          Abstract Background: Emotional distress is common in Colombian armed conflict victims. Multiple-victimisation is associated with an increase in emotional distress than victimisation due a single event. However, the association between poly-victimisation and emotional distress among victims of the armed conflict in Colombia has not been documented. Objective: To study the association between multiple-victimisation and emotional distress in victims of armed conflict in the State of Magdalena, Colombia. Methods: A cross-sectional study was designed, with a secondary analysis of registration of the Psychosocial Care Program and Victim Integral Health (PAPSIVI) in the State of Magdalena, from 2013 to 2014. The profile formula grouped demographic variables, victimising events, and a set of symptoms of emotional distress (perceived discrimination, depressive and anxiety-stress). Odds ratio (OR, 95%CI) were established as measures of association. Results: A total of 943 people were included, with 67.4% women, and ages between 18 and 94 years (mean 47.9 ±14.2). A total of 109 (11.7%) suffered from multiple victimisation. Multiple victimisation events were associated with more emotional distress, depressive symptoms (OR = 1.5; 95%CI, 1.3-1.8), perceived stigma (OR = 1.3; 95%CI, 1.1-1.5), and anxiety-stress (OR = 1.2; 95%CI 1.0-1.4) than a single event. Conclusions: There are more emotional distress in multiple victimisations than in a single victimisation event during armed conflict in this region of Colombia. Further studies are required on this topic.

          Translated abstract

          Resumen Introducción: El sufrimiento emocional es frecuente en víctimas del conflicto armado colombiano. La polivictimización se asocia a mayor número de sufrimientos emocionales que la victimización debida un único evento. Sin embargo, hasta la fecha no se ha documentado la asociación entre polivictimización y sufrimiento emocional en víctimas del conflicto armado en Colombia. Objetivo: Estudiar la asociación entre polivictimización y sufrimiento emocional en víctimas del conflicto armado del Departamento del Magdalena, Colombia. Métodos: Se diseñó un estudio transversal, un análisis secundario del registro del Programa de Atención Psicosocial y Salud Integral a Víctimas (PAPSIVI) del Departamento del Magdalena, 2013-2014. El formulario de caracterización agrupó variables demográficas, eventos victimizantes y un conjunto de manifestaciones de sufrimiento emocional (discriminación percibida, depresión y ansiedad). Se establecieron razones de disparidades como medidas de asociación. Resultados: Se incluyó a 943 personas, el 67,4% mujeres, con edad de 18-94 anos (media, 47,9 ± 14,2). Un total de 109 (11,7%) presentaron polivictimización. La polivictimización se asoció a mayor sufrimiento emocional que la victimización por un único evento, síntomas depresivos (odds ratio = 1,5; intervalo de confianza del 95%, 1,3-1,8), estigmatización percibida (odds ratio = 1,3; intervalo de confianza del 95%, 1,1-1,5) y ansiedad-estrés (odds ratio = 1,2; intervalo de confianza del 95%, 1,0-1,4). Conclusiones: La polivictimización incrementa el sufrimiento emocional más que la victimización por un único evento en personas víctimas del conflicto armado en esta región colombiana. Es necesario investigar más en esta área.

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          Aproximación al uso del coeficiente alfa de Cronbach

          Introducción: Las escalas se usan frecuentemente en la investigación y en la práctica clínica de la psiquiatría. No obstante, todas las escalas deben ser formalmente validadas antes, con el propósito de conocer de las propiedades psicométricas en una población específica. Descripción: Las escalas pueden ser validadas con el uso de un patrón de referencia o sin él; la segunda opción es la única forma de validar algunos instrumentos. Establecer la consistencia interna de una escala es una aproximación a la validación del constructo y consiste en la cuantificación de la correlación que existe entre los ítems que la componen. Valores de alfa de Cronbach entre 0,70 y 0,90 indican una buena consistencia interna. La determinación del alfa de Cronbach se indica para escalas unidimensionales entre tres y veinte ítems. Se debe informar este valor cada vez que se emplee la escala y puede usarse como única medida de validez cuando es difícil una validación con un patrón de referencia.
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            Lifetime assessment of poly-victimization in a national sample of children and youth.

            To use a lifetime assessment of victimization experiences to identify children and youth with high cumulative levels of victimization (poly-victims). Also to compare such children to other victims and non-victims, and assess the contribution of cumulative victimization to levels of psychological distress. A national sample of 1,467 children aged 2-17 recruited through random digit dialing and assessed via telephone interviews (with caretakers and youth themselves) about a comprehensive range of 33 types of victimization experiences in the previous year and at any time in their lives. Nearly 80% of the children and youth reported at least one lifetime victimization. The mean number of lifetime victimizations was 3.7 and the median 2.6. The total number of different lifetime victimizations was highly predictive of symptoms of current distress. The best linear prediction of distress on the basis of cumulative victimization entailed weighting child maltreatment and sexual assault by factors of 4 and 3 respectively compared to other victimizations. We proposed classifying poly-victims as those 10% of children and youth with the highest victimization scores, and calculating different thresholds for children at different ages. Poly-victims designated in this way had significantly more distress, more non-victimization adversities than other youth and were less likely to come from an intact family. Lifetime assessment of victimization has value as a means of identifying groups of highly victimized children and youth. This paper describes a procedure under which practitioners can assess for a group of children, termed "poly-victims," who have a very high burden of lifetime victimization. These children merit identification because they have high levels of psychological distress, some of the most serious victimization profiles, and a presumed vulnerability for further victimization.
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              The importance of assessing the fit of logistic regression models: a case study.

              The logistic regression model is being used with increasing frequency in all areas of public health research. In the calendar year 1989, over 30% of the articles published in the American Journal of Public Health employed some form of logistic regression modeling. In spite of this increase, there has been no commensurate increase in the use of commonly available methods for assessing model adequacy. We review the current status of the use of logistic regression modeling in the American Journal of Public Health. We present a brief overview of currently available and easily used methods for assessing the adequacy of a fitted logistic regression model. An example is used to demonstrate the methods as well as a few of the adverse consequences of failing to assess the fit of the model. One important adverse consequence illustrated in the example is the inclusion of variables in the model as a result of the influence of one subject. Failure to address model adequacy may lead to misleading or incorrect inferences. Recommendations are made for the use of methods for assessing model adequacy and for future editorial policy in regard to the review of articles using logistic regression.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rcp
                Revista Colombiana de Psiquiatría
                rev.colomb.psiquiatr.
                Asociacion Colombiana de Psiquiatria. (Bogotá, Distrito Capital, Colombia )
                0034-7450
                September 2017
                : 46
                : 3
                : 147-153
                Affiliations
                [1] Santa Marta Magdalena orgnameUniversidad del Magdalena orgdiv1Facultad de Ciencias de la Salud Colombia
                [2] Santa Marta Magdalena orgnameUniversidad del Magdalena Colombia
                Article
                S0034-74502017000300147
                10.1016/j.rcpeng.2016.06.002
                28728798
                fbdf61fa-00a0-43c1-8504-273d3d0532e8

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

                History
                : 22 June 2016
                : 01 April 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 52, Pages: 7
                Product

                SciELO Colombia


                Depressive symptoms,Social stigma,Cross-sectional study,Anxiety,Victimización Aspectos mentales Síntomas depresivos Estigma social Ansiedad Estrés emocional Estudio transversal,Emotional stress,Victimisation,Mental aspects

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