- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02503488
Decreasing Youth Involvement in Violence in Burundi
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The African Great Lakes Region is marked by several countries which have been ravaged by violence for several years. One of these countries is Burundi, a small state bordered by Rwanda, Tanzania and the Democratic Republic of the Congo. This country has been stricken by more than a decade of civil war, which ended only in 2006.
Today, many people still struggle in coping with the aftermath of the war. Political parties remain largely drawn along ethnic lines. These identities are often manipulated in order to incite violence and intimidation against opposing parties or groups. Violence between rival youth wings was a disturbing feature of the 2010 elections in Burundi, with similar conditions manifesting themselves in advance of the 2015 presidential election.
Further complicating the situation in Burundi, one of the problems people in war-affected populations often face is the high impairment due to mental health problems. Studies in crisis regions have shown that multiple experiences of traumatic life events seriously damages mental health and can lead to disorders such as Posttraumatic Stress Disorder (PTSD) or depression. Further, the risk of developing PTSD rapidly increases with the number of traumatic events experienced, as the occurrence of PTSD is more likely when the accumulation of trauma exceeds a certain limit. This phenomenon has been described as the "building block effect". This means, people in the context of armed conflicts and war are especially at risk to develop PTSD, as the total load of perceived stress is much higher than anywhere else. Furthermore, recent studies have revealed that combatants and other populations living in violent and insecure circumstances may adapt to their environment by developing an attraction to perpetrating violence, i.e. appetitive aggression. While appetitive aggression helps individuals to survive in violent environments by reducing their likelihood of developing trauma-related symptoms, it increases the risk of getting involved in the perpetration of violence.
In order to address the mental health needs of the participants in the present study, the investigators will be utilizing an intervention, Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET), that has been demonstrated to reduce posttraumatic symptomology and readiness for aggressive behavior.
Objectives:
The aim of the present study is to investigate the intersection of politics and mental health within the context of Burundi. Specifically, the study will be seeking to answer the following research questions:
- Mental Health Barriers to Participation in Peace Building Initiatives: What, if any, role does the presence of mental health issues such as PTSD and depression play in effective participation in peace-building efforts? Can FORNET contribute to peace building programs?
Links Between Mental Health Issues and Political Participation: What is the role of mental health issues in shaping the readiness to resort to violence as a result of political beliefs and attitudes toward members of other political parties in a post-conflict setting?
- Appetitive Aggression. Does the concept of appetitive aggression influence the manner of political participation? Does appetitive aggression have a relationship to the perpetration of politically-motivated violence?
- Trauma-related disorders. Do trauma-related disorders such as PTSD and depression influence the manner of political participation? Do they have a relationship to the perpetration of politically-motivated violence?
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Bujumbura, Burundi
- vivo international & Psychologues sans Frontières mental health center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- High degree of symptoms of posttraumatic stress disorder according to the Posttraumatic Symptom Scale
- High degree of appetitive aggression
- Violent behavior during the past three months
Exclusion Criteria:
- Current use of mind altering drugs
- Psychotic symptoms
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Program Group
The treatment arm will consist of 20 randomly selected participants who will receive Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) for their traumatic symptomology, aggression, and depression.
FORNET consists of a guided exposure of the participant's traumatic experiences in chronological order and integrating them into a coherent biographical memory.The intervention addresses the participant's positive, negative, and violent memories of events that have taken place during their lifetime, and also provides participants an opportunity to asses their current situation and future plans.
FORNET can be completed in six sessions and each session lasts 90 minutes on average.
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See arm description.
Other Names:
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Active Comparator: Treatment As Usual (TAU)
Participants in the TAU group will receive group and individual psycho-social support from trained peer-support workers, with 10 sessions occurring throughout the course of the intervention for each participant.
In addition, there will be sensitisation trainings as well as mentoring for establishing greater financial independence.
Last, TAU will include one-day events promoting social cohesion and peace.
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See arm description
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Baseline PTSD Scores at 3-months-followup and 9-months-followup
Time Frame: Baseline, 3 months, 9 months
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Will be assessed using the PSS-I
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Baseline, 3 months, 9 months
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Change in Baseline Depression Scores at 3-months-followup and 9-months-followup
Time Frame: Baseline, 3 months, 9 months
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Will be assessed using the Patient Health Questionnaire-9
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Baseline, 3 months, 9 months
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Change in Baseline Appetitive Aggression Scores at 3-months-followup and 9-months-followup
Time Frame: Baseline, 3 months, 9 months
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Assesses attitudes towards the perception and disposition of different forms of violence using the Appetitive Aggression Scale for Children (AAS-C).
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Baseline, 3 months, 9 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Baseline Physical State at 3-months-followup and 9-months-followup
Time Frame: Baseline, 3 months, 9 months
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Will be assessed using a structured list of a range of ailments
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Baseline, 3 months, 9 months
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Change in Social Integration Scores at 3-months-followup and 9-months-followup
Time Frame: Baseline, 3 months, 9 months
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Will assess levels of participant integration with family and community using scores between 0-4, with higher scores indicating higher levels of social integration.
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Baseline, 3 months, 9 months
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Change in Scores on the Attitudes Toward Members of Other Political Parties Scale at 3-months-followup and 9-months-followup
Time Frame: Baseline, 3 months, 9 months
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Will assess nature of attitudes towards other political parties with which the participant is not affiliated.
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Baseline, 3 months, 9 months
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Change in Scores on the Opinion on the Civil War Scale at 3-months-followup and 9-months-followup
Time Frame: Baseline, 3 months, 9 months
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Will assess participant opinions on their acceptance of members of other ethnic groups, responsibility for the civil war, and reparation and transitions post-conflict.
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Baseline, 3 months, 9 months
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Anselm Crombach, University of Konstanz, vivo international e.V., Psychologues sans Frontiers Burundi
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- UKonstanz
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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