Assess the use of mind-body interventions to improve PTSD symptoms in adolescents exposed to war trauma in post-conflict communities in Bosnia & Hercegovina. Open Access

Abstract

An exposure to unexpected extreme traumatic events can lead to Posttraumatic-stress disorder (PTSD) in up to 10 – 40% of war survivors (Sareen, 2014). Evidence suggests that PTSD symptoms and psychological distress can persist far beyond the years of experiencing the occurrence exposure (Hasanovic et al., 2008). During the war from 1992-1995 in Bosnia & Hercegovina, civilians experienced ongoing life-threatening events and trauma with a high risk of developing PTSD under such conditions. The war had an enormous mental health impact and psychological consequences on Bosnian civilians from exposure to long-term and multiple severe traumatic experiences (Ringdal & Ringdal, 2016). According to the World Health Organization, 10%-50% of Bosnia's population, or 400,000 people, have been diagnosed with PTSD (Milic, 2011). However, internal organizations supporting citizens with PTSD argue that number is closer to 1.7 million. Still, due to stigmatization, lack of awareness of symptoms, and education surrounding this mental illness, the prevalence may be higher than the 400,000 diagnosed, given the higher estimate of suspected cases.

Bosnia & Hercegovina (BiH) is still coming out of post-conflict conditions, driven by widespread political corruption and economic stagnation, which have a further negative impact on mental health beyond the influence of cumulative trauma exposure from the war (Comtesse et al., 2019). Untreated PTSD after exposure to severe trauma during the Bosnian war that lasted from 1992-1995, and post-war conditions, might perpetuate psychological consequences and high rates of Post-Traumatic Stress Disorder (PTSD) in Bosnian civilians (Ringdal & Ringdal, 2016). In a country where access to mental health care is limited and PTSD highly stigmatized, it is prudent and humane to seek innovative public health interventions to improve mental health outcomes and quality of life for Bosnian citizens by providing broader access to promising alternative treatment options. While the use of mind-body interventions to treat PTSD is receiving increasing attention in clinical trials involving war veterans in the US, to date, no research has been performed on Bosnian adolescents exposed to war trauma using alternative methods to treat PTSD symptoms (Hilton et al., 2017).

Table of Contents

Chapter I: Introduction 1

Problem Statement 2

Purpose Statement 2

Significance Statement 3

Definition of Terms 5

Chapter II: Review of the Literature 7

Chapter III: Methodology 25

Funding Agency: U.S. Embassy in Bosnia & Herzegovina BOLD Small Commission 25

Grant Announcement 26

The Grant Review Process 27

Grant Proposal Reviewers 27

Chapter IV: Incorporation of Reviewer Comments 35

Chapter V: Bold Initiatives Commission Small Grants Program Proposal 40

1. Basic information about the Grant Proposal 40

2. Elevator Pitch 40

3. Definition of Situation 41

4. Project Goals & Objectives 43

5. Description of Project Activities 44

6. Anticipated Outputs 47

7. Plan for Engagement 47

8. Activity Location 48

9. Project Beneficiaries 48

10. Project Schedule & Timeline 49

11. Monitoring & Evaluation 49

12. Previous U.S. Government Funding 49

13. Detailed Budget 49

14. Budget Narrative 50

  Table 1: Interview Guide 51

  Table 2: Project Schedule & Timeline 52

  Table 3: Detailed Budget 53

References 54

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Prevention Science
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Mental Health Education, Health Health Sciences, Alternative Medicine
Keyword	anxiety health behavior mind-body intervention Post-traumatic Stress disorde meditation biofeedback stress depression holistic intervention chronic disease
Committee Chair / Thesis Advisor	Upton, Rebecca , Emory University
Committee Members	Rutz, Daniel, Emory University

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