The effect of trauma and daily stressors on executive and emotion control: a study in North-Ugandan teenage boys

Rose
Baudoncq

Executief functioneren - wablief?!

Toch misschien een uitweg uit de negatieve spiraal voor stress

beladen, getraumatiseerde Oegandese weeskinderen

 Of those children who survived, “4-5 million were disabled, 12 million left homeless,more than 1 million orphaned or separated from their parents and some 10 millionpsychologically traumatised” in the last 10 years of warfare (Unicef, 1996, p13). Oeganda kende meer dan 2 decennia een vreselijke burgeroorlog.Het effect van deze langdurige stresssituatie kan niet onder woorden worden gebracht.We ondernemen een poging om een tip van de sluier op te lichten en zoomen in op dementale gezondheid van 72 Oegandese weeskinderen…

 

Executief functioneren en stress

De mentale vermogens van de mens zijn zeer uitgebreid, gaande van taalkundige,sociale en psychologische vaardigheden tot ruimtelijk inzicht en logica. Eén belangrijkonderdeel hiervan heet ons executief functioneren. Dit is een paraplu-begrip gebruikt inde psychologie dat ons vermogen om te plannen, te organiseren, problemen op telossen, controle uit te oefenen over ons gedrag,… omschrijft. Zodoende lopen we nietdoelloos rond als een kip zonder kop en zonder eigen wil. Een belangrijk onderdeel vanons executief functioneren is de inhibitie. Dit omvat de vaardigheid om een automatischetendens te onderdrukken. We kennen allemaal wel situaties waarin we onze executieveknop vergaten in te drukken. We nemen zoals elke ochtend de weg naar school terwijlwe vandaag uitzonderlijk naar de tandarts moeten en halverwege moeten we onsomdraaien... Executieve controle zorgt ervoor dat we onze automatische pilootuitschakelen en doelgericht een andere route nemen. Executive controle is hetgeen onsmensen onderscheid van die kip… Een typische test die deze belangrijke vaardigheid meet is de bekende Stroop test. Lees de volgende woorden:groen blauw geel paars rood blauw geel groen paars rood blauw Dat was gemakkelijk! Probeer nu de kleur te benoemen in plaats van de woorden te lezen:groen blauw geel paars rood blauw geel groen paars rood blauw Dat was al heel wat moeilijker nietwaar? Bij deze laatste oefening moet je brain de automatische lees-tendens onderdrukken omde juiste kleur te benoemen. Hiervoor was executieve controle nodig. De kip zou blijvenlezen (indien ze dit al kon…). Executieve controle is heel belangrijk in ons dagdagelijkse leven. Het is een sterkevoorspeller voor academisch functioneren, succes in je job, sociaal functioneren, fysiekeen mentale gezondheid en algemene levenskwaliteit. Bovendien blijkt uit onderzoek datmeer executieve controle gelinkt is aan een betere stressbestendigheid. Goed nieuwswant executieve controle kan je trainen. Zo zijn er veel computerprogramma’s die dittrainen maar ook deelname aan een gevechtssport, yoga of mindfulness blijkt executievecontrole positief te beïnvloeden. In het Westen hebben we veel last van stress. Maar als we iets verder kijken dan onzeneus lang is, zien we dat er ook (en vooral) veel stress aanwezig is in andere uithoekenvan de wereld en vooral in oorlogsgebieden. Onderzoek heeft meermaals aangetoonddat oorlog en conflict leiden tot veel stress bij de bevolking, in het bijzonder bij kinderenen jongeren. Een bijzonder kwetsbare groep zijn weeskinderen. Als executieve controleeen beschermende rol zou kunnen spelen op ons stressniveau, hoe zit dit bij kwetsbareweeskinderen?  

Het onderzoek in Noord-Oeganda

Ons onderzoek onderzocht het executief functioneren bij 72 mannelijke Noord-Oegandese jongeren tussen 14 en 19 jaar. Twintig participanten hadden minstens 1ouder verloren, de overige 52 hadden nog beide ouders. De testen werden bij dezestudenten afgenomen op het internaat, in een klein kamertje zonder elektriciteit. Elkestudent vulde verschillende vertaalde vragenlijsten in die de geestelijke gezondheidonderzochten, waaronder trauma-, angst- en depressie symptomen. De Stroop test werdafgenomen om het executief functioneren te achterhalen. Daarnaast ontwikkelden weeen emotionele variant van deze executieve test.

 

De belangrijkste resultaten

• In tegenstelling tot onze verwachtingen ervoeren de weeskinderen niet meerangst, depressie of trauma symptomen in vergelijking met de kinderen die nogbeide ouders hadden. • Verrassend genoeg presteerde de groep weeskinderen ook even goed op beidetesten van executieve controle in vergelijking met de andere kinderen. Deze resultaten kunnen mogelijks het resultaat zijn van het beschermend effect vanandere familieleden, het ondersteunend kader van het internaat, de beperkte grootte vanonze steekproef,... • Het emotioneel executief functioneren was echter wel beduidend zwakker bijweeskinderen die meer trauma-symptomen ervoeren. Hieruit blijkt datgetraumatiseerde weeskinderen een extra kwetsbare groep vormen.  

Wat nu?

De testen in dit onderzoek zijn speciaal ontwikkeld voor deze doelgroep en kunnentoekomstig onderzoek stimuleren en hulpverleners ter plekke helpen bij het inschattenvan het executief vermogen van Oegandese jongeren. Getraumatiseerde weeskinderenondergaan veel extra stressfactoren - ze moeten het vaak alleen redden op straat,hebben geen geld, volgen geen onderwijs, komen in de prostitutie terecht, stelen enkomen in aanraking met de politie… Het is vaak een negatieve spiraal. Gezienexecutieve controle een belangrijk effect heeft op ons dagdagelijks leven en onzementale gezondheid zou het een interessante focus kunnen zijn voor hulpverleners omde weerbaarheid van stress beladen kinderen, zoals wezen, te vergroten. Kan hetstimuleren van executieve controle het begin zijn van een uitweg uit de negatieve spiraalvoor deze kwetsbare en gestresseerde kinderen?

 

 

Zie bijlage voor Stroop Test in kleur!!

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Universiteit of Hogeschool
Universiteit Gent
Thesis jaar
2014