Insomnia, Depression and Anxiety as Associated by Traumatic Events, Coping Strategies and Coping Resources among Internally Displaced Adolescents in North-East Nigeria

Abstract

Background: Internally displaced adolescents (IDAs) in Nigeria are a high risk group for mental health problems. More knowledge is needed about the associations between traumatic events, coping strategies, coping resources (social support and optimism) and mental health problems (insomnia, depression, and anxiety) in this group. Methods: In this cross-sectional study, a disproportionate stratified sampling strategy was used to select 109 adolescents (10-21 years of age) from an internally displaced persons camp, while a purposive sample was used to recruit 27 IDAs in non-camp setting. Insomnia Severity Index, Revised Children’s Anxiety, Depression Scale, Harvard Trauma Questionnaire Part I, Coping Style Questions, Crisis Support Scale, and Life Orientation Test were used. Results: Significant negative correlations were observed between whom respondents are living with and depression, while their needs positively correlated with insomnia, depression and anxiety. There was significant positive relationship between traumatic events score and insomnia, depression and anxiety. Problem and emotion-focused coping were associated with lower levels of insomnia. Whereas problem, emotion, avoidance-focused coping and social support were associated with lower levels of depression and anxiety symptoms. In hierarchical analysis, traumatic events contributed 51% variance on insomnia, 47% on depression and 45% on anxiety. Addition of coping strategies and coping resources significantly explained insomnia (7% versus 1%), depression (21% versus 3%), and anxiety (24% versus 5%). Conclusion: There is a need for intervention to integrate problem, emotion and avoidance focused coping alongside with adequate social support in adjustment of IDA’s mental health problems.