Politically motivated violence has been a hallmark of life in Northern Ireland for the past 37 years. Despite the ceasefires in 1994 to 1995, violent incidents remain a relatively common occurrence. A range of community-based services developed to help people cope. In this article, the psychological health of people who use these services is assessed by means of the General Health Questionnaire, the Beck Depression Index, and the Posttraumatic Stress Diagnostic Scale. Pearson correlations indicate that 10 years after the ceasefires in Northern Ireland, the psychological health of community service users remains compromised in terms of death, individual, social, and cultural contexts. These issues are discussed in relation to questions regarding the effects of ongoing violence, resilience, and effectiveness of services.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
2.
Beck, A.T., Steer, R.A., & Garbin, M.G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100.
3.
Blackledge, J.T. (2004). Functional contextual processes in posttraumatic stress. International Journal of Psychology and PsychologicalTherapy, 4, 443-467.
4.
Bloomfield, K. (1998). “We will remember them”: Report of the Northern Ireland Victims Commissioner. Belfast, Northern Ireland: The Stationery Office.
5.
Brewin, C.R., Andrews, B., & Valentine, J.D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748-766.
6.
Brunner, J. (2006, September). How do posttraumatic responses turn into chronic disorders, and why is this a moral question? On catalysts, supplements and emotional excess. Paper presented at the Third International Trauma Research Net Conference: Trauma—Stigma and Distinction , St. Moritz, Switzerland.
7.
Burrows, R., & Keenan, B. (2004). Bearing witness: Supporting parents and children in the transition to peace. Child Care in Practice, 10, 107-125.
8.
Burstow, B. (2005). A critique of posttraumatic stress disorder and the DSM. Journal of Humanistic Psychology, 45, 429-445.
9.
Cairns, E. (1988). Social class, psychological wellbeing and minority status in Northern Ireland. The International Journal of Social Psychiatry, 35, 231-236.
10.
Cairns, E., & Lewis, C.A. (1999). Collective memories, political violence and mental health in Northern Ireland. British Journal of Psychology , 90, 25-33.
11.
Cairns, E., & Mallet, J. (2003). Who are the victims? Self-assessed victimhood and the Northern Irish conflict (Research and Statistical Series, No. 7). Belfast, Northern Ireland: Northern Ireland Office Statistics and Research Branch.
12.
Cairns, E., & Wilson, R. (1984). The impact of political violence on mild psychiatric morbidity in Northern Ireland. The British Journal of Psychiatry , 145, 631-635.
13.
Curran, P.S., Bell, P., Murray, A., Loughrey, G., Roddy, R., & Rocke, L.G. (1990). Psychological consequences of the Enniskillen Bombing. The British Journal of Psychiatry, 156, 479-482.
14.
Darby, J., & Williamson, A. (Eds.). (1978). Violence and social services in Northern Ireland. London: Heinemann .
15.
Deloitte & Touche (2001). Evaluation of services to victims and survivors of the Troubles. Belfast, Northern Ireland: Victims Unit, OFMDFM.
16.
Dillenburger, K. (1992). Violent bereavement: Widows in Northern Ireland . Aldershot: Avebury.
17.
Dillenburger, K. (2002). Psychological perspectives on the Troubles: Violent bereavement. Psychological Perspectives on the Troubles: Adults. Belfast, Northern Ireland: Northern Irish Branch of the British Psychological Society.
18.
Dillenburger, K., Akhonzada, R., & Fargas, M. (2006). Post-trauma: Is evidence-based practice a fantasy?International Journal of Behavioral and Consultation Therapy , 2, 95-107.
19.
Dillenburger, K., Akhonzada, R., & Fargas, M. (in press). Community services for people affected by violence: An exploration and categorization. Journal of Social Work.
20.
Dillenburger, K., Fargas, M., & Akhonzada, R. (2007). The PAVE Project report: Exploring the effectiveness of services for victims of the Troubles in Northern Ireland. Belfast, Northern Ireland: Queen's University.
21.
Dillenburger, K., & Keenan, M. (2001). Islands of pain in a sea of change: Behaviour analysis and bereavement. European Journal of Behaviour Analysis , 2, 187-207.
22.
Dillenburger, K., & Keenan, M. (2005). Bereavement: A D.I.S.C. analysis. Behavior and Social Issues, 14, 92-112.
23.
Dong, W., & Erins, B. (1995). Scotland's health: Scottish health survey. Edinburgh, UK: The Scottish Office Department of Health .
24.
Erickson, F. (1982). The counselor as gatekeeper: Social interaction in interviews. New York: Academic Press.
25.
Fay, M.T., Morrissey, M., Smyth, M., & Wong, T. (1999). The cost of the Troubles study. Report on the Northern Ireland Survey: The experience and impact of the Troubles. Belfast, Northern Ireland: International Conflict Research (INCORE).
26.
Foa, E.B., Cashman, L., Jaycox, L., & Perry, K. (1997). The validation of a self-report measure of PTSD: The Posttraumatic Diagnostic ScaleTM (PDSTM). Psychological Assessment, 9, 445-451.
27.
Foa, E.B., & Meadows, E.A. (1997). Psychosocial treatments for posttraumatic stress disorder: A critical review. Annual Review ofPsychology, 48, 449-480.
28.
Follette, V.M., Ruzek, J.I., & Abueg, F.R. (1998). A contextual analysis of trauma: Theoretical considerations . In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.), Cognitive-behavioral therapies for trauma (pp. 3-12). New York: The Guilford Press.
29.
French, B. & Campbell, P. (2005). Crime victimisation in Northern Ireland: Findings from the 2003/04 Northern Ireland crime survey (NIO Statistics and Research Bulletin4/2005).
30.
Gillespie, K., Duffy, M., Hackmann, A., & Clark, D.M. (2002). Community based cognitive therapy in the treatment of post-traumatic stress disorder following the Omagh bomb. Behaviour Research and Therapy, 40, 345-357.
31.
Gilligan, C. (2006). Traumatised by peace? A critique of five assumptions in the theory and practice of conflict-related trauma policy in Northern Ireland . Policy & Politics, 34, 325-345.
32.
Goldberg, D., McDowell I., & Newell, C. (1996). Measuring health: A guide to rating scales and questionnaires (2nd ed.). New York: Oxford University Press.
33.
Hamber, B., & Kelly, G. (2005). A place for reconciliation? Conflict and locality in Northern Ireland (Report 18). Belfast, Northern Ireland: Democratic Dialogue.
34.
Hamber, B., Kulle, D., & Wilson, R. (2001). Future policies for the past. Belfast, Northern Ireland: Democratic Dialogue.
35.
Hayes, P., & Campbell, J. (2000). Dealing with post-traumatic stress disorder: The psychological sequelae of Bloody Sunday and the response of State services . Research on Social Work Practice, 10, 705-721.
36.
Healey, A. (2004). A different description of trauma: A wider systemic perspective—A personal insight. Child Care in Practice , 10, 167-184.
37.
Health Promotion Agency. (2002). Health and lifestyle survey for Northern Ireland 2002. Belfast, Northern Ireland: Author.
38.
Health survey for England 1995. (1997). London: The Stationery Office.
39.
Hillyard, P., Kelly, G., McLaughlin, E., Patsios, D., & Tomlinson, M. (2003). Bare necessities: Poverty and social exclusion in Northern Ireland. Belfast, Northern Ireland: Democratic Dialogue.
40.
Holmes, T.H., & Rahe, R.H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213-218.
41.
Jones, L. (2006, September 14-17). On trauma, grief, and memory . Keynote address at the Third International Trauma Research Net Conference: Trauma—Stigma and Distinction, St Moritz, Switzerland.
42.
Jones, L., & Kafetsios, K. (2002). Assessing adolescent mental health in war-affected societies: The significance of symptoms. Child Abuse & Neglect, 26, 1059-1080.
43.
Jones, L., & Kafetsios, K. (2005). Exposure to political violence and psychological well-being in Bosnian adolescents: A mixed method approach. Clinical Child Psychology and Psychiatry, 10, 157-176.
44.
Jones, L., Rrustemi, A., Shahini, M., & Uka, A. (2003). Mental health services for war-affected children. Report of a survey in Kosovo. British Journal of Psychiatry , 183, 540-546.
45.
Joseph, S., Linley, P.A., & Harris, G. (2005). Understanding positive change following trauma and adversity: Structural clarification. Journal of Loss and Trauma, 10, 83-96.
46.
Kelly, G., & Smyth, M. (1999) Report on a survey of voluntary groups serving the needs of those bereaved and injured in the Troubles. Belfast, Northern Ireland: The Victims Liaison Unit .
47.
Kulle, D. (2001). Victims and survivors: A study of the dynamics of the victims' debate in Northern Ireland. In J. Magowan & N. Patterson (Eds.), Here and now . . . and then . . . Developments in victims and survivors work (pp. 79-87). Belfast, Northern Ireland: The Northern Ireland Voluntary Trust.
48.
Kutchins, H., & Kirk, S.A. (1999). Making us crazy: DSM— The psychiatric bible and the creation of mental disorders. London: Constable.
49.
Lee, E. ( 2001). The invention of PTSD. How critics of post-traumatic stress disorder explain its status as the disorder du jour. Retrieved May 2, 2001, from www.spiked-online.com/Printable/0000000054B0.htm
50.
Lifton, R. (1983). Responses of survivors to man-made catastrophes . Bereavement Care, 2, 2-6.
51.
Linley, P.A. (2003). Positive adaptation to trauma: Wisdom as both process and outcome. Journal of Traumatic Stress, 16, 601-610.
52.
Mallet, J. (2000). Poverty and health: A psychological analysis. Unpublished PhD Thesis. University of Ulster, Coleraine, Northern Ireland.
53.
McDougall, B. (2006, June). First interim report. Belfast, Northern Ireland: Northern Ireland Victims Commissioner Office.
54.
McWhirter, L. (2002). Health and social care in Northern Ireland: A statistical profile. Belfast, Northern Ireland: Northern Ireland Statistics & Research Agency.
55.
Monaghan, R. (2004). An imperfect peace: Paramilitary “punishments” in Northern Ireland. Terrorism and Political Violence, 16, 439-461.
56.
Morrissey, M., & Smyth, M. (2002). Northern Ireland after the Good Friday Agreement. Victims, grievance and blame. London: Pluto Press.
57.
Northern Ireland health and social wellbeing survey. (1997/ 2001). Belfast, Northern Ireland: Northern Ireland Statistics & Research Agency.
58.
Omagh Support & Self-Help Group. (2004 ). Strategic plan 2004 to 2007. Retrieved September 8, 2006, from www.omaghbomb.co.uk/publications.html .
59.
O'Reilly, D., & Browne, S. (2001). Health and health service use in Northern Ireland: Social variations. A report from the Health and Social Wellbeing Survey 1997 . Belfast, Northern Ireland: Department of Health, Social Services and Public Safety.
60.
O'Reilly, D., & Stevenson, M. (2003). Mental health in Northern Ireland: Have “the Troubles” made it worse?Journal of Epidemiology and Community Health, 57, 488-492.
61.
Orsillo, S.M., Batten, S.V., & Hammond, C. (2001). Acute stress disorder and posttraumatic stress disorder: A brief overview and guide to assessment. In M. M. Anthony, S. M. Orsillo, & L. Roemer (Eds.). Practitioner's guide to empirically based measures of anxiety. AABT Clinical Assessment Series (pp. 245-252). New York: Kluwer Academic/Plenum Publishing.
62.
Paterson, M.C., Poole, D., Trew, K., & Harkin, N. (2001). The psychological and physical health of police officers retired recently from the Royal Ulster Constabulary. Irish Journal of Psychology, 22, 1-27.
63.
Spates, C.R. (2003). PTSD (Posttraumatic Stress Disorder): A behavior analytic interpretation of the disorder and its treatment. Japanese Journal of BehaviorAnalysis, 17(2), 161-173.
64.
Sprang, G. (2000). Coping strategies and traumatic stress symptomatology following the Oklahoma City bombing. Social Work and Social Sciences Review, 8, 207-218.
65.
Strassberg, D. (2006, September 14-17). Who has the right to speak?The Third International Trauma Research Net Conference: Trauma—Stigma and Distinction, St Moritz, Switzerland.
66.
Summerfield, D. (1999). A critique of seven assumptions behind psychological trauma programmes in war-affected areas. Social Science & Medicine, 48, 1449-1462.
67.
Summerfield, D. (2000). War and mental health: A brief overview. British Medical Journal, 321, 232-235.
68.
Summerfield, D. (2001). The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category. British Medical Journal, 322, 95-98.
69.
Tennant, C. (1977). The General Health Questionnaire: A valid index of psychological impairment in Australian populations. Medical Journal of Australia,2, 392-394.
70.
Ward, J.T., Cousens, S.N., Smith-Bathgate, B., Leitch, M., Everington, D., Will, R.G. et al. (2004). Obstacles to conducting epidemiological research in the UK general population. British Medical Journal , 329, 277-279.
71.
Withuis, J. (2005). Does PTSD really exist? On trauma, trauma culture, and trauma abuse. Retrieved April 3, 2005, from www.Icodo.nl/uk/services/icodoinfo-english.shtml.
72.
Young, A. (1995). The harmony of illusions: Inventing post-traumatic stress disorder. Princeton, NJ: Princeton University Press.
