Tobias Hecker and his working group at Bielefeld University (AE17) study the drivers, consequences and prevention of violence, abuse and neglect of children. We study the interplay between risk factors, protective factors, adversities and outcomes at various stages of the human development (developmental perspective).
In our research, we use a multi-informant approach in which we include the perspective of children and adolescents and their guardians. The parameters of studies range across socio-ecological levels, from the molecular individual level to the impact of family and community factors (contextual perspective). We use a multi-method approach and collect our data on various levels, for example on the level of clinical symptoms, the behavioral level, the cognitive level, and the biological and molecular level.
Out of the findings of our basic research we develop and test evidence-based preventative interventions, such as Interaction Competencies with Children (translational perspective). Our research focuses on intervention studies using rigorous and experimental research methods (e.g., cluster randomized controlled trials).
A centerpiece of our research is the global perspective on violence against children with a focus on societies (community perspective), where violence against children is highly prevalent and socially accepted.
Child maltreatment inflicts immediate and often lasting physical and psychological pain on affected children. It has been associated with a broad range of negative short- and long-term outcomes, including psychological difficulties and poor academic performance. These relationships are often interpreted as being causal in nature, with maltreatment assumed to cause negative developmental trajectories. However, most findings are based only on correlational analyses, which do not allow for such an interpretation. Causal relationships can only be determined by experimental studies. When it comes to the study of childhood maltreatment, though, the research using experimental methodologies are scarce. The high prevalence and social acceptance of the use of violence in child rearing in Sub-Saharan Africa provides an excellent opportunity for experimental manipulations on the basis of interventions seeking to reduce maltreatment.
In this project, we aim to complement current research by testing the effects of a maltreatment-reducing intervention on a spectrum of outcomes in the context of educational institutions in Sub-Saharan Africa. The studies open up the possibility of testing the causal relationship between maltreatment and various outcomes, ranging from children’s well-being to social and cognitive functioning. In experimental field studies, the project will test the effectiveness of the intervention Interaction Competencies with Children that aims for a reduction in maltreatment. We will investigate the effects of (reducing) maltreatment in the general population of children across educational settings, societies, cultures on the basis of a school-based multi-site cluster-randomized controlled trial (CRCT) in Tanzania, Uganda and Ghana. In addition, we will investigate these effects in another CRCT in a high-risk group of orphaned children. The project will also focus on the effects of maltreatment on pre-school children. In addition to determining the effectiveness of the intervention, the proposed studies allow for the monitoring of the temporal effects of maltreatment on children between the ages of 3 to 17 both in community samples and high-risk samples.
Principal investigator: Tobias Hecker
Participating researchers:
Florian Scharpf, Anette Kirika, Getrude Mkinga, Faustine Masath, Eliud Kabelege, Mabula Nkuba, Maregesi Machumu, Joseph Ssenyonga, Charles Mugoba Muwonge, Margaret Ekatushabe, Emmanuel Njarko-Tetteh, Amoah Karikari
Despite the negative consequences associated with violent discipline, it has remained legal in schools in many countries. The high prevalence rates of corporal punishment by teachers further emphasize the need for interventions to reduce this practice. Yet, existing prevention programs are rarely evaluated and often difficult to implement due to limited resources. In this project, we aim to implement and scientifically evaluate the preventative intervention approach Interaction Competencies with Children (ICC). It aims at preventing maltreatment and improving the adult-child relationship by introducing essential interaction competencies in the work with children and is available for different target groups, among others for teachers. Key principles of the ICC-T training program are: (a) a participative approach, (b) a trustful atmosphere, (c) practice orientation, and (d) sustainability. Five core components form the ICC-T training program: 1) teacher-student interactions, 2) self-reflection and maltreatment prevention, 3) effective non-violent discipline strategies, 4) identifying & supporting burdened students, 5) implementation into daily work. ICC-T aims at reducing violence by teachers in school settings and may contribute to less exposure to violence and improved psychological well-being of many students. We have also been able to gather initial evidence of effectiveness in three cluster-randomized controlled trials (CRCT) in Tanzania and Uganda. Further CRCTs are to follow in various countries over the next few years.
Principal investigator: Tobias Hecker
Participating researchers: Mabula Nkuba, Katharin Hermenau, Joseph Ssenyonga, Faustine Masath
Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. As maltreatment occurs in all alternative care settings, we emphasize that improving care quality may be more important than the type of care. Although basic nutrition, sanitation, and medical care are essential, interactions with responsive nonviolent caregivers are crucial to the children’s physical and behavioral development. Therefore, we advocate for focusing on the prevention of maltreatment and violence in institutional care and other care settings in Sub-Saharan Africa. The preventative intervention approach Interaction Competencies with Children (ICC) aims at preventing maltreatment and improving the adult-child relationship by introducing essential interaction competencies in the work with children and is available for different target groups, among others for caregivers. ICC-C has been inspired by the parenting guidelines of the American Academy of Pediatrics (The American Academy of Pediatrics, 1999) and the FairstartGlobal training concept (Rygaard, 2010). It is designed for caregivers caring for children of pre-school to primary school age and early adolescence (4 to 14 years). ICC-C offers a basic introduction to the essential interaction competencies in the work with children focusing mainly on warm, sensitive, and reliable caregiver-child relationships and non-violent, warm, and sensitive caregiving strategies. ICC-C is guided by the following key principles: (a) a participative approach, (b) a trustful atmosphere, (c) practice orientation, (d) teambuilding and new ideas for games, and (e) sustainability. Seven core components form the content of ICC-C: 1) child development, 2) caregiver-child relationship, 3) effective non-violent caregiving strategies, 4) self-reflection and maltreatment prevention, 5) supporting burdened children, 6) child-centered institutional care, and 7) teamwork and supervision. In a first pilot study, ICC-C proved its feasibility and showed first promising results with caregivers in Tanzanian orphanages. In a Cluster Randomized Controlled Trial (CRCT) in orphanages in Tanzania, we have now found initial evidence of the program's effectiveness. In further studies, we now want to replicate the promising results and test the effectiveness and sustainability of the ICC approach in other settings with equally scientifically rigorous designs.
This study will extend the successful intervention program Interaction Competencies with Children and develop a version for parents (ICC-P) in addition to the previously successful versions for teachers (ICC-T) and caregivers (ICC-C). The aim of the adapted program for parents is to prevent and reduce family violence. In a first step the program will be adapted to the requirements of the work with parents and families. In a second step, the feasibility will be tested. Finally, a three-arm cluster-randomized controlled trial (CRCT) in schools will enable us to establish (1) whether our school-based intervention can reduce violence in schools and families; and (2) whether the students’ immediate well-being and their medium-term social and cognitive functioning and learning achievements improve. In our CRCT, we experimentally manipulate the level of violence by randomly allocating schools to three conditions: 1) prevention of school violence by implementing ICC-T, 2) prevention of school and family violence by implementing ICC-T and ICC-P, and 3) no specific intervention. We apply a longitudinal design with three data assessment points: baseline assessment prior to the intervention, follow-up assessment 6 months after the intervention and second follow-up assessment 18 months after the intervention.
Principal investigator: Tobias Hecker
Participating researchers: Mabula Nkuba, Eliud Kabelege, Anke Hoeffler
Violence in childhood is a pervasive human rights, health and development challenge. But there is a large international variation in what behavioural acts of violence are considered normal, acceptable and common. There is a large body of evidence showing long-term adverse health, education and other consequences of exposure to childhood violence - but this evidence is overwhelmingly drawn from high-income, lower prevalence settings where acts of violence may be considered less acceptable. There is some cross-cultural evidence that acts of violence may produce fewer adverse behavioural outcomes for children when those acts are perceived to be normative - but existing studies have been hampered by small sample sizes, and critically, have not considered the role of biological embedding of exposure to trauma.
In this project, an interdisciplinary team will take advantage of existing data from three ongoing cohort studies in ten countries, and cross-sectional data from 96 countries, to explore how social norms and attitudes towards violent experiences affect the relationships between violence and various health, education, labour and biomarker outcomes. The team will 1) conceptualise and explore qualitatively and quantitatively how children define normal, acceptable and common acts of violence in a range of contexts; 2) measure the biological embedding of exposure to ‘normative’ physical, sexual and emotional violence 3 in childhood; 3) explore individual cognitive appraisals and emotional reactions to experience of ‘normative’ violence, and whether biological embedding varies according to these; 4) explore how social norms about violence within families and schools affect individual attitudes and violence outcome relationships, and 5) explore how of social norms in communities, regions and across countries about violence shape family and school norms, individual attitudes and violence-outcome relationships. All of these aims will be underpinned and refined by 6) collaboration with advisory groups of children, adolescents, and global leaders working in the field of violence prevention. These groups will advise on research design, framing, and interpretation of results, and support to think critically about how to frame the findings so that they impact and influence policy.
Further information: https://gepris.dfg.de/gepris/projekt/502779696
Principal investigators: Tobias Hecker, Susan Elliott, Karen Devries
Participating researchers: among others Anke Hoeffler (Univesity of Konstanz), Robert Kumsta (Ruhr-University Bochum), Kate Goessmann
In recent years, Haiti has made significant progress in both getting children into school and addressing teacher absenteeism. Despite this, school performance remains very poor in the country. Among the many obstacles that Haitian children face is violence by teachers. Research from around the world shows that violence against children has negative and long-lasting repercussions on children’s physical and emotional well-being. In schools, violence by teachers has been related to decreased school performance and higher dropout rates.
The purpose of this study is to assess the demand for, the feasibility and effectiveness of the intervention program Interaction Competencies with Children for Teachers (ICC-T) for reducing emotional and physical violence in primary schools in Haiti. ICC-T consists of a 5.5-day training workshop focused on providing teachers with practical information and tools to prevent the use of violent disciplinary strategies in class and improving their interaction competences with children. Although the ICC-T has been notably successful at reducing violence in schools in other countries, its suitability and adaptability to a wide range of cultural contexts has not been tested yet.
In a first step the feasibility is tested in six large primary schools in the country (3 community and 3 public schools), where ICC-T is implemented. All teachers in these schools will be asked to participate. In a second step a cluster-randomized controlled trial (CRCT) will be caried out to test the effectiveness of ICC-T in this cultural context.
Principal investigators: Anke Hoeffler and Tobias Hecker
Participating researchers: Ana Lopez García
According to actual figures of the United Nations High Commissioner for Refugees (UNHCR), the number of refugees has reached an unprecedented number of 22.5 million over the half of whom are children and adolescents. Most refugees flee from war and conflict in their home countries to neighboring countries, which are relatively safe, yet struggle with economic hardships themselves. In these host countries, refugees are required to reside in refugee camps where they often face new stressors such as overcrowding and scarcity of resources. Our research project seeks to investigate experiences of trauma and violence in refugee families in refugee camps and how these experiences relate to children`s mental health, psychosocial and cognitive functioning. A representative sample of 230 family triads (child, mother, father) have been assessed in three refugee camps in Tanzania. The project is carried out in cooperation with the University of Zurich, Switzerland, and the Dar es Salaam University College of Education. Multi-methods will be used for data collection: Structural clinical interviews have been applied to assess experiences of trauma and violence, mental health and psychosocial functioning in children and parents. Neuropsychological tests of attention, memory and executive functioning provide a measure of children`s cognitive functioning. A behavioral observation paradigm is used to assess the interaction between mother and child.
Principal investigator: Tobias Hecker
Participating researchers: Florian Scharpf, Edna Kyaruzi, Markus Landolt, Sven Mueller, Roos Haer, Faustine Masath, Getrude Mkinga, Markus Paulus
Understanding the psychological and biological underpinnings of behavioral vulnerability and resilience to traumatic stress is a public health priority. Compelling human evidence linking trauma exposure and/or trauma-related psychopathology to specific epigenetic alterations remains sparse and no clear picture of an epigenetic PTSD signature has emerged so far.
In this project, we investigate a well-powered and well-characterized sample of refugee families exposed to multiple severe trauma who have resettled in refugee camps using state-of-the-art array-based technology to explore PTSD symptom related alterations across the genome. For this purpose, we have already successfully collected data from a representative sample of Burundian refugee family triads (father, mother, and one child) in three large refugee camps that are located in Tanzania. We aim to identify PTSD-associated alterations of DNA methylation that distinguish between individuals who developed PTSD following war-related trauma exposure and unaffected individuals with the same exposure. We further aim to show that trauma load is related to DNA methylation patterns. Lastly, we aim to demonstrate the mediating role of DNA methylation in the association between trauma exposure and PTSD risk.
Further information: http://gepris.dfg.de/gepris/projekt/451968036
Principal Investigators: Tobias Hecker and Robert Kumsta
Participating researchers: Florian Scharpf, Katharina Mattonet
Sexual violence against children is a violation of human rights, resulting in mental, psychological, emotional, social and physical consequences. Sexual violence may have a considerable and lifelong impact on the individual, their families, intimate partners and communities. Although there is now emerging literature on sexual violence against children across Sub-Saharan Africa (e.g., Goessmann, et al., 2020), we have no reliable evidence from Nigeria. In our project we survey adolescents in- and outside of school (10-17 year olds) and establish the prevalence of sexual violence. We aim to gain deeper insights into various types of sexual violence (ranging from receiving explicit messages and pictures by mobile phone/email, to lewd comments, unwanted touching to rape), the perpetrators (boyfriend/girlfriend, peers, relative, teacher and others in positions of authority) and the circumstances.
Principal Investigators: Anke Hoeffler and Tobias Hecker
Participating researchers: Wasiu Olorunlambe, Kate Goessmann
According to current diagnostic systems, psychopathological symptoms only co-occur because they are caused by an underlying latent factor, i.e., the disorder. A network perspective, in contrast, emphasizes the dynamic interactions between symptoms, which give rise to a disorder (Borsboom, 2017). Available evidence shows that conflict-affected youth have often been exposed to high levels of severe interpersonal violence, which renders them vulnerable for the development of PTSD and other mental health problems (e.g. Catani, 2018; Miller & Jordans, 2016; Scharpf et al., 2020). Notwithstanding, little is known about the PTSD symptom profile of conflict-affected youth. The main objective of this study is therefore to investigate the symptom structure of PTSD symptoms among a large sample of conflict-affected children and adolescents using network analysis. This will also inform about differences and similarities to the PTSD symptom networks of other trauma-exposed populations and thus contribute to efforts of replication of previous findings, which has been suggested as an important task for future network analysis studies (Cao et al., 2019; Fried et al., 2018). Another objective of this study is to investigate variations in PTSD symptom networks based on age, gender and trauma type. This may help to better understand developmental and gender-specific differences in the risk for and clinical expression of PTSD and provide novel insights into the etiology and treatment of the disorder in children and adolescents.
Principal investigators: Florian Scharpf, Tobias Hecker
Participating researchers:
Hawkar Ibrahim (University of Bielefeld, Germany and Koya University, Iraq), Laura Saupe (University of Eichstätt, Germany), Kirsi Peltonen (Tampere University, Finland), Samir Qouta (Doha Institute for Graduate Studies, Qatar), Anselm Crombach (University of Konstanz, Germany), Roos van der Haer (Leiden University, Netherlands), Frank Neuner and Claudia Catani (University of Bielefeld, Germany)
War has profound consequences for societies, impacting social networks and the trust and norms of civic engagement that sustain them. However, existing studies offer conflicting results. Some find war exposure reduces social capital, while others conclude the opposite. These mixed results suggest there are nuances in the experience of such life-changing events that are not being considered. The research faces methodological challenges as well due to the lack of random assignment to war exposure and difficulties in collecting data before an event or constructing a control group. A potential explanation for these diverging results is that war exposure increases the need to cooperate but also degrades mental health, which impairs social functioning. Those that are psychologically resilient, however, more readily cooperate in the face of common challenges, increasing their social capital.
This project has the aim to implement a brief, low-cost, and validated psychosocial intervention in Borno State, Nigeria – a region highly susceptible to attacks by Boko Haram (terror organization). The researchers test its effectiveness in improving mental health and social capital by conducting a rigorous Randomized Control Trial, and gathering extensive longitudinal data. The aim of the study is to make a multidisciplinary contribution to knowledge on war exposure, mental health and social cooperation in war contexts, and to create an inroad for the development of mental-health approaches to fostering community resilience during war and its aftermath.
Moreover, this project is related to the project “Building resilience in the aftermath of displacement: the intergenerational effects of a randomized mental health intervention for refugee families” which is also investigated by Jonathan Hall and Tobias Hecker (among others). Both studies aim to uncover the benefits of improving mental health and social functioning in low-resource settings.
Further information: https://www.vr.se/english/swecris.html#/project/2022-02476_VR
Principal investigator: Jonathan Hall
Participating researchers: Tobias Hecker, Anke Hoeffler, James Walsh, Kathleen Klaus
People coping with extreme forms of adversity, such as armed conflict and displacement, often live in regions that depend on rainfall for agriculture and drinking water and are thus particularly vulnerable to climate-change related drought and resource scarcity. Individuals and communities can adapt to climate change by adopting new agricultural methods, cooperating with others to manage water supplies, and investing in shared infrastructure. This is facilitated by non-cognitive skills important for effective decision-making, including risk acceptance, patience, and prosociality. However, experiencing adversity increases the likelihood of suffering from stressrelated mental health issues that reduce cognitive bandwidth and negatively impact the skills and abilities required for successful adaptation.
This project will use a randomized control trial of a smart greenhouse farming intervention, alone and in combination with a low-cost mental health intervention (SH+), in two refugee settlements in Uganda’s southwestern district Isingiro to examine if improving mental health will enhance non-cognitive skills and increase engagement in climate smart farming techniques that increase household and community adaptation to climate change. The interdisciplinary project will develop theory on psychological processes and climate adaptation and contribute with empirically-tested knowledge that could guide future research and inform effective policy interventions.
Further information: https://www.vr.se/english/swecris.html#/project/2022-01573_Formas
Principal investigator: Jonathan Hall
Participating researchers: Tobias Hecker, Herbert Ainamani, James Walsh
War has profound consequences for societies, impacting social networks and the trust and norms of civic engagement that sustain them. However, existing studies offer conflicting results. Some find war exposure reduces social capital, while others conclude the opposite. These mixed results suggest there are nuances in the experience of such life-changing events that are not being considered. The research faces methodological challenges as well due to the lack of random assignment to war exposure and difficulties in collecting data before an event or constructing a control group. A potential explanation for these diverging results is that war exposure increases the need to cooperate but also degrades mental health, which impairs social functioning. Those that are psychologically resilient, however, more readily cooperate in the face of common challenges, increasing their social capital.
This project has the aim to implement a brief, low-cost, and validated psychosocial intervention in Borno State, Nigeria – a region highly susceptible to attacks by Boko Haram (terror organization). The researchers test its effectiveness in improving mental health and social capital by conducting a rigorous Randomized Control Trial, and gathering extensive longitudinal data. The aim of the study is to make a multidisciplinary contribution to knowledge on war exposure, mental health and social cooperation in war contexts, and to create an inroad for the development of mental-health approaches to fostering community resilience during war and its aftermath.
Moreover, this project is related to the project “Building resilience in the aftermath of displacement: the intergenerational effects of a randomized mental health intervention for refugee families” which is also investigated by Jonathan Hall and Tobias Hecker (among others). Both studies aim to uncover the benefits of improving mental health and social functioning in low-resource settings.
Further information: https://www.vr.se/english/swecris.html#/project/2022-02476_VR
Principal investigator: Jonathan Hall
Participating researchers: Tobias Hecker, Anke Hoeffler, James Walsh, Kathleen Klaus
Developing countries host a majority of the world’s refugees, many suffering from poor mental health. Mental health in turn impacts economic preferences such as patience, risk-taking, and prosociality. These non-cognitive skills are crucial for integration, impacting educational achievement, health status and labor market success. Mental health of parents, particularly mothers, further impacts child development, contributing to the long shadow cast by war. Improving mothers’ mental health may thus have positive intergenerational effects, with long-term benefits for developing countries. Lacking resources, mental health programs in these countries face considerable challenges. Low-cost interventions delivered by briefly trained lay facilitators offer a potential solution. Recent studies corroborate their efficacy and cost-effectiveness, but their benefits for children remain largely unexamined.
To fill this gap, this project will implement a brief, low-cost, transdiagnostic and validated psychosocial intervention among 720 South Sudanese mothers across 24 villages in Rhino refugee camp (Uganda). Thereby, it will test its effectiveness in improving the mental health and non-cognitive skills of participants and their children by conducting a rigorous Randomized Controlled Trial, and gathering extensive longitudinal data. This allows the research team to examine in an interdisciplinary way the process of change in mental health brought about by the intervention and its impact on decision-making measured by economic games.
Further information: https://www.vr.se/english/swecris.html#/project/P22-0514_RJ
Principal investigator: Jonathan Hall
Participating researchers: Tobias Hecker, Herbert Ainamani, Kirsi Peltonen, Matthias Sutter