Coping strategies among conflict-affected adults in low- and middle-income countries: A systematic literature review.

Mental health is recognised as a key issue for populations affected by conflict. The aim of this systematic literature review is to examine coping strategies among conflict-affected civilians in low- and middle-income countries. The objectives were to examine (1) the types of coping strategies used by conflict-affected civilians; (2) factors influencing coping strategies; (3) relationships between coping strategies and mental health outcomes. A database search was conducted on May 13, 2014. Qualitative and quantitative studies that report on coping strategies used by adult conflict-affected civilians in LMICs were included, yielding 50 articles. Coping strategies were organised into a typology of problem-solving, support seeking, escape-avoidance, distraction, and positive cognitive restructuring domains. Support-seeking, positive cognitive restructuring, and problem-solving domains were the most frequently reported coping domains across the articles. Significant factors influencing coping included gender and exposure to trauma. The relationship between coping and mental health outcomes was nuanced. The diverse findings reported across the studies reflect the variety of contexts from which the samples are drawn, the range of coping typologies, and differing methodological approaches to exploring coping and mental health. Context-specific studies are needed in order to capture the social and cultural influences on coping and mental health.