 
Presented at the 18th IUHPE World Conference. FEMALE SURVIVORS OF ETHNIC WAR IN FORMER YUGOSLAVIA AND THEIR SENSE OF COHERENCE Presenter: Ryoko Ebina, Global Health Communications Yoshihiko Yamazaki, University of Tokyo Psychological research on war and stress reactions has been dominated by an almost exclusive focus on pathological outcomes. Even though war related research generally has a pathological orientation that seeks who get more likely to enter a given disease category and the reasons, there is some research with a salutogenic orientation (which focuses on the origins of health) that seeks to explain why people are located toward the positive end of the health ease/dis-ease continuum. Instead of focusing on stressors, the salutogenic orientation comes to focus on coping resources. It keeps us from falling into the trap of focusing solely on the etiology of a given disease rather than always searching for the total story of a human being including one’s sickness (Antonovsky, 1987). Sense of Coherence (SOC) is a major determinant of maintaining one’s position on the health ease/dis-ease continuum and of movement toward the healthy end. SOC is defined as a global orientation that expresses the extent to which one has a pervasive enduring though dynamic feeling of confidence that the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable, explicable (comprehensibility); the resources are available to one to meet the demands posed by these stimuli (manageability); and these demands are challenges, worthy of investment and engagement (meaningfulness) (Antonovsky, 1987). ? The aims of this study were to investigate the psycho-social processes of female survivors who were adolescents or entering into adulthood during the war. They lived through the first decade of their adulthood in the confusion and reconstruction periods after the war, but were never diagnosed with PTSD or other psychiatric symptoms arising from ethnic war in the former Yugoslavia. This study was also intended to reveal the psycho-social factors and coping experiences that affected their SOC and contributed to their health, and thereby to understand why some of those who had experienced war and stressful life changes were able to maintain good health and were never diagnosed with PTSD or other psychiatric symptoms. In 2002 (T1) and 2004 (T2), data was collected from 17 female participants, using in-depth interviews that followed the interview guide with semi-structured questions. The participants were women who experienced the ethnic war when they were 13 to 23 years of age (from ages of 26 to 37 at T2) and who had never been diagnosed PTSD or other psychiatric symptoms. The interview guide consisted of face sheet that explained the purpose of the research; core interview questions; and SOC scale that comprises of 29 items that are rated on a 7-point Likert scale and Cronbach’s alpha scores between 0.84 and 0.93 (Antonovsky, 1987). This interview guide was provided to the participants via email before the interview. The interview places were at the participants’ houses or quiet cafes in Osijek, which was located on a quarter of Croatian territory including Osijek-Baranja and Vukovar-Srijem countries in the north-eastern part of Croatia where the war was concentrated (Jurcevic and Urlic, 2002). The specificity of the war in Croatia was that some areas were under many war activities, whereas the others were relatively free of direct war effects (Grubisic-Ilic, Kozaric-Kovacic, et al., 2002). The interviews were audio-recorded after gaining their consent and transcribed for analysis. The average length of the interviews was about 2 hours. The results were examined with participants verifying, in order to increase credibility and rigor of the study. ? Ebina stayed with two of the participants in Osijek, for one month at T1 and for two weeks at T2 for participant observation, and wrote memo in the field-note in order to understand social, cultural, economical, and political aspects of their life and used it when the data was analyzed. Seventeen participants were divided into three groups, high SOC score group (the total scores were from 145 to 160 out of 203) that meant those who had strong SOC, middle score group (the total scores were from 120 to 144), and low score group (the total scores were from 85 to 119) that meant those who had weak SOC; by the ratio of the number of people of each group was 1:2:1, and analyzed. Four processes were identified as the typical psycho-social processes experienced by the participants from the beginning of the war until now. Four major themes; 1) childhood stability, 2) acceptance of the perceived negativity, 3) perceived happiness, 4) active meanings in work; emerged from the analysis in psycho-social factors and coping experience that have affected on where one attains a given location on the SOC continuum. There was no big difference in age and family’s ethnical composition. Not to increase suicide victims or victims of other war byproduct such as pathological outcomes in future, the diverse approach is required to be a part of a broader health promoting processes, which include promoting internal and external trainings and supportive environment with understanding their psycho-social processes through the war and factors and coping experience that have contributed to their health and well-being. These would be all parallel sources of help, rather than taking place as an isolated kind of action such as treatment. And these approaches should initiate a new pattern of life experiences, then, gradual healthy changes, including positive change of SOC, can occur in the war survivors and their community. 
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