Gender, Social Support, and Posttraumatic Stress in Postwar Kosovo

Abstract

The effects of social support and traumatic experiences on mental health in conflict situations may be different by gender. The Kosovo Emergency Department Study was conducted in July and August 2001 to assess mental health 2 years after the end of the war in Kosovo. Of 306 emergency department patients (87.7% response rate), all were ethnic Albanian, 97.4% had experienced traumatic events, and 89.5% had posttraumatic stress symptoms. Women and persons who experienced more traumatic events had higher posttraumatic stress scores. Persons with social support had lower posttraumatic stress scores. In a final model, social support had a greater protective effect for women, whereas traumatic events had a greater detrimental effect on men. Two years after the war in Kosovo, there remained a high prevalence of posttraumatic stress symptoms, particularly among women with low social support. Interventions targeting social support may be important public health efforts in the postwar context.

Prevalence and predictors for post-traumatic stress disorder, depression and general health in a population from six villages in South Lebanon

“…Females scored exceptionally high for PTSD (32.6%) compared to males (15.2%). Female risk factors have been widely documented in the literature contributing to a higher vulnerability for mental health related disorders following trauma exposure [2,11,20,49,54]. In a meta-analysis of risk factors for PTSD in adults exposed to trauma, Brewin et al [11] found that risks included female gender, education level, previous trauma, psychiatric history, age of trauma, and race with effect sizes of factors becoming stronger after a traumatic event, such as, severity of trauma, lack of social support and additional life stressors.…”

“…check points, curfews, instability in flow of goods and services) could have also put females at further risk of having high PTSD thresholds. Social support has been found to be a major protective factor against PTSD symptoms in trauma-exposed females [2]. Further research is needed to identify risk status and enhancing protective factors in female civilian populations residing in high conflict areas.…”

“…Ahern et al [2] found that social support had a greater protective effect on women than men. However, this could be because of differences in earlier trauma exposure and not gender itself [30].…”

Weighing the Costs of Disaster

“…For example, females may experience greater objective exposure, may have greater prior trauma, or may have a greater number of postdisaster stressors (Kimerling, Mack, & Alvarez, 2009). Note, however, in multivariate models that controlled for possible confounds of this nature, female gender was still found to predict both greater disaster-related psychopathology (Ahern, Galea, Fernandez, et al, 2004;Hoven et al, 2005;Galea, Tracy, Norris, & Coffey, 2008;Weems et al, 2010) and reduced resilience Bonanno, Galea, et al, 2007).…”

Post-Traumatic Stress Disorder in Kosovo Veterans

“…Nearly 16 years after the 1998-1999 war, which had left a large part of the population with mood disorders (47.6%) and anxiety (41.8%; Priebe et al, 2010), a number of studies were conducted in Kosovo on post-traumatic stress in war victims. Those studies were focused on hospitalized persons (Ahern et al, 2004), relatives of the victims (Morina, Rudari, Bleichhardt, & Prigerson, 2010), victims of torture (Wang et al, 2012), refugees (Ai, Peterson, & Ubelhor, 2002), and adolescents (Gordon, Staples, Blyta, Bytyqi, & Wilson, 2008).…”