PTSD, mental illness, and care among survivors of sexual violence in Northern Uganda: Findings from the WAYS study.

Amone-P’Olak, Kennedy; Elklit, Ask; Dokkedahl, Sarah Bøgelund

doi:10.1037/tra0000295

Cited by 18 publications

(23 citation statements)

References 39 publications

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“…The same phenomenon has been found among formerly abducted girls [ 62 ] and female victims of war-related sexual violence [ 27 ], who were likely to face or perceive stigma, discrimination, and social rejection. In line with research from Africa [ 41 , 63 ], we found a significant relationship between mental health disorders and post-enslavement social stressors such as perceived stigma and social rejection. This finding is also consistent with results from meta-analytic studies that showed that, in general, perceived discrimination has negative outcomes on individual well-being [ 64 , 65 ].…”

Section: Discussionsupporting

confidence: 90%

Trauma and perceived social rejection among Yazidi women and girls who survived enslavement and genocide

Ibrahim

Ertl

Catani

et al. 2018

BMC Med

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BackgroundIn August 2014, the Islamic State of Iraq and Syria (ISIS), a terrorist organization, attacked the Yazidi’s ancestral homeland in northwestern Iraq. Among other atrocities, they abducted thousands of women and girls and traded many of them into sexual slavery. The aim of this study is to determine the mental health of women and girl survivors of these events in relation to enslavement and experiences with genocide-related events, as well as perceived social rejection in their community.MethodsBetween February and July 2017, trained local assessors interviewed a sample of 416 Yazidi women and girls (65 of whom had survived sexual enslavement), aged between 17 and 75 years, and living in internally displaced person camps in the Kurdistan Region of Iraq. Post-traumatic stress disorder (PTSD) and depression symptoms were assessed using validated Kurdish versions of standard instruments. Scales for trauma exposure and perceived rejection were developed for the purpose of this study.ResultsParticipants reported a high number of traumatic events. More than 80% of girls and women, and almost all participants who were formerly enslaved, met criteria for a probable DSM-5 PTSD diagnosis. Trauma exposure and enslavement predicted poor mental health. In addition, among formerly enslaved girls and women, perceived social rejection in their community mediated the relationship between traumatic enslavement events and depression symptoms.ConclusionsIn a context of maximum adversity, enslavement and war-related events contribute to high levels of PTSD and depression. Perceived social rejection seems to play a role in the relationship between trauma exposure and mental health among abducted genocide survivors. Providing psychosocial support and treatment for Yazidi people is essential and urgently required.Electronic supplementary materialThe online version of this article (10.1186/s12916-018-1140-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Trauma and perceived social rejection among Yazidi women and girls who survived enslavement and genocide

Ibrahim

Ertl

Catani

et al. 2018

BMC Med

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“…Sixty-six (n =119, 66%) reported sexual abuse: 35% (n = 63) of whom returned from captivity with at least 1 child, and 43% (n = 78) met the criteria for PTSD (Impact of Events Scale-Revised score [IES-R] <33). Our study findings were inconsistent with study of Amone P'Olak et al [14] study explored whether feelings of anger, shame, and guilt mediated the effects of war experiences and PTSD and if this association is heightened in former child soldiers from Northern Uganda. Nearly 40% of the sample were former child soldiers (N = 122), and 189 were civilians.…”

Section: Discussioncontrasting

confidence: 99%

The Relationship between Trauma, PTSD, and Mental Health Problems among Palestinian Refugee Children

Thabet

2018

JOJNHC

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The study showed that 88% of students had experienced personal trauma, 84% had witnessed trauma to others, and 88% had seen demolition of property during the war. Boys reported more exposure to personal trauma, witnessing trauma to others, seeing demolition of property, and overall traumatic events compared to girls. Girls reported more exposure to stressful life events, exposure to trauma (not related to war-trauma), PTSD, and depression. The showed that 54% of

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“…Child soldiers are also often abducted into armed groups such as the LRA against their wishes and attempts to escape are accompanied by severe physical attacks or death. Former child soldiers have the additional burden of being both recipients and perpetrators of violence (Amone-P’Olak, Dokkedahl, & Elklit, 2017), with studies showing greater difficulties in psychological recovery and reintegration into the community (Amone-P’Olak, Elklit & Dokkedahl, 2017; Bayer, Klasen, & Adam, 2007), which ultimately may impede trauma recovery.…”

Section: Discussionmentioning

confidence: 99%

Testing competing factor models of the latent structure of post-traumatic stress disorder and complex post-traumatic stress disorder according to ICD-11

Murphy

Elklit

Dokkedahl

et al. 2018

European Journal of Psychotraumatology

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With the publication of the International Statistical Classification of Diseases and Related Health Problems, 11th edition (ICD-11) due for release in 2018, a number of studies have assessed the factorial validity of the proposed post-traumatic stress disorder (PTSD) and complex (CPTSD) diagnostic criteria and whether the disorders are correlated but distinct constructs. As the specific nature of CPTSD symptoms has yet to be firmly established, this study aimed to examine the dimension of affect dysregulation as two separate constructs representing hyper-activation and hypo-activation. Seven alternative models were estimated within a confirmatory factor analytic framework using the International Trauma Questionnaire (ITQ). Data were analysed from a young adult sample from northern Uganda (n = 314), of which 51% were female and aged 18–25 years. Forty per cent of the participants were former child soldiers (n = 124) while the remainder were civilians (n = 190). The prevalence of CPTSD was 20.8% and PTSD was 13.1%. The results indicated that all models that estimated affective dysregulation as distinct but correlated constructs (i.e. hyper-activation and hypo-activation) provided satisfactory model fit, with statistical superiority for a seven-factor first-order correlated model. Furthermore, individuals who met the criteria for CPTSD reported higher levels of war experiences, symptoms of anxiety and depression, and somatic problems than those with PTSD only and no diagnosis. There was also a much larger proportion of former child soldiers that met the criteria for a CPTSD diagnosis. In conclusion, these results partly support the factorial validity of the ICD-11 proposals for PTSD and CPTSD in a non-Western culture exposed to mass violence. These findings highlight that more research is required across different cultural backgrounds before firm conclusions can be made regarding the factor structure of CPTSD using the ITQ.

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PTSD, mental illness, and care among survivors of sexual violence in Northern Uganda: Findings from the WAYS study.

Cited by 18 publications

References 39 publications

Trauma and perceived social rejection among Yazidi women and girls who survived enslavement and genocide

Trauma and perceived social rejection among Yazidi women and girls who survived enslavement and genocide

The Relationship between Trauma, PTSD, and Mental Health Problems among Palestinian Refugee Children

Testing competing factor models of the latent structure of post-traumatic stress disorder and complex post-traumatic stress disorder according to ICD-11

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