Trauma

Citation:

Kinyanda, Eugene, Helen Weiss, Margaret Mungherera, Patrick Onyango-Mangen, Emmanuel Ngabirano, Rehema Kajungu, Johnson Kagugube, Wilson Muhwezi, Julius Muron, and Vikram Patel. 2016. "Intimate Partner Violence as seen in Post-Conflict Eastern Uganda: Prevalence, Risk Factors and Mental Health Consequences." BMC International Health & Human Rights 16 (5): 1-11.

Authors: Eugene Kinyanda, Helen Weiss, Margaret Mungherera, Patrick Onyango-Mangen, Emmanuel Ngabirano, Rehema Kajungu, Johnson Kagugube, Wilson Muhwezi, Julius Muron, Vikram Patel

Abstract:

Background: Conflict and post-conflict communities in sub-Saharan Africa have a high under recognized problem of intimate partner violence (IPV). Part of the reason for this has been the limited data on IPV from conflict affected sub-Saharan Africa. This paper reports on the prevalence, risk factors and mental health consequences of IPV victimization in both genders as seen in post-conflict eastern Uganda.

Methods: A cross-sectional survey was carried out in two districts of eastern Uganda. The primary outcome of IPV victimization was assessed using a modified Intimate Partner Violence assessment questionnaire of the American Congress of Obstetricians and Gynecologists.

Results: The prevalence of any form of IPV victimization (physical and/or sexual and/or psychological IPV) in this study was 43.7 % [95 % CI, 40.1-47.4 %], with no statistically significant difference between the two genders. The factors significantly associated with IPV victimization were: sub-county (representing ecological factors), poverty, use of alcohol, and physical and sexual war torture experiences. The mental health problems associated with IPV victimization were probable problem alcohol drinking, attempted suicide and probable major depressive disorder.

Conclusion: In post-conflict eastern Uganda, in both genders, war torture was a risk factor for IPV victimization and IPV victimization was associated with mental health problems.

Keywords: Intimate partner violence, post-conflict, Africa, risk factors, Mental health consequences

Topics: Armed Conflict, Domestic Violence, Economies, Poverty, Health, Mental Health, Trauma, Post-Conflict, Sexual Violence, Torture, Sexual Torture Regions: Africa, East Africa Countries: Uganda

Year: 2016

Citation:

Sherwood, Katie, and Helen Liebling-Kalifani. 2012. “A Grounded Theory Investigation Into The Experiences Of African Women Refugees: Effects On Resilience And Identity And Implications For Service Provision1.” Journal of International Women’s Studies 13 (1): 86-108.

Authors: Katie Sherwood, Helen Liebling-Kalifani

Abstract:

Keywords: women, refugees, trauma, Africa, gender based violence

Topics: Displacement & Migration, Refugees, Gender-Based Violence, Health, Mental Health, Trauma, Humanitarian Assistance, Context-Appropriate Response to Trauma, Rights, Violence Regions: Africa, East Africa, Southern Africa, Northern Europe Countries: Somalia, United Kingdom, Zimbabwe

Year: 2012

Citation:

Farwell, Nancy. 2003. “In War’s Wake: Contextualizing Trauma Experiences and Psychosocial Well-Being Among Eritrean Youth.” International Journal of Mental Health 32 (4): 20–30.

Author: Nancy Farwell

Abstract:

This study examines war trauma experienced by Eritrean youth, their psychological symptoms and contextual actors related to their psychosocial well-being in the postwar environment in Eritrea. The youth offered retrospective accounts of trauma experiences in semi-structured interviews that included open- and closed-ended questions and the administration of the Harvard Trauma Questionnaire. Among the ninety-seven youth in this school-based sample from four regions of Eritrea, exposure to trauma and economic hardship were significant predictors of psychological distress. Refugee status did not predict lower symptom levels, a factor related to the stressors encountered in exile as well as to the earlier war events that forced the youth and their families to flee their country. For many youth, grief over the loss of parents and close relatives was not resolved. The youth were generally positive about the future, both personally and in the context of a free and independent Eritrea. This article suggests that the intrapsychic post-traumatic stress disorder framework may be too narrow for conceptualizing war trauma, which is essentially psychosocial in nature, and deeply contextualized in a community's socioeconomic and political realities of conflict and its aftermath. Expanding this knowledge base is important order to ensure that practitioners and policy makers can effectively assist youth and their families with the postconflict tasks of healing and reintegration, essential elements of building a lasting peace.

Topics: Age, Youth, Economies, Poverty, Gender, Girls, Boys, Health, Trauma, Humanitarian Assistance, Context-Appropriate Response to Trauma, Post-Conflict Regions: Africa, East Africa Countries: Eritrea

Year: 2003

Citation:

Heit, Shannon. 2009. “Waging Sexual Warfare: Case Studies of Rape Warfare Used by the Japanese Imperial Army during World War II.” Women’s Studies International Forum 32 (5): 363–70. doi:10.1016/j.wsif.2009.07.010.

Author: Shannon Heit

Abstract:

Even in peacetime, women are victims, though to a lesser degree, of the same atrocities that become their fate in war. It is important to recognize that patriarchal and subjective attitudes towards women in peacetime make a logical, though horrifying, progression to the treatment of women during war and armed conflicts. Rape during wartime is an act as old as war itself, but it was not documented as a strategic military practice of warfare until World War I. After World War I these crimes were never prosecuted, further encouraging the use of mass rape as a strategic military operation in subsequent conflicts. Using case studies of documented rape warfare under the Japanese Imperial Army during World War II, we are able to discern two categories of rape: that as a weapon of terror as seen in the example of The Rape of Nanking during World War I and that as a form of sexual slavery as exemplified in the case of the “Korean Comfort Women” stations during World War II. This article outlines what actions must be taken to bring the perpetrators of wartime rapes to justice—a necessary step to bringing peace and reconciliation to the victims and in preventing future atrocities.

Topics: Armed Conflict, Gender, Women, Gender-Based Violence, Health, Trauma, Sexual Violence, Rape, Sexual Exploitation and Abuse, SV against Women, Violence Regions: Asia, East Asia Countries: Japan

Year: 2009

Citation:

Shalhoub-Kevorkian, Nadera, and Sana Khsheiboun. 2009. “Palestinian Women’s Voices Challenging Human Rights Activism.” Women’s Studies International Forum 32 (5): 354–62. doi:10.1016/j.wsif.2009.07.012.

Authors: Nadera Shalhoub-Kevorkian, Sana Khsheiboun

Abstract:

A recent study in the Occupied Territories has shown that the most vulnerable groups of society (women, children, and the elderly) are psychologically influenced by the attacks on Palestinian home and land. Psychological and sociological research in Gaza has shown that women suffer the most from psychosomatic problems, while the children and the elderly are subject to depression, severe trauma, and post-traumatic stress disorder. Women's testimonies in the region have demonstrated their capacity to protect themselves, their work, and even their studies despite the dangers involved. These appear to heighten women's defensive mechanisms for facing continuously aggressive acts and practices. Women's stories about homelessness and loss are mainly constructed through their own understanding that the attack on the Palestinian home is part of a larger trend of dominating military forces against the Palestinian ‘Other’. Women have maintained that the destruction of their homes hindered their own progress especially in the domain of protecting family unity, and they have concluded that it is precisely the goal of such policies to destabilize society in this manner. This article uses case studies and interviews with Palestinian women to support a socio-political analysis of this particular situation in the Occupied Territories.

Topics: Armed Conflict, Gender, Women, Health, Mental Health, PTSD, Trauma, Rights, Human Rights Regions: MENA, Asia, Middle East Countries: Palestine / Occupied Palestinian Territories

Year: 2009

Citation:

Ager, Alastair, Eba Pasha, Gary Yu, Thomas Duke, Cynthia Eriksson, and Barbara Lopes Cardozo. 2012. “Stress, Mental Health, and Burnout in National Humanitarian Aid Workers in Gulu, Northern Uganda.” Journal of Traumatic Stress 25 (6): 713–20. doi:10.1002/jts.21764.

Authors: Alastair Ager, Eba Pasha, Gary Yu, Thomas Duke, Cynthia Eriksson, Barbara Lopes Cardozo

Abstract:

This study examined the mental health of national humanitarian aid workers in northern Uganda and contextual and organizational factors predicting well-being. A cross-sectional survey was conducted among 376 national staff working for 21 humanitarian aid agencies. Over 50% of workers experienced 5 or more categories of traumatic events. Although, in the absence of clinical interviews, no clinical diagnoses were able to be confirmed, 68%, 53%, and 26% of respondents reported symptom levels associated with high risk for depression, anxiety disorders, and posttraumatic stress disorder (PTSD), respectively. Between one quarter and one half of respondents reported symptom levels associated with high risk regarding measured dimensions of burnout. Female workers reported significantly more symptoms of anxiety, depression, PTSD, and emotional exhaustion than males. Workers with the United Nations and related agencies reported fewest symptoms. Higher levels of social support, stronger team cohesion, and reduced exposure to chronic stressors were associated with improved mental health. National humanitarian staff members in Gulu have high exposure to chronic and traumatic stress and high risk of a range of poor mental health outcomes. Given that work-related factors appear to influence the relationship between the two strategies are suggested to support the well-being of national staff working in such contexts.

Topics: Gender, Women, Gender Roles, Gender Analysis, Health, Mental Health, PTSD, Trauma, Humanitarian Assistance Regions: Africa, East Africa Countries: Uganda

Year: 2012

Citation:

Schaal, Susanne, Roland Weierstall, Jean-Pierre Dusingizemungu, and Thomas Elbert. 2012. “Mental Health 15 Years after the Killings in Rwanda: Imprisoned Perpetrators of the Genocide against the Tutsi versus a Community Sample of Survivors.” Journal of Traumatic Stress 25 (4): 446–53. doi:10.1002/jts.21728.

Authors: Susanne Schaal, Roland Weierstall, Jean-Pierre Dusingizemungu, Thomas Elbert

Abstract:

Objectives of this study were to compare rates of mental health disorders in Rwandan genocide perpetrators with those of genocide survivors and to investigate potential predictors of symptoms of posttraumatic stress disorder (PTSD) and depression for both groups. We expected high rates of mental disorders in both study groups and hypothesized that symptom severity would be predicted by female gender, older age, lower level of education, higher level of trauma exposure, lower level of agreement to reconciliation, and the participation in killing. Structured clinical interviews were carried out with 269 imprisoned perpetrators (66% men) and 114 survivors (64% women). Significantly more survivors than perpetrators met symptom criteria for PTSD (46% vs. 14%) and suffered from anxiety symptoms (59% vs. 36%). A substantial proportion of both groups suffered from clinically significant depression (46% vs. 41%). PTSD severity in perpetrators was associated with trauma exposure, high levels of agreement to reconciliation, and no participation in killing; the severity of depression was associated with trauma exposure and no participation in killing. In the survivor sample, the severity of PTSD and depression were both correlated with female gender, trauma exposure, and low levels of agreement to reconciliation. Results suggest that both groups exhibit considerable psychiatric morbidity.

Topics: Armed Conflict, Civil Wars, Gender, Women, Genocide, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Violence Regions: Africa, Central Africa, East Africa Countries: Rwanda

Year: 2012

Citation:

Falb, Kathryn L., Marie C. McCormick, David Hemenway, Katherine Anfinson, and Jay G. Silverman. 2013. “Suicide Ideation and Victimization Among Refugee Women Along the Thai–Burma Border.” Journal of Traumatic Stress 26 (5): 631–35. doi:10.1002/jts.21846.

Authors: Katherine Anfinson, Kathryn L. Falb, David Hemenway, Marie C. McCormick, Jay G. Silverman

Abstract:

Refugee women may experience multiple forms of victimization. The hypotheses underlying the present analyses were that experiences of victimization during conflict and intimate partner violence (IPV) would be associated with heightened odds of suicide ideation among refugee women living in 3 camps along the Thai–Burma border. Descriptive statistics were generated to describe the prevalence of conflict victimization, past-year IPV victimization, past-month suicide ideation, and covariates among partnered women with complete data (N = 848) from a cross-sectional survey conducted in early 2008. Logistic generalized estimating equations were used to assess the crude and adjusted relationships between variables. The mean age of women was 32.12 years, 91.0% were married, and 78.8% were of Karen ethnicity. Overall, 7.4% of women reported past-month suicide ideation. Of those women who did not experience any victimization or conflict victimization only, 5.1% and 5.2% reported suicide ideation, respectively. By contrast 26.7% of women who experienced only IPV victimization reported suicide ideation, and 50.0% of women who experienced both forms of victimization reported suicide ideation. Understanding each form of violence victimization and their relationships to suicide ideation may be important for targeting psychosocial services and violence prevention programs within protracted refugee settings.

Topics: Armed Conflict, Displacement & Migration, Refugees, Gender, Women, Gender Analysis, Health, Mental Health, Trauma, Households Regions: Asia, Southeast Asia Countries: Myanmar, Thailand

Year: 2013

Citation:

Chan, Christian S., and Jean E. Rhodes. 2013. “Religious Coping, Posttraumatic Stress, Psychological Distress, and Posttraumatic Growth Among Female Survivors Four Years After Hurricane Katrina.” Journal of Traumatic Stress 26 (2): 257–65. doi:10.1002/jts.21801.

Authors: Christian S. Chan, Jean E. Rhodes

Abstract:

Positive and negative religious coping strategies and their relation with posttraumatic stress (PTS), psychological distress, and posttraumatic growth (PTG) were examined in the context of Hurricane Katrina. Positive religious coping was hypothesized to be associated with PTG, whereas negative religious coping was hypothesized to be associated with PTS and psychological distress. Low-income mothers (N = 386, mean age = 25.4 years, SD = 4.43) were surveyed before, and 1 and 4 years after the storm. Results from structural regression modeling indicated that negative religious coping was associated with psychological distress, but not PTS. Positive religious coping was associated with PTG. Further analysis indicated significant indirect effects of pre- and postdisaster religiousness on postdisaster PTG through positive religious coping. Findings underscore the positive and negative effect of religious variables in the context of a natural disaster.

Topics: Environment, Environmental Disasters, Gender, Women, Gender Analysis, PTSD, Trauma, Religion Regions: Americas, North America Countries: United States of America

Year: 2013

Citation:

Kimbrel, Nathan A., Margaret E. Johnson, Carolina Clancy, Michael Hertzberg, Claire Collie, Elizabeth E. Van Voorhees, Michelle F. Dennis, Patrick S. Calhoun, and Jean C. Beckham. 2014. “Deliberate Self-Harm and Suicidal Ideation Among Male Iraq/Afghanistan-Era Veterans Seeking Treatment for PTSD.” Journal of Traumatic Stress 27 (4): 474–77. doi:10.1002/jts.21932.

Authors: Patrick S. Calhoun, Carolina Clancy, Claire Collie, Michelle F. Dennis, Michael Hertzberg, Margaret E. Johnson, Nathan A. Kimbrel, Elizabeth E. Van Voorhees, Jean C. Beckham

Abstract:

The objectives of the present research were to examine the prevalence of deliberate self-harm (DSH) among 214 U.S. male Iraq/Afghanistan-era veterans seeking treatment for posttraumatic stress disorder (PTSD) and to evaluate the relationship between DSH and suicidal ideation within this population. Approximately 56.5% (n = 121) reported engaging in DSH during their lifetime; 45.3% (n = 97) reported engaging in DSH during the previous 2 weeks. As hypothesized, DSH was a significant correlate of suicidal ideation among male Iraq/Afghanistan-era veterans, OR = 3.88, p < .001, along with PTSD symptom severity, OR = 1.03, p < .001, and combat exposure, OR = 0.96, p = .040. A follow-up analysis identified burning oneself, OR = 17.14, p = .017, and hitting oneself, OR = 7.93, p < .001, as the specific DSH behaviors most strongly associated with suicidal ideation. Taken together, these findings suggest that DSH is quite prevalent among male Iraq/Afghanistan-era veterans seeking treatment for PTSD and is associated with increased risk for suicidal ideation within this population. Routine assessment of DSH is recommended when working with male Iraq/Afghanistan veterans seeking treatment for PTSD.

Topics: Combatants, Male Combatants, Gender, Men, Health, Mental Health, Trauma Regions: Africa, MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2014