High rates of posttraumatic stress disorder after war in Uganda

Aug 1 2007

A survey of adults displaced by war in northern Uganda found high rates of posttraumatic stress disorder (PTSD) and depression, and that these individuals were more likely to favor violent means to end the conflict compared to persons without these symptoms, according to a study in the August 1 issue of JAMA: The Journal of the American Medical Association, a theme issue on violence and human rights.

Patrick Vinck, Ph.D., of the University of California, Berkeley, and colleagues assessed the level of exposure to war-related violence and the prevalence of PTSD and depression symptoms by surveying 2,585 adults in villages and camps for internally displaced persons in four districts of northern Uganda in April and May 2005. The researchers also examined if these factors are associated with respondents' views as to whether violent or nonviolent means should be pursued to achieve peace in northern Uganda.

War in Uganda has been waged since the late 1980s by the Lord's Resistance Army (LRA) against the Ugandan People's Democratic Army and the people of Uganda. Numerous people have been killed or abducted and up to a million and a half people have been displaced in camps, where they live in poverty and despair, according to background information in the article.

The researchers found that about three-quarters of the respondents (74.3 percent) met PTSD symptom criteria and almost half (44.5 percent) met depression symptom criteria. Four patterns of exposure to trauma were distinguished: those with low exposure (group 1; 21.4 percent); witnesses to war-related violence (group 2; 17.8 percent); those threatened with death and/or physically injured (group 3; 16.4 percent); and those abducted (group 4; 44.3 percent). Respondents in groups 3 and 4, who experienced the most traumatic exposures, were more likely to have PTSD and depression symptoms compared with group 1. Respondents who met the PTSD symptom criteria were more likely to identify violence as a means to achieve peace. Respondents who met the depression symptom criteria were less likely to identify nonviolence as a means to achieve peace.

According to the authors, “… local cultures, beliefs, and social factors play a role in shaping attitudes and opinions toward peace. Efforts to establish peace and accountability mechanisms must be informed by population-based data that reflect the opinions, attitudes, and needs of all sectors of a society. Such research should identify how patterns of war-related exposure to violence, psychosocial trauma, and cultural and political factors influence the process of social reconstruction and peace building in the aftermath of mass violence.”
(JAMA. 2007;298(5):543-554.)

http://jama.ama-assn.org/