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      Descriptive Characterization of Psycho-Trauma, Psychological Distress, and Post-traumatic Stress Disorder among Children and Adolescent Internally Displaced Persons in Kaduna, Nigeria

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          Abstract

          Background

          A postelection violent conflict in Kaduna resulted in 800 deaths and 65,000 displaced people leading to setting up of camp for internally displaced persons (IDPs). We set out to determine the prevalence and pattern of psycho-traumatic stressful life events, psychological distress, and post-traumatic stress disorder (PTSD) among child/adolescents IDPs.

          Methods

          A descriptive cross-sectional study of 73 child/adolescent IDPs were selected by total sampling. Stressful life event checklist measured conflict-related trauma and reaction of adolescents to traumatic stress (RATS) measured post-trauma reaction of children/adolescents. Hopkins Symptoms Checklist 37 for Adolescents measured psychological distress associated with trauma. Diagnostic Interview Schedule for Children was used for diagnosis of PTSD.

          Results

          Of 73 respondents, 3 (4.1%) had probable PTSD, 2 (2.7%) had definitive PTSD, and mean score of the child/adolescent IDPs on HSCL-37A and RATS was 44.7 (SD = 6.3) and 31.9 (SD = 5.7), respectively. Most frequently occurring psychological distress among female participants was suddenly scared for no reason 7 (19.5%) and becoming angry easily and feeling fearful 5 (13.9%). The average score for female participants were higher than that for males on depressive and anxiety subscale of HSCL-37A.

          Conclusion

          We concluded that children/adolescent IDPs were exposed to psycho-trauma following postelection violent conflict and developed psychological distress. However, the low prevalence of psychological distress and PTSD suggested that living with parents and psychosocial intervention provided could have led to much lower morbidity.

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          Most cited references 16

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          Gender differences in health: are things really as simple as they seem?

          It is conventional wisdom in medical sociology and social epidemiology that in industrialized societies men die earlier than women, but that women have poorer health than men. A number of explanations for these differences have been postulated and tested (for example, different biological risks, acquired risks, reporting biases and experiences of health care). Using two recent British data sets we find that the pattern of sex differences in morbidity is more complicated than the conventional wisdom often suggests. The direction and magnitude of sex differences in health vary according to the particular symptom or condition in question and according to the phase of the life cycle. Female excess is only consistently found across the life span for psychological distress and is far less apparent, or reversed, for a number of physical symptoms and conditions. Detailed inspection of papers on gender differences published in the last decade reveals that our findings are not unique, but that a relatively undifferentiated model of consistent sex differences has nevertheless continued to predominate in the literature. We believe that the topic of gender differences in health warrants periodic re-examination.
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            Annual Research Review: Resilience and mental health in children and adolescents living in areas of armed conflict--a systematic review of findings in low- and middle-income countries.

            Researchers focused on mental health of conflict-affected children are increasingly interested in the concept of resilience. Knowledge on resilience may assist in developing interventions aimed at improving positive outcomes or reducing negative outcomes, termed promotive or protective interventions. We performed a systematic review of peer-reviewed qualitative and quantitative studies focused on resilience and mental health in children and adolescents affected by armed conflict in low- and middle-income countries. Altogether 53 studies were identified: 15 qualitative and mixed methods studies and 38 quantitative, mostly cross-sectional studies focused on school-aged children and adolescents. Qualitative studies identified variation across socio-cultural settings of relevant resilience outcomes, and report contextually unique processes contributing to such outcomes. Quantitative studies focused on promotive and protective factors at different socio-ecological levels (individual, family-, peer-, school-, and community-levels). Generally, promotive and protective factors showed gender-, symptom-, and phase of conflict-specific effects on mental health outcomes. Although limited by its predominantly cross-sectional nature and focus on protective outcomes, this body of knowledge supports a perspective of resilience as a complex dynamic process driven by time- and context-dependent variables, rather than the balance between risk- and protective factors with known impacts on mental health. Given the complexity of findings in this population, we conclude that resilience-focused interventions will need to be highly tailored to specific contexts, rather than the application of a universal model that may be expected to have similar effects on mental health across contexts. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
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              Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda

              Background The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD) and depression amongst these internally displaced persons (IDPs), and investigate associated demographic and trauma exposure risk factors. Methods A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression. Results Over half (54%) of the respondents met symptom criteria for PTSD, and over two thirds (67%) of respondents met symptom criteria for depression. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure. Conclusion This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/129910
                URI : http://frontiersin.org/people/u/170430
                URI : http://frontiersin.org/people/u/385958
                URI : http://frontiersin.org/people/u/376752
                URI : http://frontiersin.org/people/u/362682
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                28 October 2016
                2016
                : 7
                Affiliations
                1Department of Clinical Services, Federal Neuropsychiatric Hospital , Kaduna, Kaduna, Nigeria
                2Department of Psychiatry, Ahmadu Bello University , Zaria, Kaduna, Nigeria
                3Department of Paediatrics, Ahmadu Bello University , Zaria, Kaduna, Nigeria
                Author notes

                Edited by: Shervin Assari, University of Michigan, USA

                Reviewed by: Arezoo Shajiei, University of Manchester, UK; François Borgeat, Université de Montréal, Canada; Masoumeh Dejman, Johns Hopkins University, USA

                *Correspondence: Taiwo Lateef Sheikh, latshe@ 123456yahoo.com

                Specialty section: This article was submitted to Public Mental Health, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2016.00179
                5083839
                Copyright © 2016 Sheikh, Mohammed, Eseigbe, Adekeye, Nuhu, Lasisi, Muhammad, Sulaiman, Abdullateef, Hayyatudeen and Akande.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 24, Pages: 6, Words: 4656
                Categories
                Psychiatry
                Original Research

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