Browsing by Author "Elbert, Thomas"
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Item The Cycle of Violence: Associations Between Exposure to Violence, Trauma-Related Symptoms and Aggression—Findings from Congolese Refugees in Uganda(University of Zurich, 2015) Hecker, Tobias; Fetz, Simon; Ainamani, Herbert; Elbert, ThomasWar-related trauma exposure has been linked to aggression and enhanced levels of community and family violence, suggesting a cycle of violence. Reactive aggression—an aggressive reaction to a perceived threat—has been associated with posttraumatic stress disorder (PTSD). In contrast, appetitive aggression—a hedonic, intrinsically motivated form of aggression—seems to be negatively related to PTSD in offender and military populations. This study examined the associations between exposure to violence, trauma-related symptoms and aggression in a civilian population. In semistructured interviews, 290 Congolese refugees were questioned about trauma exposure, PTSD symptoms, and aggression. War-related trauma exposure correlated positively with exposure to family and community violence in the past month (r = .31, p < .001), and appetitive (r = .18, p = .002) and reactive aggression (r = .29, p < .001). The relationship between war-related trauma exposure and reactive aggressive behavior was mediated by PTSD symptoms and appetitive aggression. In a multiple sequential regression analysis, trauma exposure (β = .43, p < .001) and reactive aggression (β = .36, p < .001) were positively associated with PTSD symptoms, whereas appetitive aggression was negatively associated (β=−.13, p = .007) with PTSD symptoms. Our findings were congruent with the cycle of violence hypothesis and indicate a differential relation between distinct subtypes of aggression and PTSD.Item Prevalence Of Violence-Related Traumatic Events And Symptoms Of Post-Traumatic Stress Disorder Among The Congolese Refugees In Uganda.(Makerere University College of Health Sciences, 2016-08-15) Ainamani, Herbert E; Elbert, Thomas; Olema, David K; Hecker, TobiasIntroduction: Following the waves of violence in Congo after the 1994 genocide in Rwanda, there has been an influx of Congolese refugees into Uganda and more have continued to flock into the country up to date. These refugees were exposed to multiple traumatic events that continue to be detrimental to their psychological well-being. Whereas there has been vast research on the prevalence of Post-traumatic Stress Disorder (PTSD) based on a single most traumatizing event, literature on the relative contribution of cumulative exposure to different traumatic events and PTSD symptom severity is still scanty in refugee or trauma studies. Objective: In this study, we investigated the prevalence and association of violence-related traumatic events of war to PTSD symptom severity among the Congolese refugees in Nakivale refugee settlement in Uganda. Methods: Using the Post-traumatic Symptom Scale Interview (PSSI)and a prepared checklist of war and non-war traumatic events, exposure to different types of traumatic events and their association with PTSD symptom severity was assessed. Results: We found a high prevalence of different types of violence-related traumatic events among our sample of the Congolese refugees with 99%, 98.2% and 98.2% of the participants having experienced or witnessed War, Community, and Family related traumatic events respectively. Additionally the prevalence of Community and Family related traumatic events within one month prior to the interview was at 84.7% and 57.7% respectively. PTSD symptom severity was positively associated with a higher number of and the type of traumatic events. Conclusion: Congolese refugees experienced a number of violence-related traumatic events and they continued to experience the same in the form of community and family related traumatic events in re-settlement. Repeated number of traumatic events was associated with increasing severity of PTSD symptoms. Our results highlighted the need for better provision of psychological services among refugee populations as well as their protection against continued violence-related traumatic events in their families and communities of resettlement.Item PTSD symptom severity relates to cognitive and psycho-social dysfunctioning – a study with Congolese refugees in Uganda(Informa UK Limited, trading as Taylor & Francis group, 2017-02-14) Ainamani, Herbert E.; Elbert, Thomas; Olema, David K.; Hecker, TobiasBackground: In the ongoing conflict in the Democratic Republic of the Congo (DRC), civilians have been heavily exposed to traumatic stressors. Traumatizing experiences cumulatively heighten the risk for trauma-related disorders, and with it affect cognitive and psycho-social functioning. Objectives: We aimed at investigating the association between trauma-related disorders and cognitive and psycho-social functioning and hypothesized that PTSD symptom severity would negatively correlate with executive functioning, working memory and psycho-social functioning in everyday life. Method: In total, 323 Congolese refugees (mean age: 31.3 years) who arrived in the Ugandan Nakivale refugee settlement after January 2012 were assessed regarding their exposure to traumatic events, PTSD symptom severity (posttraumatic symptom scale interview), executive functioning (Tower of London), working memory performance (Corsi block tapping task) and psycho-social dysfunctioning (Luo functioning scale). Results: Hierarchical regression analyses indicated a significant negative association between PTSD symptom severity and working memory (β = –0.32, p < 0.001), as well as executive functions (β = –0.19, p = 0.003). Furthermore, the impairment of psycho-social functioning in everyday life was positively related with PTSD symptom severity (β = 0.70, p < 0.001), and negatively with executive functioning (β = –0.15, p = 0.003). However, working memory performance was not significantly related to psycho-social dysfunctioning (β = 0.09, p > 0.05). Conclusion: Trauma survivors not only suffer from the core PTSD symptoms but also from impaired cognitive functioning. PTSD symptom severity seems furthermore to be related to impaired psycho-social functioning. Our findings suggest that trauma-related mental health problems may heighten the risk for poverty and lack of prospect and further aggravate the consequences of war and conflict.