Browsing by Author "Hecker, Tobias"

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    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, Thomas
    War-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.
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    Gender differences in response to war related trauma and posttraumatic stress disorder – a study among the Congolese refugees in Uganda
    (BMC Psychariatry, 2020) Ainamani E., Herbert; Thomas, Elbert; Kani Olema, David; Hecker, Tobias
    Background: The wars in the Democratic Republic of Congo have left indelible marks on the mental health and functioning of the Congolese civilians that sought refuge in Uganda. Even though it is clear that civilians who are exposed to potentially traumatizing events in war and conflict areas develop trauma-related mental health problems, scholarly information on gender differences on exposure to different war-related traumatic events, their conditional risks to developing PTSD and whether the cumulative exposure to traumatic events affects men and women differently is still scanty. Methods: In total, 325 (n = 143 males, n = 182 females) Congolese refugees who lived in Nakivale, a refugee settlement in the Southwestern part of Uganda were interviewed within a year after their arrival. Assessment included exposure to war-related traumatic events, and DSM-IV PTSD symptom severity. Results: Our main findings were that refugees were highly exposed to war-related traumatic events with experiencing dangerous flight as the most common event for both men (97%) and women (97%). The overall high prevalence of PTSD differed among women (94%) and men (84%). The highest conditional prevalence of PTSD in women was associated with experiencing rape. The dose-response effect differed significantly between men and women with women showing higher PTSD symptom severity when experiencing low and moderate levels of potentially traumatizing event types. Conclusion: In conflict areas, civilians are highly exposed to different types of war-related traumatic events that expose them to high levels of PTSD symptoms, particularly women. Interventions focused at reducing mental health problems resulting from war should take the context of gender into consideration
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    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, Tobias
    Introduction: 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.
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    PTSD symptom severity relates to cognitive and psycho-social dysfunctioning – a study with Congolese refugees in Uganda
    (European Journal of Psychotraumatology, 2017) Ainamania, Herbert E; Elberta, Thomas; Olemaa, David K; Hecker, Tobias
    Background: 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.
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    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, Tobias
    Background: 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.