Browsing by Author "Thomas, Elbert"

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    The Cycle of Violence.Associations Between Exposure to Violence, Trauma-Related Symptoms and Aggression—Findings from Congolese Refugees in Uganda
    (vivo international, 2015-08) Herbert, Ainamani; Simon, Fetz; Tobias, Hecker; Thomas, Elbert
    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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    Exploring the Potential Distinction Between Continuous Traumatic Stress and Posttraumatic Stress in an East African Refugee Sample
    (SAGE, 2017) Herbert E., Ainamani; Tobias, Hecker; Katharin, Hermenau; Eva, Haefele; Thomas, Elbert
    Posttraumatic stress (PTS) indicates a continuous stress response that persists though threats to life had been experienced in the past. However, threats to life are frequently ongoing. For these contexts, the concept of continuous traumatic stress (CTS) has been put forward. Based on structured clinical interviews with Congolese refugees (N = 226), this study investigated the CTS concept and whether it can be distinguished from PTS. We found that current exposure to violence correlated positively with concerns about its recurrence in the CTS group (r = .46). An ANCOVA indicated that higher intrusion symptom severity in the PTS group (no symptom reduction under safe conditions) was explained by higher lifetime trauma exposure (η2 = .125). In contexts of continuous trauma exposure, symptom-like responses may be regarded as appropriate responses to realistic danger. In these contexts, the possibility that symptom changes are a response to real threats should be considered to avoid overestimation of PTSD prevalences
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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