The Assessment of Post Traumatic Stress Disorder Among Internally Displaced Persons in Jos North Local Government Area of Plateau State
CHAPTER ONE
PURPOSE OF THE STUDY
The main purpose was to determine the rate of PTSD among IDP displaced by armed forces from rural areas of conflict to the city of Jos North LGA of Plateau state.
CHAPTER TWO
LITERATURE REVIEW
POST TRAUMATIC STRESS DISORDER
Ozer, (2003) completed an exhaustive meta-analysis examining the predictors of PTSD and found similar results at Brewin, (2000). They found that the strongest predictor of developing PTSD was dissociation either during or immediately following the traumatic experience. They indicated that this relationship was strongest in those seeking mental health services and in those studies that had longer elapsed time between trauma and assessment. They found a small to moderate relationship between PTSD and perceived life threat, perceived lack of social support and reporting intensely negative emotional reactions during or immediately after the trauma. Thus, no reaction (dissociation) is predictive of developing PTSD and extreme emotional reactions are predictive of developing PTSD. This indicates that the victim needs to quickly process information, including emotional information, and engage positive coping mechanisms as soon as possible. Finally, Ozer et al. (2003) noted small but significant relationships between prior trauma history, personal psychiatric history and family history of psychiatric problems and development of PTSD in response to trauma. Through a closer examination of the trauma history research they found that there was a moderate relationship between trauma and PTSD if the traumatic event was a crime, as opposed to a natural disaster. Furthermore, in examining different personal psychiatric diagnoses they found that depression was moderately predictive of developing PTSD in response to trauma.
A high level of PTSD after previous trauma also seems to be a risk factor. Brunet, Boyer, Weiss and Marmar (2001) found that 75% of those who had high levels of PTSD symptoms after the initial trauma also reported high PTSD symptoms for a subsequent trauma. This relationship was not observed in those who reported moderate and low PTSD symptoms. Brunet et al. (2001) concluded that clinicians should assess the presence of previous PTSD symptoms and the severity of any previous PTSD episodes when they assess risk of further PTSD symptoms. Similarly, researchers have linked higher heart rare after a traumatic experience to subsequent diagnosis of PTSD, indicating that physiological arousal may be important in the development of PTSD (Bryant, Harvey, Guthrie & Moulds, 2000).
Sandron, Joel, & Exra, (2015)The authors investigated trends in probable post-traumatic stress disorder (PTSD) prevalence in the general population of New York City in the first 6 months after the September 11 terrorist attacks. Three random digit dialing telephone surveys of adults in progressively larger portions of the New York City metropolitan area were conducted 1 month, 4 months, and 6 months after September 11, 2001. A total of 1,008, 2,001, and 2,752 demographically representative adults were recruited in the three surveys, respectively. The current prevalence of probable PTSD related to the September 11 attacks in Manhattan declined from 7.5% (95% confidence interval: 5.7, 9.3) 1 month after September 11 to 0.6% (95% confidence interval: 0.3, 0.9) 6 months after September 11. Although the prevalence of PTSD symptoms was consistently higher among persons who were more directly affected by the attacks, a substantial number of persons who were not directly affected by the attacks also met criteria for probable PTSD. These data suggest a rapid resolution of most of the probable PTSD symptoms in the general population of New York City in the first 6 months after the attacks. The psychological consequences of a large-scale disaster in a densely populated urban area may extend beyond persons directly affected by the disaster to persons in the general population.
CHAPTER THREE
DISCUSSION, CONCLUSION, LIMITATION AND RECOMMENDATIONS
DISCUSSION
This study revealed that most of the respondents had witnessed some form of violence or the other during the various ethno-religious conflicts occurring in the state. This high level of exposure to violence may be because tensions between ethnic groups rooted in allocation of resources, electoral violence, frequent Boko Haram attacks, fears of religious dominance, and contested land rights often explode into violence at the slightest of provocation. These conflicts often erupt over the most flimsy of reasons ranging from arguments and misunderstanding among residents, theft, and even just mutual suspicion. Reprisals attacks are also a common occurrence in the study area. This finding is similar to that of a study carried out among residents of Kashmir, India which reported lifetime prevalence for any traumatic experience of 58.69% and specifically exposure to combat or war zone as 73.23% (Margoob, Firdosi, Banal, Khan and Malik, 2006). In another study carried out among residents of East Timor who had endured 25 years of Indonesian Military occupation, the results revealed that 76% of them had experienced direct exposure to combat situation (76%) (Modvig, Lopez, Rodenburg, Salud and Cabigon, 2000).
CHAPTER FOUR
CONCLUSIONS AND RECOMMENDATIONS
CONCLUSION
The occurrence of a wide variety of psychological symptoms and syndromes in the populations in conflict situations is widely documented by available research. Also, this research provides evidence about the increase incidence psychological consequences of armed attack, conflict among civilian population. There is no doubt that the populations in war and conflict situations should receive mental health care as part of the total relief, rehabilitation and reconstruction processes with special attention to be paid to females victims. As happened in the first half of the 20th century, when war gave a big push to the developing concepts of mental health, the study of the psychological consequences of the wars of the current century could add new understandings and solutions to mental health problems of general populations.
LIMITATION
Limitations of this study include the fact that it concentrated on IDPs in Jos which is small sample size which may also explain the relatively high rate of PTSD found. This study was conducted among the members of the population who were most affected by the recurring conflict. Thus, the prevalence rates of PTSD among them may not be reflective of the general population to which inferences are made. Also, no questionnaire was used for data and designed for screening of PTSD in clinical primary care settings and May thus result in inherent biases with respect to fully exploring the symptoms of PTSD among the Internally Displaced Persons.
RECOMMENDATIONS
Based on the findings of this study it was recommended as follows:
That health services offered to IDPs who are victims of conflicts, insurgency and natural disasters, it should include both chemotherapy and psychotherapy in order to keep the flesh and the soul together and avert increasing incidence of mental disorders. Victims of attacks and communal conflicts should be adequately compensated to at least provide succor that would reduce their psychological pains that may gradually result into chronic mental problems. Governments at all levels, non-governmental organizations, religious bodies and all well meaning individuals should step out campaigns against armed attacks and conflicts and educate the masses on the need to live together in peace and harmony as sure way of promoting good mental health. Security agencies should intensify efforts towards arresting perpetrators of violence and make them to face the wrath of the law to serve as deterrent to others.
REFERENCES
- Bowlby, J. (1960). ‘Separation Anxiety.’ International Journal of Psychoanalysis, 41: 89-113.
- Chinelo, O., & Mkpelenga D. (2013). Psychological implication of cultural conflicts.
- Commission, N.P. (2006). Population and Housing Census of the Federal Republic of Nigeria. Plateau State Priority Tables Abuja: National Population Commission p. 1-2.
- Cordell, K. and Wolff, S. (2010). Ethnic Conflict. Polity Press. ISBN 13: 978-0-7456-3931-4
- Elijah M.G., Chris, P, & Hala, E. (2014). The mental health, quality of life satisfaction of internally displaced persons living in Nakuru country Kenya.
- Holmes, J. (1993). John Bowlby & Attachment Theory. Makers of modern psychotherapy. London: Routledge. ISBN 0-415-07729-X.
- Howe, D. (2011). Attachment across the life course, London: Palgrave.
- HUMAN RIGHTS WATCH (2014, MARCH 14). Nigeria: Boko Haram Attacks Cause.
- Karunakara, UK., Neuner, F. (2004). Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the West Nile. African Health Sciences, 4: 83-93.
- Kessler, R.C., Sonnega, A., Bromet, E., & Hughes M, CB N (1995). Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psych 52: 1048-60.
- Krause, J. (2011). A Deadly Cycle: Ethno-Religious Conflict in Jos, Plateau State, Nigeria. Geneva.
