Cohort profile: mental health following extreme trauma in a northern Ugandan cohort of W ar-A ffected Y outh S tudy (The WAYS Study)

Abstract

War experiences are associated with the risk of long-term mental health problems. The War-affected Youths (WAYS) Study comprises a cohort of 539 youths (61% female) aged between 18 to 25 (at baseline) randomly sampled from the population of war-affected youths in northern Uganda. The study aims to chart the trajectory of long-term mental health consequences of war and the roles of individual, family, and community contextual risk and protective factors in influencing the course of mental health using Social Ecology Model, thus, addressing both the individual and its social ecology. Knowledge of postwar contexts may inform policy and guide interventions on postwar psychosocial adjustment and reintegration in conflict-prone Great Lakes region of Africa (Rwanda, Burundi, DR Congo, Uganda, Central African Republic, and South Sudan). Two waves of data collection have been conducted and more data collection is planned. At baseline, information on demographic characteristics, pre-war experiences, psychosocial outcomes, coping, stigma/discrimination, family and community acceptance and relationship, family functioning, and post-war experiences were obtained. At follow-up, information on general health, gender-based violence, PTSD, social skills, trauma memory quality, rumination, self-esteem, and psychosocial outcomes were collected. Approval to access the data can be obtained on application to the Principal Investigator upon submission of a research proposal with ethical approval from the applicant's institution. This research is funded by Wellcome Trust and Gulu University.

Testing competing factor models of the latent structure of post-traumatic stress disorder and complex post-traumatic stress disorder according to ICD-11

“…Trauma exposure was measured using the United Nations Children’s Fund (UNICEF) War Trauma Screening Scale, which was originally developed for Bosnia and Herzegovina but has been adapted for use in African war-affected youth (Amone-P’Olak et al, 2013). The instrument consists of items relating to personal injury (six items), witnessing violence (11 items), injuries and threats to self (five items), deaths (seven items), physical threats to loved ones (four items), material losses (four items), harm to loved ones (four items), separation (two items), displacement (five items), participating in armed groups (four items) and sexual abuse (three items).…”

ICD-11 Trauma Questionnaires for PTSD and Complex PTSD: Validation among Civilians and Former Abducted Children in Northern Uganda

“…Thirty-six percent were found to fulfill the criteria for PTSD, depression, and anxiety simultaneously [13]. A longitudinal study, the War-Affected Youth Study (WAYS), by Amone-P'Olak et al [14], found that war experiences were significantly associated with difficulties performing daily activities and tasks (t=-2.62, p<.001), especially for females compared to male participants (t=-2.62, p<.05). Overall, women were more at risk of long-term mental health outcomes compared to men [14].…”

“…A longitudinal study, the War-Affected Youth Study (WAYS), by Amone-P'Olak et al [14], found that war experiences were significantly associated with difficulties performing daily activities and tasks (t=-2.62, p<.001), especially for females compared to male participants (t=-2.62, p<.05). Overall, women were more at risk of long-term mental health outcomes compared to men [14]. Due to the extent of trauma found in previous studies and the prolonged period of the war, we presuppose that northern Uganda has a relevant population for the study of C-PTSD.…”

“…The adapted version for West African war-affected youth was used, which had been altered by Amone-P'Olak et al [14] to better capture the context of war in African countries ( Table 2). The parents education was scored as 1='none', 2='Primary School', 3='Secondary School', 4='Diploma', 5='Bachelor Degree' and 6 ='Masters Degree'.…”

“…Mental health was furthermore assessed by the African Youth Psychosocial Assessment Instrument (APAI), which is a field-based instrument developed for use in northern Uganda [14]. disorders in the DSM-IV and ICD-10 [17].…”