Mechanisms of Psychological Distress following War in the Former Yugoslavia: The Role of Interpersonal Sensitivity

Abstract

While high prevalence rates of psychological symptoms have been documented in civilian survivors of war, little is known about the mechanisms by which trauma exposure might lead to poor psychological outcomes in these populations. One potential mechanism that may underpin the association between war-related traumatic experiences and psychopathology is interpersonal sensitivity. In the current study, we applied structural equation modeling to investigate the impact of interpersonal sensitivity on posttraumatic stress disorder (PTSD) symptoms, depression symptoms, and anger responses following exposure to war trauma. 3313 survivors of the war in the former Yugoslavia were identified and selected using a multistage, probabilistic sampling frame and random walk technique. Participants were interviewed regarding trauma exposure, interpersonal sensitivity, and PTSD symptoms, depression symptoms, and anger responses. Structural equation modeling analyses revealed that the relationship between trauma and PTSD symptoms and depression symptoms was partly statistically mediated by interpersonal sensitivity. Further, findings indicated that the relationship between trauma and anger responses was fully statistically mediated by interpersonal sensitivity. These results suggest that interpersonal sensitivity may function as a key mechanism that contributes to psychopathology following trauma.

Interpersonal sensitivity as mediator of the relations between war experiences and mental illness in war-affected youth in northern Uganda: Findings from the WAYS study.

“…In the context of the war-affected youth, some of whom perpetrated horrendous atrocities against the civilian population to which they have been reintegrated, it has been defined as sensitivity to perceived or actual behaviors and feelings of others toward them that may define their mental health outcomes. Subsequent studies have reported that interpersonal sensitivity is linked to exposure to traumatic experiences, including war trauma ( Hauff & Vaglum, 1994 ; Nickerson, Priebe, Bryant, & Morina, 2014 ), with exposure to war often associated with higher levels of interpersonal sensitivity ( Hagenaars, Fisch, & van Minnen, 2011 ; Nickerson et al, 2014 ). Furthermore, interpersonal sensitivity has been linked to negative mental health outcomes, including PTSD, depression, and anxiety ( Hauff & Vaglum, 1994 ; Nickerson et al, 2014 ).…”

“…Subsequent studies have reported that interpersonal sensitivity is linked to exposure to traumatic experiences, including war trauma ( Hauff & Vaglum, 1994 ; Nickerson, Priebe, Bryant, & Morina, 2014 ), with exposure to war often associated with higher levels of interpersonal sensitivity ( Hagenaars, Fisch, & van Minnen, 2011 ; Nickerson et al, 2014 ). Furthermore, interpersonal sensitivity has been linked to negative mental health outcomes, including PTSD, depression, and anxiety ( Hauff & Vaglum, 1994 ; Nickerson et al, 2014 ). Responses such as lack of trust and interpersonal insensitivity may be adaptive, albeit in the short run, in the aftermath of war, especially where stigma and poor community relations trigger traumatic reminders and threats to war survivors ( Nickerson et al, 2014 ).…”

“…Furthermore, interpersonal sensitivity has been linked to negative mental health outcomes, including PTSD, depression, and anxiety ( Hauff & Vaglum, 1994 ; Nickerson et al, 2014 ). Responses such as lack of trust and interpersonal insensitivity may be adaptive, albeit in the short run, in the aftermath of war, especially where stigma and poor community relations trigger traumatic reminders and threats to war survivors ( Nickerson et al, 2014 ). Consequently, it is possible that interpersonal sensitivity might explain continued experience of mental health problems such as PTSD, depression, and psychosis.…”

“…Furthermore, the war in Northern Uganda was fought in the community and sometimes victims knew the perpetrators. Consequently, postwar environment is fraught with personal vendetta, lack of trust, and interpersonal sensitivity, perceived or real ( Nickerson et al, 2014 ). Although postwar interpersonal sensitivity may be unfounded, perceptions of it may lead to mental health problems, as demonstrated by previous findings ( Hauff & Vaglum, 1994 ; Vidyanidhi & Sudhir, 2009 ; Wilhelm, Boyce, & Brownhill, 2004 ).…”

“…Although postwar interpersonal sensitivity may be unfounded, perceptions of it may lead to mental health problems, as demonstrated by previous findings ( Hauff & Vaglum, 1994 ; Vidyanidhi & Sudhir, 2009 ; Wilhelm, Boyce, & Brownhill, 2004 ). Moreover, interpersonal sensitivity has the potential to disrupt social relations and daily functioning, as an outburst of anger and preoccupation with previous traumatic experiences may, in turn, engender further anger-related reactions and personal threats, leading to poor social relations and mental illness ( Nickerson et al, 2014 ). Interpersonal sensitivity is suggested to be common, especially in postconflict environments, where obsession with previous political, social, and economic prejudices, as well as preoccupation with revenge, may be rampant ( Lopes Cardozo, Vergara, Agani, & Gotway, 2000 ).…”