Psycho-Trauma, Psychosocial Adjustment, and Symptomatic Post-Traumatic Stress Disorder among Internally Displaced Persons in Kaduna, Northwestern Nigeria

Abstract

Background: In April 2011, a post election violent conflict in Northern Nigeria led to resettlement of internally displaced persons (IDPs) in a camp in Kaduna, the worst affected state. We set out to determine prevalence and socio-demographic factors associated with post-traumatic stress disorder (PTSD) among IDPs. We also determined types of psycho-trauma experienced by the IDPs and their psychosocial adjustment.Methods: Cross-sectional systematic random sampling was used to select 258 adults IDPs. We used Harvard trauma questionnaire to diagnose “symptomatic PTSD,” composite international diagnostic interview (CIDI) for diagnosis of depression, and communal trauma event inventory to determine exposure to psycho-trauma. We assessed social adjustment using social provision scale. Multiple logistic regression analysis was used to determine independent predictors of PTSD.Results: Of the 258 IDPs, 109 (42.2%) had a diagnosis of PTSD, 204 (79.1%) had poor living conditions, and only 12 (4.7%) had poor social provision. The most frequent psycho-traumas were destruction of personal property (96.1%), been evacuated from their town (96%) and witnessing violence (88%). More than half (58%) of IDPs had experienced 11–15 of the 19 traumatic events. Independent predictors of PTSD among respondents were having a CIDI diagnosis of depression (adjusted odds ratios 3.5, 95% confidence interval 1.7–7.5; p = 0.001) and witnessing death of a family member (3.7, 1.2–11.5; p = 0.0259).Conclusion: We concluded that exposure to psycho-trauma among IDPs in Kaduna led to post conflict PTSD. Death of a family member and co-morbid depression were independent predictors of PTSD among IDPs. Though their living condition was poor, the IDPs had good psychosocial adjustment. We recommended a structured psychosocial intervention among the IDP targeted at improving living condition and dealing with the psychological consequences of psycho-trauma.

Descriptive Characterization of Psycho-Trauma, Psychological Distress, and Post-traumatic Stress Disorder among Children and Adolescent Internally Displaced Persons in Kaduna, Nigeria

“…Male children/adolescent IDPs consistently had experienced more traumatic events in all the three domains of the stressful life event questionnaire (stressful life events concerning the family, experiences with illness, accidents and disasters, and physical and sexual mistreatment) with the exception of experiencing sexual insult/harassment and very stressful events of great danger. Similar pattern was also observed in the adult IDPs study (2). …”

“…This is lower than 11–15 trauma events exposure of majority of adult population studied from the same IDPs camp in an earlier study (2). This will suggest that the children/adolescents IDPs had less exposure to trauma compared with the adult population but the findings may be due to experience of destruction of “destruction of personal properties” by adults, which children/adolescent IDPs may not report.…”

“…A camp for the internally displaced persons (IDPs) was set up in Kaduna city, the capital of the state to cater for the IDPs. Studies conducted among adults IDPs in the same camp indicated 42% of the 258 adults IDPs had a diagnosis of post-traumatic stress disorder (PTSD) with more than half experiencing 11–15 traumatic events (2). About 60 and 16% of the adult IDPs had probable depression and definite depression, respectively (3).…”

An evaluation of psychological distress and social support of survivors and contacts of Ebola virus disease infection and their relatives in Lagos, Nigeria: a cross sectional study − 2014

“…EVD can be perceived as a life-threatening event that meets a key diagnostic criterion of PTSD in DSM [19]. The development of PTSD following life-threatening event has been demonstrated among Nigerians [20] and among health workers who had contact with Severe Acute Respiratory Syndrome (SARS) [7]. Other less severe disorders caused by reaction to extremely stressful situations such as acute stress reaction and adjustment disorders could also present with the above psychological distress.…”

Expert panel’s modification and concurrent validity of the Teacher Stress Inventory among selected secondary school teachers in Nigeria

“…Even within Nigeria, there is a wide cultural variation of a stressor that will be significant enough to constitute a stress reaction (Sheikh et al 2014). Thus, instruments that will be applicable to assess teachers' stress in Nigeria must consider these contextual factors.…”