What Factors Are Associated with PTSD in Conflict-Affected Communities in Nigeria?

What you need to know

• The prevalence of post-traumatic stress disorder (PTSD) was very high (73.9%) among adults in conflict-affected communities in Nigeria.
• Higher education levels, larger family size, discrimination, and family history of mental illness were associated with increased risk of PTSD.
• The findings highlight the need for mental health interventions and support services in conflict-affected areas.

Understanding PTSD in Conflict Settings

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. In conflict-affected areas, exposure to violence, loss, and ongoing stress can put people at high risk for developing PTSD. This study looked at the prevalence of PTSD and associated risk factors among adults living in communities affected by conflict in Cross River State, Nigeria.

High Prevalence of PTSD

The researchers found that 73.9% of adults in the study met criteria for PTSD. This is an alarmingly high rate, much higher than what has been found in some other conflict-affected populations. For comparison, previous studies have found PTSD rates of 42-64% in other parts of Nigeria affected by terrorism and conflict. The very high prevalence in this study highlights the severe psychological toll that ongoing conflict is taking on these communities.

Risk Factors for PTSD

Several factors were associated with increased risk of having PTSD:

Higher Education Levels

Surprisingly, people with higher levels of education (especially tertiary/university education) were more likely to have PTSD symptoms. The researchers suggest this may be because more educated individuals were more likely to have lost jobs or livelihoods due to the conflict, causing additional stress. This finding is different from some other studies that have found lower education to be a risk factor for PTSD.

Larger Family Size

People living in households with 4 or more family members were at higher risk for PTSD. The researchers hypothesize this could be due to increased stress from trying to provide for and protect a larger family in difficult circumstances. More research is needed to understand this connection.

Discrimination

Experiencing discrimination or unfair treatment due to being affected by conflict was associated with higher rates of PTSD. This highlights how the social impacts of conflict, not just direct trauma exposure, can affect mental health.

Family History of Mental Illness

Having a family member with mental health problems increased the risk of PTSD. This could reflect both genetic vulnerability and the added stress of caring for a family member with mental illness in a challenging environment.

Other Notable Findings

While not statistically significant in the final analysis, some other factors were associated with PTSD in initial analyses:

• Loss of loved ones due to conflict
• Financial strain
• Being female (though the gender difference was small)

The study did not find significant associations between PTSD and factors like age, marital status, or occupation.

Implications for Mental Health Support

The extremely high prevalence of PTSD symptoms found in this study underscores the urgent need for mental health services and psychosocial support in conflict-affected communities. The findings suggest several key areas to focus on:

1. Providing targeted support for more educated individuals who may have lost professional roles or livelihoods.

2. Developing interventions that address family-level stress and support larger families.

3. Combating discrimination and social stigma faced by conflict-affected individuals.

4. Screening for family history of mental illness as a potential risk factor.

5. Addressing poverty and financial strain as part of a holistic approach to mental health.

The researchers emphasize the need for a multisectoral approach that goes beyond just clinical treatment to address the broader social and economic impacts of conflict that contribute to poor mental health outcomes.

Limitations and Future Directions

As a cross-sectional study, this research cannot prove causal relationships between the identified risk factors and PTSD. Longitudinal studies following people over time would help clarify these relationships. Additionally, the study relied on self-reported symptoms rather than clinical diagnosis of PTSD.

Future research could explore protective factors that help some individuals avoid developing PTSD despite exposure to conflict. Understanding resilience could inform prevention efforts. Studies examining access to and effectiveness of existing mental health services in the region would also be valuable.

Conclusions

• The extremely high prevalence of PTSD symptoms (73.9%) in conflict-affected communities in Nigeria indicates a severe mental health crisis requiring urgent attention.
• Risk factors like higher education, larger family size, and discrimination highlight the complex social factors contributing to PTSD beyond just direct trauma exposure.
• A comprehensive approach addressing both clinical treatment and broader social/economic impacts of conflict is needed to improve mental health outcomes in these communities.