THE RELATIONSHIP BETWEEN PSTD AND RESILIENCE AMONG SOLDIERS WHO FOUGHT LRA REBELLION IN NORTHERN UGANDA By Sedrack Atuhaire

Introduction  The Lord’s Resistance Army (LRA) rebellion in Northern Uganda had far reaching impact on the mental health of the war victims.  This attracted experts, and humanitarian agencies to provide care to trauma victims.  In their interventions, soldiers suffering from PTSD and other related mental illnesses were ignored (Pham, et al, 2009).

Introduction...  The concept of resilience has featured in the literature outlining the progression of mental health conditions among war veterans (Daud, et al, 2008).  However, resilience and how it relates to PTSD has not received much attention.  This study examined the relationship between PSTD and resilience among soldiers who fought LRA rebellion.

Research Questions 1.What are the psychological factors that are associated with resilience and effective coping? 2.What is the relationship between PTSD and Resilience among war veterans?

Significance  The study will inform mental health practitioners on the urgent need of mental health services in military settings not only in Uganda but also in Africa and beyond.

The concept of resilience  Resilience refers to “the ability to adapt well to adversity, trauma, tragedy, threats, or even significant sources of stress.” (APA 2011).  Bonanno (2004) defined resilience as the ability to maintain a state of normal equilibrium in the face of extremely unfavourable circumstances.

Resilience …  Not all people exposed to traumatic events experience PTSD. What then protects them? Resilience has been found to provide protection.  Resilience equips individuals with the ability to face, encounter, and overcome traumatic circumstances and environments.

Resilience...  Resilient individuals seem to be able to understand what has happened to them (insight), develop an understanding of what has happened to others (empathy) and experience a quality of life that is often denied to others (achievement) (Dent and Cameron, 2003).

Resilience...  The mediating factors for resilience are; beliefs, attitudes, coping strategies, behaviours and psychosocial cohesion.  These will affect differences in the way individuals display resilience.  Resilience has dynamic quality. As situations, opportunities and environment change, individuals also adjust in the level of resilience.

Methodology  A sequential study using correlation and descriptive studies.  Purposive and convenience sampling strategies were used army veterans were recruited for the study.  The Life Events module of the University of Michigan Composite International Diagnostic Interview (UM-CIDI)was used to identify participants with PTSD.

Methodology...  Resilience was measured using the Connor- Davidson Resilience scale (CD-RISC). Has excellent Psychometric properties with young adults.  A 25 item rated on a 5 point Likert Scale.  Data was analysed using SPSS in which a regression analysis was applied.  Thematic content analysis was also used for qualitative data.

RESULTS Conflict events Crossfire shootings (0.27) Close to bomb attack (0.17) Severely tortured (0.12) Being abducted (0.11) Seen dead bodies (0.421)

Current experiences  Recurrent thoughts about trauma (0.41)  Night mares (0.27)  Flashbacks (0.18)  Emotional upset (0.13)  Avoidance (0.32)  Overly alert (0.19)

Results  Social support (as measured by marital relations, extended family relations, parent child relations and extramarital relations) predicted PTSD ( r = -.137, p =.016 ). Indicated increased resilience  Personal growth (measured by emotions, emotional intelligence and self-confidence) also predicted PTSD (r = -.106, p =.076) Also indicated increased resilience.

Results……  Evaluating the association of resilience and trauma exposure with PTSD revealed main effects for combat exposure, lifetime trauma exposure, and resilience.  There was a significant (P <.05) interaction between combat exposure and resilience. Higher levels of resilience were particularly protective among individuals with high combat exposure.

Results…..  High rate of substance use (alcohol) (95%)among war veterans which predicts the presence of PTSD-associated symptoms.

Results...  After controlling for age, social status, trauma exposure, and PTSD diagnosis, resilience was uniquely associated with: decreased suicidality, reduced alcohol problems, lower depressive symptom severity, and fewer current health complaints and lifetime and recent medical problems.

Conclusions  These results suggest that resilience is a construct that plays a unique role in the occurrence of PTSD and severity of other functional correlates among former deployed soldiers.  Future studies in this area would benefit from a prospective design, the evaluation of other possible protective processes (e.g., social support), and specific examination of particular aspects of resilience.

Conclusions...  Trauma can have varied impact on individuals and communities. Knowledge of resilience and vulnerability factors can be of substantial benefit in the assessment and management of trauma victims.  Timely interventions can be done to optimise outcome. At present cognitive– behavioural therapy and group work can be effective.

Recommendations  There is a need to institute a counselling department to handle the high severity of psychological problems affecting the soldiers.  UPDF should partner with NGOs, and other agencies to design appropriate interventions to deal with trauma among war veterans.

Recommendations...  There is a need to put into consideration an issue of drug and substance abuse among soldiers which has for long been neglected.  There is a need to sensitize and mobilize war veterans to always seek for health care to resolve their issues instead of resorting to drugs.  Future studies should look at the number of events exposed to and the events perceived to be more traumatic.

Limitations  The small sample size undermined this study’s predictive power. The results must therefore be generalized with extreme caution.  The time lapse between the traumatic event and the first wave of measurement may have missed out on resilience-related processes such as recovery from symptoms among some of the participants.

References  American Psychological Association (2011)  Bonanno, G. A. (2004) Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Journal of Psychology, 59, 20–28.  Daud, A., Klinteberg, B. & Rydelius, PA. (2008). Resilience and vulnerability among refugee children of traumatised and non- traumatised parents. Child and Adolescent Psychiatric and Mental Health, 2(7),  Dent, R. J. & Cameron, S. (2003). Developing Resilience in Children who are in Public Care: the educational psychology perspective. Educational Psychology in Practice, 19(1), 3-19.

Acknowledgements  To my co-author Novatus Nyemara  Department of Psychology Bishop Stuart University  PCAF Organizing Committee

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