@article {5301, title = {Exposure to war crimes and implications for peace building in northern Uganda}, journal = {JAMA}, volume = {298}, number = {5}, year = {2007}, note = {Vinck, Patrick
Pham, Phuong N
Stover, Eric
Weinstein, Harvey M
eng
Research Support, Non-U.S. Gov{\textquoteright}t
2007/08/02 09:00
JAMA. 2007 Aug 1;298(5):543-54. doi: 10.1001/jama.298.5.543.}, month = {Aug 1}, pages = {543-54}, abstract = {CONTEXT: Since the late 1980s, the Lord{\textquoteright}s Resistance Army has waged war against the Ugandan People{\textquoteright}s Democratic Army and the people of northern Uganda. Ending the conflict and achieving peace have proven to be challenges. In this context, it is important to examine population-based data on exposure to war crimes to understand how survivors perceive mechanisms aimed at achieving a lasting peace. OBJECTIVES: To assess the level of exposure to war-related violence and the prevalence of posttraumatic stress disorder (PTSD) and depression symptoms in northern Uganda and to determine how these variables are associated with respondents{\textquoteright} views about peace. DESIGN, SETTING, AND PARTICIPANTS: Multistage, stratified, random cluster survey of 2585 adults aged 18 years or older conducted in villages and camps for internally displaced persons in 4 districts of northern Uganda in April and May 2005. MAIN OUTCOME MEASURES: Rates and patterns of exposure to trauma; symptom criteria for PTSD, assessed via the PTSD Checklist-Civilian Version with a total severity score of 44; symptoms of depression, assessed via the Johns Hopkins Depression Symptom Checklist with a cutoff of 42; and opinions and attitudes about peace. RESULTS: Among the respondents, 1774 of 2389 (74.3\%) met PTSD symptom criteria and 1151 of 2585 (44.5\%) met depression symptom criteria. Four patterns of exposure to trauma were distinguished: those with low exposure (group 1; 21.4\%), witnesses to war-related violence (group 2; 17.8\%), those threatened with death and/or physically injured (group 3; 16.4\%), and those abducted (group 4; 44.3\%). Respondents in groups 3 and 4, who experienced the most traumatic exposures, were more likely to have PTSD symptoms compared with group 1 (group 3 vs group 1: odds ratio [OR], 7.04 [95\% confidence interval {CI}, 5.02-9.87]; group 4 vs group 1: OR, 6.07 [95\% CI, 4.77-7.71]). Groups 3 and 4 were also more likely to meet depression symptom criteria (group 3 vs group 1: OR, 5.76 [95\% CI, 4.34-7.65]; group 4 vs group 1: OR, 4.00 [95\% CI, 3.16-5.06]). Respondents who met the PTSD symptom criteria were more likely to identify violence as a means to achieve peace (OR, 1.31; 95\% CI, 1.05-1.65). Respondents who met the depression symptom criteria were less likely to identify nonviolence as a means to achieve peace (OR, 0.77; 95\% CI, 0.65-0.93). CONCLUSIONS: Our study found high prevalence rates for symptoms of PTSD and depression in a conflict zone. Respondents reporting symptoms of PTSD and depression were more likely to favor violent over nonviolent means to end the conflict.}, keywords = {*Attitude, *Warfare, Adult, Combat Disorders/*epidemiology/psychology, Depression/*epidemiology/psychology, Female, Humans, Male, Prevalence, Stress Disorders, Post-Traumatic/*epidemiology/psychology, Survivors/*psychology/statistics \& numerical data, Uganda, War Crimes/psychology/*statistics \& numerical data}, isbn = {1538-3598 (Electronic)
0098-7484 (Linking)}, author = {Vinck, P. and Pham, P. N. and Stover, E. and Weinstein, H. M.} }