Trauma exposure, posttraumatic stress disorder, resilience and posttraumatic growth among refugees in Kyaka II settlement, Western Uganda

Abstract

Uganda is a leading refugee host country in Sub-Saharan Africa. Whereas some refugees show remarkable resilience amidst various adversities before, during, and after flight from their home countries, others suffer post trauma challenges such as PTSD. In some contexts, positive outcomes following exposure to, and actual consequences of traumatic events have been reported, but in Uganda there is a dearth of research on posttraumatic growth among refugees. In this paper, we sought to examine the relationship between trauma exposure, posttraumatic stress disorder, resilience and posttraumatic growth among refugees in Kyaka II settlement in Uganda. A cross sectional correlational study involving 181 participants, 100 females, employed standardized researcher administered questionnaires to measure Trauma exposure, PTSD, Resilience and PTG. Data were analyzed using SPSS: Pearson’s correlations and PROCESS macro for the serial mediation (direct and indirect paths). Refugees reported exposure to various traumatic events. Majority of participants showed severe to very severe levels of PTSD (66.3%); low resilience (64.1%) and low PTG (96.6%). Trauma exposure was negatively associated with PTG and resilience while positively associated with PTSD. In the serial mediation model, trauma exposure significantly predicted lower resilience (b = -0.30, SE = 0.06, p < .001) and higher PTSD (b = 0.30, SE = 0.07, p = .0001), as well as lower PTG (b = -0.61, SE = 0.11, p < .001). Resilience was associated with lower PTSD (b = -0.87, SE = 0.09, p < .001) and higher PTG (b = 0.83, SE = 0.11, p < .001), while PTSD was negatively associated with PTG (b = -0.53, SE = 0.07, p < .001). All indirect paths in the mediation model were statistically robust. After controlling for relevant demographic covariates, education level significantly predicted PTG. The majority of refugees still experience high levels of PTSD symptoms several years after settling in Uganda, indicating the pervasive impact of trauma on their wellbeing. Recommendations include culturally sensitive and effective trauma focused interventions as well as comprehensive accessible community mental health services to restore normal functioning, build resilience and PTG for the affected refugees.