Post Traumatic Stress Disorder – A Northern Uganda Clinical Perspective

Abstract

Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition, which develops after a person experiences, witnesses, is confronted with or hears about emotionally stressful and painful experiences beyond what a human being can bear. The traumatic event may be life threatening; threatens body integrity and causes considerable fear, horror and a sense of helplessness in the affected individual (APA, 1992). Traumatic events are psychologically wounding to the individual and leave deep scars (Anonymous, 2009; and Tonks, 2007) on trauma victims; they are dehumanising, demoralising and humiliating, and may put an abrupt end to the hopes and plans of an otherwise enterprising individual, as the individual loses the sense of the future (Bardin, 2005) as one of the clinical features of post-traumatic stress disorder. The experience of traumatic stress in the history of human kind is perhaps not new and was probably limited to the processes of survival in pre-historic times. However with civilization and modernization the nature scope and experience of traumatic stress has become more complex and sophisticated in terms of clinical significance, individual perception and interpretation of the traumatic experience, and public health importance. In Uganda the nature of traumatic stress ranges from natural events including road traffic accidents, industrial accidents, domestic accidents, floods, landslides and occasional earth tremors to manmade traumatic events such as orchestrated domestic violence, child abuse and neglect, and organized violence and war, the most recent of which took place from 1986 to 2009. In recent times there has been an upsurge of child abductions for human sacrifice in Uganda, and this has been extremely traumatizing to affected families and relatives. War is of particular significance as it is manmade, is associated with significant mental health problems (Murthy & Lakshminarayana, 2006), causes more suffering, deaths and disability within the same time unit than an epidemic, and imposes considerable economic and social burden on communities (Murray et al, 2002). The psychological and psychiatric consequences of traumatic experience have been the subject of initial disagreement and debate in the international literature. However the personal accounts of victims of violence and war as detailed by Judith L. Herman (1997) in her book on trauma; and client accounts