Effect of Parenting and Social Support on PTSD Symptoms in Children who Experienced Upsetting Events

Charles Ingabire,¹ Lauren Ng,²  Catherine Kirk,² Vincent Sezibera,³ Theresa Betancourt^3-4

¹ Partners in Health Rwanda – Inshuti Mu Buzima, Rwinkwavu, Rwanda

² Francois Xavier Bagnoud Center for Health and Human Rights, Boston, USA

³ National University of Rwanda, Butare, Rwanda

⁴ Department Global Health and Population, Harvard School of Public Health, Boston, USA

ABSTRACT

Background: Families and communities often provide primary support to children who have experienced upsetting events. This may be particularly true in Rwanda where families face multiple stressors and mental health services are limited. This study analyzes the relationship between parenting and social support on posttraumatic stress disorder (PTSD) symptoms in children who experienced potentially traumatic events in Rwanda.

Methods: 681 HIV+, HIV-affected, and non-HIV-affected children aged 10-18, were interviewed (51.5% female, mean age 13.6). Children verbally completed the UCLA PTSD-RI assessing PTSD symptoms and upsetting events. Multiple linear regressions were run in which reporting an upsetting event and locally-adapted measures of parenting and social support predicted PTSD symptoms, after controlling for sex, age, and HIV stratification.

Results: 64.1% of children reported an event that continues to upset them. PTSD symptoms ranged from 0 to 22 (mean 7.23); only 17.7% reported no symptoms. Parenting and social support negatively predicted PTSD symptoms while age and reporting an upsetting event positively predicted symptoms (all p<.01).

Conclusions: Good parenting and social support may reduce PTSD symptoms in children who have experienced upsetting events. Interventions that strengthen parents, families, and communities may help children cope with multiple adversities.

Sezibera Bios

Vincent Sezibera, PhD

A Senior Lecturer in the Department of Psychology (Chairperson) at the National University of Rwanda (NUR) and an outpatient consultant and therapist at the NUR University Center for Mental Health, Dr. Sezibera specializes in PTSD and child and adolescent traumatic grief. His doctorate in psychology, from the Catholic University of Louvain, Belgium focuses on trauma and bereavement among young survivors of the 1994 genocide in Rwanda. 

A Rwanda national specialized in the field of clinical psychology; Dr. Sezibera has conducted different researches and developed some protocols aiming at the Post-Traumatic Stress Disorder (PTSD) and Complicated Grief (CG) treatment. Among the protocols, Dr. Sezibera developed a treatment protocol on rumination change and its effect on the PTSD prevalence. In the population of children and adolescents, Dr. Sezibera is developing the “Memory Box” method for healing bereaved and traumatized children. His ongoing research endeavors are oriented on the assessment of these treatment protocols’ effectiveness in the population of multi-traumatized survivors of the 1994 genocide against Tutsi in Rwanda. His teaching load is related to Psychopathology, Psychotherapies: Cognitive and Behavioral approach, Personality theories, Grief and Mourning, etc.

The spring and summer 2011, Dr. Sezibera was visiting as a Fulbright Scholar-in-Residence at TCSPP-Chicago and Harold Washington Community College. From August 2011 to date, Dr. Sezibera is a Part-Time Dissertation Affiliate Faculty in the International PhD Department, Associate Professor.

March 30-April 29, 2012; Dr. Sezibera was hosted at the Harvard School of Public Health, FXB Center for Health and Human Rights, as Research Associate where he delivered lectures and conferences related to his extensive research on Trauma and PTSD.

For contact:

E-mail: vsezibera@nur.ac.rw

Trauma, Resilience, and Vulnerability in Post-genocide Rwanda: A Qualitative Hypothesis-generating Study

  Carl F. Auerbach, Ph.D.; Vincent Sezibera, Ph.D.; Fabien Dushimirimana,, B.A; Moise Nkurunziza,, B.A., Isaïe Mihigo, B.A.

Yeshiva University and National University of Rwanda

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Abstract

This qualitative hypothesis-generating study examines trauma, resilience, and vulnerability in post-genocide Rwanda. The first study examined resilience in a purposive sample of 20 research participants. All the partisans had been young children during the genocide, and both of their parents had been killed during the genocide. The interviews were analyzed using a grounded theory procedure (Straus & Corbin, 1990), from which the following theoretical narrative emerged. (1) The loss and violence of the genocide shattered the participants’ assumptive world. (2) Based on their educational achievements, they developed a sense of self efficacy that allowed them to put their traumatic past behind them and develop a belief in a positive future. (3) Safety, provided by the policies of the Rwandan government, (4) Connection and mutual support, provided by AERG, and (5) Ability to regulate fear and anger, provided by their church organizations. A second study examined a vulnerable group, consisting of a convenience sample of 12 participants aged from 25 to 79. The following theoretical narrative emerged. (1) The violence and loss of the genocide shattered the participants’ assumptive world. (2) The participants did not feel protected by the Rwandan government. (3) The participants felt isolated from their neighbors, whom they viewed with suspicion. (4) The participants experienced PTSD symptoms triggered by events they associated with the genocide. These results provide guidelines for adapting existing quantitative trauma, resource, and resilience scales to a Rwandan context.

Incidence of depression in Epilepsy patients

 

ABSTRACT

Epilepsy and depression are frequent pathologies especially in the developing countries where the level of health facilities and the standards of living are very low.  Scholars have stated the relationship between epilepsy and depression but with less precision on symptoms and socio-demographic variables difference.

The study assessed the co-morbidity between the two different diagnostic entities, one neurologic (epilepsy) and the other psychiatric (depression).  From a purposive sample of 392 people consulting for epilepsy, only 105 patients whose EEG diagnosis was positive were recruited in accordance with the inclusion criteria. Screening for depression, the Hamilton Rating Scale for Depression (HRSD) was used for the depression prevalence assessment. Results from the study showed that epilepsy patients are likely to present with depression symptoms with significant odds for all symptoms like depressive mood, insomnia, work and activities poor performance, anxiety, and somatic symptoms. Patients with generalized seizure are likely to suffer from severe comorbid depression as compared to patients with partial seizure.

Epilepsy treatment should incorporate depression diagnosis and management to ensure better management of the epilepsy burden.

 

KEY WORDS: Depression, Epilepsy, morbidity, diagnosis, Rwanda