Gender Differences in Traumatic Experiences and Posttraumatic Stress Symptoms After the Rwandan Genocide Against the Tutsi.

The effects of the 1994 Rwandan Genocide against the Tutsi are widespread and long-lasting, but little is known about how posttraumatic consequences differ regarding gender. In the present study, we estimated the associations between trauma exposure and posttraumatic stress symptoms (PTSS) in a Rwandan community sample and examined whether the associations differed by gender. The sample comprised 498 adults (75.2% women) living in Rwanda's Huye District in 2011. We used a validated self-report checklist to assess the eight most frequent traumatic experiences during the Genocide. The PTSD Checklist-Civilian version (PCL-C) was used to assess PTSS. Associations between trauma exposure and PTSS were estimated using structural equation modeling (SEM), with additional SEMs stratified by gender. The prevalence of exposure to each traumatic event ranged from 15.1% to 64.5%, with more severe PTSS among individuals who reported personal physical injury, ß = .76, 95% CI [0.54, 0.98]; witnessing sexual/physical violence against a loved one, ß = .51, 95% CI [0.20, 0.81]; a close relative/friend's death, ß = .54, 95% CI [0.24, 0.83]; property destruction, ß = .35, 95% CI [0.048, 0.51]; or a family member's death due to illness, ß = .21, 95% CI [0.00, 0.41]. Men who saw people killed and women who witnessed sexual/physical violence against a close family member reported elevated PTSS. The psychiatric impact of the Rwandan Genocide continues into the 21st century. Increased attention should be paid to the long-term and demographic patterns of distress and disorder, especially in the absence of widespread clinical mental health services.

Adherence to childhood religious affiliation and suicide intentions in women exposed to the violence of the 1994 Genocide against the Tutsi in Rwanda.

PURPOSE: To examine the association between adherence to childhood religious affiliations and serious suicide intentions in 371 women exposed to the 1994 Genocide against the Tutsi in Rwanda. METHODS: Participants were randomly sampled in 2011 from households in the Southern Province of Rwanda. Trained interviewers gathered information on socio-economic background, genocide-related trauma exposure, Major Depressive Episode (MDE) and suicide intentions (assessed with the Mini International Neuropsychiatric Interview), and Posttraumatic Stress Disorder (PTSD) (assessed with the PTSD Checklist-Civilian version). RESULTS: In this predominantly Christian sample, 62.8% (233/371) had adhered to their childhood religious affiliation. Adherence was associated with lower odds of serious suicide intentions (OR 0.321, 95% CI 0.13-0.78, P < 0.01) independent of socio-economic factors, court-designated victim status, trauma exposure, MDE, and PTSD; that association held following consideration of specific denomination. CONCLUSION: Women who adhere to their childhood religious affiliation may be less likely to have serious suicide intentions following major catastrophes. Whether that association is attributable to stronger connections with lost and remaining family and friends, or greater faith in the church as a facilitator of reconciliation and coping, requires further study.

The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C.

The factor structure of posttraumatic stress disorder (PTSD) symptoms in Euro-American populations has been extensively studied, but confirmatory factor analytic studies from non-Western societies are lacking. Alternative models of DSM-IV symptoms were tested among Rwandan adults (N=465) who experienced trauma during the 1994 genocide. A cluster random survey was conducted with interviews held in Rwandan households. PTSD was assessed with the Posttraumatic Stress Disorder Checklist-Civilian version. Competing models were the DSM-IV, emotional numbing, dysphoria, aroused intrusion, and dysphoric arousal models. Results showed that the emotional numbing, dysphoria, and dysphoric arousal models had almost identical, good fit indices and fit the data significantly better than the other models. The emotional numbing and dysphoric arousal models also exhibited good construct validity. Results suggest that the latent structure of PTSD symptoms in Rwanda are comparable to that found in Euro-American samples, thereby lending further support to the cross-cultural validity of the construct.