Militancy and children’s Post Traumatic Stress Disorder (PTSD): Experiences from Nigeria

Okala Agwu Uche; Ijeoma Blessing Uche

doi:10.1921/swssr20242255

Authors

Okala Agwu Uche Department of Social Work, and Institute of Social Policy, University of Nigeria, Nsukka https://orcid.org/0000-0003-1959-8236
Ijeoma Blessing Uche Department of Social Work, University of Nigeria, Nsukka https://orcid.org/0000-0003-1959-8236

DOI:

https://doi.org/10.1921/swssr20242255

Keywords:

children, mental health, militancy, post traumatic stress disorder, PTSD, trauma, Africa

Abstract

Armed violence is significantly associated with mental stress among those who are affected by it. The experience tends to be extreme for children, who as soft targets are very prone to suffer a combination of physical harm and mental torture even beyond childhood. To provide more evidence about this, the current study investigated the effects of militancy on the experience and prevalence of post-traumatic stress disorder among children in Imo State, Nigeria. In-depth interviews were used to obtain information from 16 respondents. A purposive sampling technique was employed to select children affected by militancy-related post-traumatic stress disorder, as well as adults, who helped with triangulating the responses of the children. Findings revealed that post-traumatic stress disorder among children included the experiences of anxiety, lack of concentration, violent nightmares, loss, displacement and disruption of daily life routine. Despite limited access to mental health services, traditional methods were commonly used to address post-traumatic stress disorder. Hence, the need to incorporate cultural perspectives into mental health interventions, emphasizing the need for culturally attuned approaches to address the mental well-being of affected children. Caregivers such as psychologists, guidance counselors, psychiatrists, school administrators, and social workers can link, advocate and collaborate with relevant authorities to establish accessible and culturally sensitive mental health services in the community.

Author Biographies

Okala Agwu Uche, Department of Social Work, and Institute of Social Policy, University of Nigeria, Nsukka

Okala A. Uche is a Senior Lecturer in the Department of Social Work and Institute of Social Policy all in University of Nigeria, Nsukka (UNN). He holds a PhD in Social Work and Community Development from the Department of Social Work, UNN. His research interests are mainly on Social Work, Community Development, Social Policy, Corrections in Social Work, Medical Social Work and other -related social issues.

Ijeoma Blessing Uche, Department of Social Work, University of Nigeria, Nsukka

Ijeoma B. Uche is a Senior Lecturer and a researcher in the Department of Social Work, University of Nigeria, Nsukka. She holds a Ph.D in Social Work (Corrections). Her research interests include Correction in Social Work, Community development, Medical Social Work, and other- related social issues

References

Abdullahi, M. M. & Abdul-Qadir, A. U. (2017). Insurgency, militancy and achieving sustainable development in Africa: Experience from Nigeria. Global Journal of Sociology: Current Issues. 7(2), 76-89. https://doi.org/10.18844/gjs.v7i2.1279

Adetula, V. A. O. (2014). African conflicts, development and regional organisations in the post-cold war international system. The Annual Claude Ake Memorial Lecture Uppsala, Sweden 30 January 2014. https://www.diva-portal.org/smash/get/diva2:799520/FULLTEXT04

Agbiboa, D. E. (2013). The Ongoing Campaign of Terror in Nigeria: Boko Haram versus the State. Stability, International Journal of Security & Development, 2(3), 52: 1-18

Agwu, P. O. (2023). Strengthening social work services in the health sectors of Low- and Middle-Income Countries: Taking lessons from social work actions/inactions in Covid-19 response in Nigeria. Social Work and Social Sciences Review, 24, 71-76. (Commentary)

Allwood MA, Bell-Dolan D, Husain SA (2002) Children’s trauma and adjustment reactions to violent and nonviolent war experiences. Journal of American Academic Child Adolescent Psychiatry 41(4) 450-457

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC, USA.

Amnesty International. (2021). Annual Report 2020/2021: The State of the World’s Human Rights. April 7, 2021 Index Number: POL 10/3202/2021. https://www.amnesty.org/en/documents/pol10/3202/2021/en/

Betancourt, T.S., & Khan, K.T. (2008). The mental health of children affected by armed conflict: Protective processes and pathways to resilience. International Review of Psychiatry, 20(3), 317-328.

Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis, qualitative research in sport. Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806

Calitz, F. J. W., de Jongh, N. J., Horn, A.; Nel, M. I., Joubert, G. (2014). Children and adolescents treated for post-traumatic stress disorder at the Free State Psychiatric Complex. South African Journal of Psychology, 20(1), 15-20.

CARE International (2023). ‘70% of those killed in Gaza are women and children”. https://www.care-international.org/news/70-those-killed-gaza-are-women-and-children-care-warns-un-security-council

Catani, C. (2018). Mental health of children living in war zones: a risk and protection perspective, World Psychiatry, 17(1): 104–105.

Chuku, C., D. A., & I. Isip (2017), Growth and fiscal consequences of terrorism in Nigeria, Working Paper Series N° 284, African Development Bank, Abidjan, Côte d’Ivoire

Clark, M. (2024). Relationships and a relational understanding in mental health research: Building on the legacy of Peter Huxley. Social Work & Social Sciences Review 25(1)4-15. https://doi.org/10.1921/swssr.v25i1.2292

Cresswell, J. W. (2013). Qualitative inquiry & research design: Choosing among the five approaches. SAGE Publication Inc.

Dami, B. E., James, A., Zubairu, D., Karick, H. & Dakwak, S. (2018). Combat exposure and PTSD among military combatants in North East Nigeria. Journal of Psychology and Clinical Psychiatry, 9(4), 400 – 404.

Dibia, I. I. (2021). The effects of terrorism on peace and national development in Nigeria. Journal of Public Administration, Finance and Law, 10(22), 315-338

Foa, E. B., Rothbaum, B. O. (1998). Treating the trauma of rape: A cognitive-behavioral therapy for PTSD. Guilford Press.

Freh, F. M. (2015). Psychological effects of war and violence on children. Journal of Psychological Abnormalities, 1, 1–2. https://doi.org/10.4172/jpab.S1-e001

Freh, F. M., Chung, M. C., Dallos, R. (2013). In the shadow of terror: Post traumatic stress and psychiatric co-morbidity following bombing in Iraq: The role of shattered world assumptions and altered self-capacities. Journal of Psychiatric Research 47(2), 215-225. https://doi.org/10.1016/j.jpsychires.2012.10.008

Human Rights Watch. (2018). World Report 2018: Events of 2017. https://www.hrw.org/world-report/2018

International Crisis Group. (2020). Violence in Nigeria’s North West: Rolling back the mayhem (Africa Report No. 288). https://www.crisisgroup.org/sites/default/files/288-violence-in-nigerias-north-west_0.pdf

Inyang, B. (2018). Militancy and youth restiveness in the Niger Delta Region of Nigeria. African Research Review, 12(4), 65-76.

Jamshed, S. (2014). Qualitative research method-interviewing and observation. Journal of Basic and Clinical Pharmacy, 5(4), 87-88. https://doi.org/10.4103/0976-0105.141942

Jeremiah, S. O., Zamani, A., Nwota, O. & Omoregie, B. (2022). Impact of militancy on education and economic security in Niger Delta region of Nigeria. World Journal of Advanced Research and Reviews, 16(2), 292–299.

Jordans, M. J., Ventevogel, P., Komproe, I. H., & Tol, W. A. (2013). Mental health care in children affected by political violence. Journal of Child Psychology and Psychiatry, 54(4), 348-366.

Kaminer, D., Seedat, S. & Stein, D. J. (2005). Post-traumatic stress disorder in children. World Psychiatry, 4(2), 121-125.

Khamis V (2012). Impact of war, religiosity and ideology on PTSD and psychiatric disorders in adolescents from Gaza Strip and South Lebanon. Social Science & Medicine 74(12) 2005-2011.

Khan, A. & Khan, N. (2019). Historical Causes of Militancy and Its Impacts on Educational Institutions in the World. International Journal of African and Asian Studies, 58, 20-31.

Kirmayer, L. J., & Pedersen, D. (2014). Toward a new architecture for global mental health. Transcultural Psychiatry, 51(6), 759-776.

Kirmayer, L. J., Sehdev, M., Whitley, R., Dandeneau, S., & Isaac, C. (2011). Community resilience: Models, metaphors and measures. International Journal of Indigenous Health, 7(1), 62-117.

Kletter, H., Rialon, R. A., Laor, N., Brom, D., Pat-Horenczyk, R., Shaheen, M., Hamiel, D., Chemtob, C., Weems, C. F., Feinstein, C., Lieberman, A., Reicherter, D., Song, S. & Carrion, V. G. (2013). Helping children exposed to war and violence: Perspectives from an international work group on interventions for youth and families. Child Youth Care Forum, 42(4), 371–388. https://doi.org/10.1007/s10566-013-9203-4

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.

Li, Y., Zhou, Y., Chen, X., Fan, F. Musa, G. & Hoven, C. (2020). Post-Traumatic Stress Disorder in children and adolescents: Some recent research findings. In I. J. Lobera (eds.). Psychosomatic Medicine. https://doi.org/10.5772/intechopen.92284

Masten, A. S., Narayan, A. J., Silverman, W. K., & Osofsky, J. D. (2015). Children in war and disaster. In M. H. Bornstein, T. Leventhal, & R. M. Lerner (Eds.), Handbook of child psychology and developmental science: Ecological settings and processes (7th ed., pp. 704–745). John Wiley & Sons, Inc..

Moghadam, A., Berger, R. & Beliakova, P. (2014). Say terrorist, think insurgent: Labeling and analyzing contemporary terrorist actors. Perspectives on Terrorism, 8(5), 2-17 https://www.jstor.org/stable/26297258

Munisamy, Y., & Elze, D.E. (2020). Trauma-Informed Social Work Practice with Children and Youth. In: Ow, R., Poon, A. (eds) Mental Health and Social Work (pp. 283-310). Social Work. Springer, Singapore. https://doi.org/10.1007/978-981-13-6975-9_10

Nosè M, Ballette F, Bighelli I, Turrini G, Purgato M, Tol W, Priebe, S. & Barbui, C. (2017). Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high- income countries: Systematic review and meta- analysis. PLoS ONE 12(2): e0171030. https://doi.org/10.1371/journal.pone.0171030

Odalonu, B. H. & Obani, E. F. (2018). The impact of militancy, insurgency and forced displacement on Nigerian economy. International Journal of Research and Innovation in Social Science (IJRISS) 2(10), 1-8.

Olofsson E, Bunketorp O, Andersson A. (2009). Children and adolescents injured in traffic –associated psychological consequences: A literature review. Acta Paediatrica 98(1)17-22. http://dx.doi.org/10.1111/j.1651-2227.2008.00998.x

Panter-Brick, C., Grimon, M.P., & Eggerman, M. (2014). Caregiver-child mental health: A prospective study in conflict and refugee settings. Journal of Child Psychology and Psychiatry, 55(4), 313—327. https://doi.org/10.1111/jcpp.12167

Patel, V., & Goodman, A. (2007). Researching protective and promotive factors in mental health. International Journal of Epidemiology, 36(4), 703-707. https://doi.org/10.1093/ije/dym147

Patel, V., & Saxena, S. (2014). Transforming lives, enhancing communities—Innovations in global mental health. New England Journal of Medicine, 370(6), 498-501. https://doi.org/10.1056/NEJMp1315214.

Ritchie, J., Lewis, J., Nicholls, C. M., & Ormston, R. (Eds.). (2018) Qualitative research practice: A guide for social science students and researchers (Second ed.). SAGE.

Saraceno, B., van Ommeren, M., Batniji, R., Cohen, A., Gureje, O., Mahoney, J., Sridhar, D. & Underhill, C. (2007). Barriers to improvement of mental health services in low-income and middle-income countries. The Lancet, 370(9593), 1164-1174. https://doi.org/10.1016/S0140-6736(07)61263-X.

Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H. & Jinks, C. (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality and Quantity, 52(4), 1893-1907. https://doi.org/10.1007/s11135-017-0574-8.

Shahar G, Cohen G, Grogan K. E., Barile, J. P, & Henrich, C. C. (2009) Terrorism-related perceived stress, adolescent depression, and social support from friends. Pediatrics, 124: (2):e235-240. https://doi.org/10.1542/peds.2008-2971

Shavaki, S. A., Harandy, T. F., Rahimzadeh, M. & Pourabbasi, A. (2020). Factors related to behavioral functioning in mothers of children with Type 1 diabetes: Application of Transactional Model of Stress and Coping. International Journal of Endocrinology and Metabolism, 18(2): e74356. https://doi.org/10.5812/ijem.74356. PMID: 32636882; PMCID: PMC7322561.

Sousa, C. & Veronese, G. (2022). No safe place”: Applying the transactional stress and coping model to active warfare, Psychological Trauma: Theory, Research, Practice and Policy, 14(4), 558-567. https://doi.org/10.1037/tra0001023

Tol, W.A., Song, S., & Jordans, M.J.D. (2011). Annual research review: Resilience and mental health in children and adolescents living in areas of armed conflict - a systematic review of findings in low- and middle-income countries. Journal of Child Psychology and Psychiatry, 52(4), 445-460.

Turner-Halliday, F., Watson, J., & Boyce, P. (2018). Implementing trauma-informed care in a child and adolescent mental health service: A randomized controlled trial. Journal of Trauma & Dissociation, 19(4), 419-433.

United Nations Development Programme. (2016). Socio-Economic Impact Assessment of the Ebola Virus Disease in West Africa, August 1, 2016. https://www.undp.org/africa/publications/socio-economic-impact-ebola-virus-disease-west-africa

United Nations. (2018). Deputy Secretary-General’s Briefing to the Security Council on the Activities of Boko Haram and the situation in the Lake Chad Basin. 22 March, 2018 https://www.un.org/sg/en/content/deputy-secretary-general/statement/2018-03-22/deputy-secretary-generals-briefing-the-security-council-the-activities-of-boko-haram-and-the-situation-the-lake-chad-basin-prepared-for-delivery.

Wang, Y., Chung, M. C., Wang, N., Yu, X., Kenardy, J. (2021). Social support and post traumatic stress disorder: A meta-analysis of longitudinal studies. Clinical Psychology Review, 85: 101998.

Woodgate, R. L., Gonzalez, M. & Tennent, P. (2023). Accessing mental health services for a child living with anxiety: Parents’ lived experience and recommendations. PLoS ONE 18(4): e0283518. https://doi.org/10.1371/journal.pone.0283518