The Impact of Posttraumatic Stress Symptoms Among Students Exposed to Multiple Forms of Lifetime Violence in Nyarugusu Refugee Camp in Tanzania

Background and Purpose

As of May 2023, over 13 million young refugees worldwide had been displaced due to violence, with approximately one in four residing in refugee camps. These young refugees often face mental health challenges stemming from exposure to various forms of violence, including emotional, physical, and sexual violence. Posttraumatic stress disorder (PTSD) is notably prevalent among refugee youth, persisting even years after resettlement, especially for those who have encountered frequent or multiple types of violence. However, research linking various forms of violence experienced in different settings to mental health issues remains scarce, particularly among students in humanitarian settings. Thus, this study aims to investigate the impact of exposure to multiple forms of lifetime violence on the severity of PTSD symptoms among students residing in the Nyarugusu refugee camp in Tanzania.

Methodology

This study utilized data from the 2018 Preventing Violence Against Children Survey (PVACS) study conducted in the Nyarugusu Refugee Camp in Tanzania. The sample size included 711 aged 11-27 nested in 27 school students within the camp. The association between the dependent variable (i.e., PTSD symptoms as measured continuously by Child PTSD Symptom Scale (CPSS), and independent variables (i.e., lifetime emotional violence, physical violence, sexual violence; and community violence, family violence, and school violence measured dichotomously as "yes or no") were examined using multiple linear regression. Covariates that included sex, age, country of origin, and social support were used as control variables. Data analyses were performed using SPSS vs.28.

Results

The average age of the students was 14.6 years old, 57.9% were males, were originally from Burundi (52.5%), and received social support (m=3.61) ranging from 0 to 5. Multiple linear regression results showed that age was positively associated with PTSD symptoms (B=0.44, p<.001), while social support was negatively associated with PTSD symptoms (B= -0.97, p<.001). This implies that as age increased, so did the PTSD symptoms. However, when social support decreased, the PTSD symptoms increased. Male students were more likely to report higher levels of PTSD symptoms compared to females. Congolese students were less likely to report higher levels of PTSD symptoms compared to Burundian students (B= -1.04, p<.048). Most importantly, students who experienced lifetime sexual violence (B= -1.04, p<.048), school violence (B= -1.04, p<.048)., and community violence (B= -1.04, p<.048) were more likely to report higher levels of PTSD symptoms compared to students who did not. Overall, all the independent variables accounted for 21% in explaining the variance of PTSD symptoms of the students.

Conclusions and Implications

Overall, this study indicated that the risk of PTSD was particularly higher for students exposed to lifetime sexual violence, school violence, and community violence. As such, this study underscores the need for humanitarian agencies in refugee camps to promote violence prevention interventions in both the community and schools, aiming to alleviate the risk of PTSD symptoms among vulnerable refugee students. Moreover, interventions should prioritize promoting education and awareness that center around minimizing cultural practices fostering violence among refugee families, schools, and communities in the Nyarugusu Refugee Camp.