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Symptoms of post-traumatic stress disorder, severe psychological distress, explosive anger and grief amongst partners of survivors of high levels of trauma in post-conflict Timor-Leste

Published online by Cambridge University Press:  29 September 2016

D. M. Silove ,
A. K. Tay ,
Z. Steel ,
N. Tam ,
Z. Soares ,
C. Soares ,
N. dos Reis ,
A. Alves  and
S. Rees
D. M. Silove
Affiliation:
Academic Mental Health Unit and Ingham Institute, University of New South Wales and South Western Sydney Local Health District, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, NSW 2170, Australia
A. K. Tay
Affiliation:
Academic Mental Health Unit and Ingham Institute, University of New South Wales and South Western Sydney Local Health District, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, NSW 2170, Australia
Z. Steel
Affiliation:
St John of God Richmond Hospital, School of Psychiatry, University of New South Wales, North Richmond, NSW 2754, Australia
N. Tam
Affiliation:
Academic Mental Health Unit and Ingham Institute, University of New South Wales and South Western Sydney Local Health District, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, NSW 2170, Australia
Z. Soares
Affiliation:
Alola Foundation, Dili, Timor-Leste
C. Soares
Affiliation:
Alola Foundation, Dili, Timor-Leste
N. dos Reis
Affiliation:
Alola Foundation, Dili, Timor-Leste
A. Alves
Affiliation:
Alola Foundation, Dili, Timor-Leste
S. Rees*
Affiliation:
Academic Mental Health Unit and Ingham Institute, University of New South Wales and South Western Sydney Local Health District, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, NSW 2170, Australia
*
*Address for correspondence: S. Rees, Psychiatry Research and Teaching Unit, University of New South Wales, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, NSW 2170, Australia. (Email: [email protected])
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Abstract

Background

Little is known about the mental health of partners of survivors of high levels of trauma in post-conflict countries.

Method

We studied 677 spouse dyads (n = 1354) drawn from a community survey (response 82.4%) in post-conflict Timor-Leste. We used culturally adapted measures of post-traumatic stress disorder (PTSD), psychological distress, explosive anger and grief.

Results

Latent class analysis identified three classes of couples: class 1, comprising women with higher trauma events (TEs), men with intermediate TEs (19%); class 2, including men with higher TEs, women with lower TEs (23%); and class 3, comprising couples in which men and women had lower TE exposure (58%) (the reference group). Men and women partners of survivors of higher TE exposure (classes 1 and 2) had increased symptoms of explosive anger and grief compared with the reference class (class 3). Women partners of survivors of higher TE exposure (class 2) had a 20-fold increased rate of PTSD symptoms compared with the reference class, a pattern that was not evident for men living with women exposed to higher levels of trauma (class 1).

Conclusions

Men and women living with survivors of higher levels of trauma showed an increase in symptoms of grief and explosive anger. The manifold higher rate of PTSD symptoms amongst women living with men exposed to high levels of trauma requires replication. It is important to assess the mental health of partners when treating survivors of high levels of trauma in post-conflict settings.

Keywords

Angergriefpost-conflictpost-traumatic stress disordertrauma
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 1 , January 2017 , pp. 149 - 159
Copyright
Copyright © Cambridge University Press 2016 

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