title: Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees.
abstract: BACKGROUND
  Political instability and the civil war in Southern Sudan have resulted in numerous atrocities, mass violence, and forced migration for vast parts of the civilian population in the West Nile region. High exposure to traumatic experiences has been particularly prominent in the Ugandan and Sudanese of the West Nile Region, representing an indication of the psychological strain posed by years of armed conflict.
  
  
  METHODS
  In this study the impact of traumatic events on the prevalence and severity of posttraumatic stress disorder (PTSD) in a random sample of 3.339 Ugandan nationals, Sudanese nationals, and Sudanese refugees (1.831 households) of the West Nile region is assessed.
  
  
  RESULTS
  Results show a positive correlation between the number of traumatic events and the number of endorsed PTSD symptoms. Of the 58 respondents who experienced the greatest number of traumatizing experiences, all reported symptoms which met the DSM-IV criteria for PTSD.
  
  
  CONCLUSIONS
  There is a clear dose-effect relationship between traumatic exposure and PTSD in the studied populations with high levels of traumatic events. In this context, it is probable that any individual could develop PTSD regardless of other risk-factors once the trauma load reaches a certain threshold.
authors.affiliation: Department of Psychology, University of Konstanz and Center for Psychiatry Reichenau, D-78457 Konstanz, Germany. Frank.Neuner@Uni-Konstanz.de
authors.forename: Frank
authors.initials: F
authors.lastname: Neuner
authors.forename: Maggie
authors.initials: M
authors.lastname: Schauer
authors.forename: Unni
authors.initials: U
authors.lastname: Karunakara
authors.forename: Christine
authors.initials: C
authors.lastname: Klaschik
authors.forename: Christina
authors.initials: C
authors.lastname: Robert
authors.forename: Thomas
authors.initials: T
authors.lastname: Elbert
mesh_terms: D000293:Adolescent; D000328:Adult; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012036:Refugees / Q000523:psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D012494:Sampling Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D013397:Sudan / Q000453:epidemiology; D014454:Uganda / Q000453:epidemiology; D014857:Warfare