Psychobiological stress in South Sudan: Post-traumatic stress symptoms and emotion dysregulation during chronic political conflict

Abstract

AbstractBackgroundMass conflict and related displacement in South Sudan has created a significant mental health need, however extant research on the impact of conflict is limited among South Sudanese people and has predominantly relied on Western-developed self report measures.MethodA total of 195 South Sudanese adults who work in both civil society and government leadership positions participated in a psychophysiological assessment of heart rate variability and self-reported PTSD and emotion dysregulation symptoms to participation in the Trauma-Informed Community Empowerment (TICE) Framework, developed and implemented by the Global Trauma Project (GTP). We utilized measures of heart rate variability to determine sympathetic and parasympathetic activity, both of which may be associated with difficulties responding to stressors as well as long-term physical health morbidity and mortality.ResultsFindings suggest pervasive difficulties in emotion regulation abilities among all participants and, consistent with the existing literature on PTSD in South Sudan, over a third of participants meet the clinical cut-off for PTSD. The majority of participants’ physiological profiles indicate unexpected levels of parasympathetic and sympathetic nervous system activity given age and gender norms, demonstrating a sample with serious health risk. Participants within healthy parasympathetic norms report greater disturbance in emotion regulation abilities, while those in and above increasing concern levels report less distress, suggesting that parasympathetic activity may facilitate emotion regulation, albeit at risk of “overcompensating”.ConclusionsThese results demonstrate the feasibility and utility of using a multimethod approach to assessment in a community-based environment and highlight the psychophysiological burden of chronic socio-political strife.