Post-traumatic stress disorder among survivors of sexual violence in a hospital in Eastern DR Congo: Predictive factors, protectors, and comorbidities

Abstract

Objectives: This study investigates post-traumatic stress disorder (PTSD) among female victims of sexual violence in a conflict-affected region of eastern Democratic Republic of the Congo. PTSD is a mental health condition that can occur after traumatic experiences such as violence or sexual assault. It involves intense stress reactions, emotional instability, intrusive memories, and avoidance of trauma-related cues. Globally, about 5.6% of trauma-exposed individuals develop PTSD. Women are twice as likely as men to be affected. PTSD is linked to a 47% higher risk of mortality (odds ratio: 1.47; 95% confidence interval: 1.06–2.04). Its impact is especially severe in conflict-affected regions. The objective of this prospective analytical study was to determine both predictive and protective factors linked to PTSD and to examine associated psychiatric comorbidities, notably anxiety and depression. Material and Methods: Data were obtained using a structured questionnaire covering socio-demographic features, details of the sexual violence (type, frequency, and duration), and evaluation of PTSD with the PTSD checklist for DSM-5, employing a provisional diagnosis based on a threshold score of 38 and DSM-5 symptom criteria. Results: Among the 312 participants, factors that increased the risk of developing PTSD included being aged between 18 and 64, lacking formal education, working as a vendor, consuming tobacco, being pregnant at the time of the assault, and exposure to multiple perpetrators. In contrast, protective factors comprised being under 18 or 65 and older, having completed secondary education, engaging in agricultural work as a cultivator, refraining from tobacco use, not being pregnant, and having encountered a single aggressor. In addition, strong correlations emerged between PTSD, anxiety, and depression, while satisfaction with social support correlated negatively with anxiety and depression and positively with self-esteem. Conclusion: Overall, integrating affirmation techniques is essential for reinforcing resilience and establishing an appropriate, individualized care framework. These crucial findings provide invaluable guidance for future interventions.