Effects of potential traumatic events (PTE) contributing to post traumatic stress disorder (PTSD) six years after cessation of war among populations in northern Sri Lanka: An analysis of a follow-up study from a nationwide sample

The study aims were firstly to identify potential traumatic events (PTE) and stressors faced by the population in the districts of Northern Sri Lanka exposed to the decades-long conflict and secondly to predict Post Traumatic Stress Disorder (PTSD) based on conceptually derived composites of the PTE. https://www.editorialmanager.com/SSMMH/ Data for this study were collected in 2015. The sample consisted of 1526 individuals in northern Sri Lanka who were all exposed to the prolonged war and who had all previously participated in a baseline study in 2014. Four composites of PTEs were identified: extreme violence; traumatic losses; exposure to conflict and ongoing stressors. The data were analyzed using path analysis and mediation models. The results revealed that these stressors explained 40% of the variance in PTSD. The direct path from “extreme violence” had the highest effect on PTSD, even six years after exposure. Mediation analysis identified that ongoing stressors mediated the relationship of exposure to conflict with PTSD, lending support to the “daily stressors” model among internally displaced persons (IDPs). The results suggest that early specific intervention will benefit those exposed to extreme violence and broader Mental Health and Psychosocial Support (MHPSS) approaches f or ongoing stressors to reduce mental distress of this population. • Potential traumatic events (PTE) of populations exposed to war and conflict can be categorized into conceptually similar composites for analysis. • This large study of a representative sample from northern Sri Lanka found evidence • That the composite of “extreme violence’ has the strongest association with post-traumatic stress disorder (PTSD). • Specific interventions for those exposed to extreme violence are indicated in addition to interventions for ongoing stressors.