Narrative exposure therapy for post-traumatic stress disorder and appetitive aggression among soldiers retiring from active service in Uganda

Abstract Background: Narrative exposure therapy (NET) is a form of treatment for trauma disorders, particularly in individuals suffering from complex and multiple traumas. It is an evidence-based trauma-focused therapeutic approach designed to help individuals process and manage experiences of trauma, especially in the context of cumulative or complex trauma. Information on the effectiveness of narrative exposure therapy in managing post-traumatic stress disorder and appetitive aggression among retiring soldiers is limited. This study aimed to determine the effectiveness of narrative exposure therapy as a form of treatment for post-traumatic stress disorder (PTSD) and appetitive aggression (AA) among soldiers retiring from active service in Uganda. Methods : An interventional study was conducted among 70 retired Uganda People’s Defence Forces (UPDF) soldiers who had earlier been screened for post-traumatic stress disorder (PTSD) and appetitive aggression at Gaddafi Barracks in Jinja District, eastern Uganda, in preparation for retirement. At baseline, participants underwent narrative exposure therapy comprising eight 90-minute sessions delivered biweekly over four months. Sessions were conducted either at nearby barracks or within participants’ homes or community settings after retirement. Following completion of the four-month intervention period, participants were reassessed for PTSD and AA at endline. Results : Mean PTSD scores decreased from 19.96 (SD = 15.00) at baseline to 13.93 (SD = 8.96) at endline, representing a mean reduction of 6.04 points. This reduction was statistically significant, t (55) = 3.57, p < .001, indicating a significant decline in PTSD symptom severity following the intervention. Similarly, mean appetitive aggression scores decreased from 34.11 (SD = 6.59) at baseline to 10.39 (SD = 4.09) at endline, representing a mean reduction of 23.71 points. This reduction was statistically significant, t (58) = 20.29, p < .001, indicating a substantial decrease in appetitive aggression following narrative exposure therapy. Conclusion : Narrative exposure therapy demonstrated effectiveness in reducing symptoms of post-traumatic stress disorder and appetitive aggression among retiring soldiers in Uganda. These findings support consideration of integrating narrative exposure therapy into the UPDF retirement process prior to community reintegration.