Researchers found that the prevalence of Post-Traumatic Stress Disorder (PTSD) remains high nearly two decades after the principal conflict in Liberia and five years after war in Liberia ended entirely.
Researchers at Columbia University's Mailman School of Public Health assessed the geographical distribution of the long-term burden of PTSD in the region.
Particularly interesting was the geographic distribution of PTSD.
Investigators found that certain villages in the region had a much higher prevalence of PTSD than did others.
When they compared to the historical record about the path of the violent civil conflict that Nimba County experienced from 1989 to 1990 the team found that these were villages that had experienced the greater burden of war.
"This suggests that there is much more to the aftermath of conflict than a 'path of blood' and that populations who are unfortunate enough to have been in the 'path of trauma' experiencing severe, violent conflict are likely to bear a burden of psychopathology for decades thereafter," said Dr. Sandro Galea, the study's first author.
Galea observed that the pattern of conflict and psychopathology is even more remarkable, when considering that so many in the sample were very young during the period of these events and did not themselves experience some of the traumatic events firsthand.
Overall the study also found a very high prevalence of PTSD.
"Our demonstration of a high prevalence of PTSD here is not surprising and is consistent with a recent nationally representative survey in Liberia showing that 44% of respondents in the general population reported symptoms consistent with PTSD," said Galea.
"We believe that the prolonged and high prevalence of PTSD is consistent with the greater burden of war experienced in Nimba County as compared with some other parts of the country.
"To put this in perspective, according to the lifetime prevalence of PTSD in the United States, studies suggest that more than one third of all PTSD after traumatic experiences resolves in the first six months after such events," noted Galea.
The investigators based their findings on a representative survey of the population in post-conflict Nimba County, Liberia, combined with a historical analysis.
Following 14 years of civil war in the Republic of Liberia, more than 250,000 lives were lost and more than one-third of the population was displaced.
The study has been published in the American Journal of Public Health.