The Contribution of Exposure to Genocidal Violence and Resulting Psychopathology in the Empathic Capacities of Victims

Introduction: In the past 3-4 decades numerous published studies advancing evidence that exposure to violence extinguishes altogether prosocial behaviors and empathic responses. In April 1994, military and civilian members of the Hutu majority in Rwanda, Africa, who comprised 85% of the population, initiated a genocidal plan to exterminate the Tutsi minority. Over the next 100 days, some 800,000 Tutsi of all ages were slaughtered. Aspects of the social and psychological aftermath of catastrophic violence serve as the historical framework for this investigation. Methods: The study area comprises 17 contiguous cells, containing 132 villages, occupying roughly 88 square kilometers in the Huye district, South Province. Employing probability proportional to size (PPS) sampling, we selected 50 villages out of approximately 5000 from which to recruit 10 study subjects per village, resulting in a planned sample size of 500 individuals. Among participants, 40% were below age 35; 77% were female (a consequence of the disproportionate killing of males during the genocide; 20%, had no schooling; 92% reported exposure to one or more items on the war time checklist. The rate of probable PTSD was: 23.90% (95%CI 18.21-29.58). A substantial proportion of Rwandan adults suffer from MDE and PTSD with rates strongly associated with genocidal violence some 17 years prior. In addition to questions on basic sociodemographic characteristics of study subjects, the interview contained the following: a Trauma Checklist ,an eight item measure of experiences of severe violence and deaths during and in the early aftermath of the Genocide; symptoms of post-traumatic stress disorder to identify persons likely to meet diagnostic criteria for PTSD. Major depressive episodes were assessed with an instrument designed by WHO used widely in the global south. In anticipation of testing the validity of our notion of possible benefits arising from violence and distress, we selected and deployed a psychometrically sound measure of empathy and prosocial behaviors developed by Caprara and colleagues with use in the global south. Mean age of the sample was 41% of the sample was below age 35 (Table 1). Women comprised over 75% of those surveyed (owing to the disproportionate killing of males during the Genocide). Over 40% of respondents had no education beyond primary school; 45%, no monetary income in the preceding year preceeding the intervidew; about 20% were widowed; 60% were Catholic. A third of respondents w their water from public wells; 20% had no access to any type of toilet facilities. Results: The overall point prevalence rate of probable PTSD was 24% (95% CI 18.21-29.58); 30% of the sample was in a current episode of major depression. With both disorders, rates were lowest among persons under age 35; twice as high for women as for men; directly associated with rising levels of trauma exposure.