Mental health of victims of sexual violence in eastern Congo: associations with daily stressors, stigma, and labeling.

An Verelst,Maarten De Schryver,Ilse Derluyn,Eric Broekaert

doi:10.1186/1472-6874-14-106

Abstract

BackgroundThe conflict-ridden context of eastern Congo has set the scene for grueling human rights violations, with sexual violence as one of the ‘weapons of war’. Currently, sexual violence continues, with a considerable increase in civilian perpetrators. However, little is known regarding the particular impact of different experiences of sexual violence on adolescents’ mental health. This study therefore investigates the impact of sexual violence on eastern Congolese adolescents’ mental health and its differing associations with daily stressors, stigma, and the labeling of sexual violence (as ‘rape’ or ‘non-consensual sexual experience’).MethodsA cross-sectional, population-based survey design was implemented in 22 secondary schools, randomly selected from a stratified sample, in Bunia, eastern Congo, a region extensively affected by war. A total of 1,305 school-going adolescent girls aged 11 to 23 participated. Self-report measures of mental health symptoms, war-related traumatic events, experiences of sexual violence, daily stressors, and stigmatization were administered. Differences in sociodemographic characteristics, traumatic experiences and daily and social stressors between types of sexual violence (rape, non-consensual sexual violence, no sexual violence) were explored through statistical analysis. ANCOVA analyses investigated associations between those risk factors and adolescents’ mental health.ResultsMore than one third of eastern Congolese adolescent girls reported experiences of sexual violence. Elevated levels of daily stressors, experiences of stigmatization, and stressful war-related events were found amongst girl victims of sexual violence, with the highest levels for girls who labeled the sexual violence as rape. Daily stressors, stigmatization, and war-related events showed a large impact on the girls’ mental health. Last, girls who labeled the sexual violence as non-consensual sexual experiences reported more post-traumatic hyper-arousal and intrusion symptoms compared to those labeling the sexual violence as rape.ConclusionsThese findings point to the important association between how war-affected adolescent girls label sexual violence (rape or non-consensual sexual experiences) and their mental health. This study also documents the large impact of sexual violence on other stressors (daily stressors, stigmatization, and stressful war events) and the impact of these stressors on girl victims’ mental health. It discusses important implications for addressing sexual violence and its consequences in war-affected contexts.

Highlights

The conflict-ridden context of eastern Congo has set the scene for grueling human rights violations, with sexual violence as one of the ‘weapons of war’
A considerable increase in sexual violence perpetrated by civilians and in sexual violence against minors [16,17] has been observed in these regions, with various reports and studies alluding to a ‘normalization’ or ‘civilization’ of rape in eastern Congo [5]
The results showed that girls who labeled their experiences as rape had a considerably higher risk of reporting daily stressors compared to adolescent victims of non-consensual sexual violence

Summary

Introduction

The conflict-ridden context of eastern Congo has set the scene for grueling human rights violations, with sexual violence as one of the ‘weapons of war’. While officially the signing of peace agreements has brought the armed conflict in eastern Congo to an end, eastern Congolese communities perceive their region as remaining in a continuous state of war, with ongoing sexual violence as one of the principal indicators [2]. These evolutions call for a broader perspective on sexual violence in these warring contexts, since the singular discourse of ‘rape as a weapon of war’ systematically neglects other forms of sexual violence, such as domestic sexual violence and sexual violence perpetrated by civilians [2,18]

Methods

Results

Discussion

Conclusion