Despite the established relationship between Post-Traumatic Stress Disorder (PTSD) and depression in Western cultures, research concerning the prevalence rates and relationship between the comorbid disorders in Non-Western communities remains sparse. The present study explored the relationship between PTSD and comorbid depression in citizens currently living in Ghana, West Africa. Ghanaian Nationals (n=140) completed the PTSD and demographic sections of the Structured Clinical Interview for the DSM-IV (SCID-I), as well as the Center for Epidemiological Studies Depression Scale (CES-D). Both measures were administered through interview format. Results revealed a lower prevalence rate of PTSD than expected. Further analysis demonstrated that meeting the diagnostic criteria for PTSD increased the chance of meeting the diagnostic criteria for depression, as well as increased depression scores. To confirm that the prevalence rates found in this study were reflective of actual cases of depression (not measurement error) a scale reliability analysis was conducted on the CES-D. The results of this analysis confirmed internal consistency. Results suggest that although the prevalence rate of PTSD was low, a relationship is present between the disorders in a non-Western sample. The reliability of the measures means that PTSD and depression were assessed for, but what is not certain is whether the actual construct of the disorders could occur differently in a non-Western sample, causing a different presentation of symptoms. Future research is needed to examine the Western construct of PTSD and depression to determine if there is a different presentation of symptoms not accounted for by Western measures. / Department of Psychological Science

Culture is important to an individual’s understanding of traumatic events and the symptoms that ensue after such events. Cultural understandings also inform how individuals cope with the traumatic stress symptoms they experience. A great deal is known about the understanding of traumatic experiences and effective coping mechanisms used in Western cultures, but non-Western cultures are generally understudied. Valuable lessons are learnt from conducting studies with understudied non-Western cultures. The research sought to explore and describe the culturally informed conceptions of traumatic experience and coping strategies in one such understudied population - the Mole-Dagbon of Ghana. The research used a qualitative exploratory descriptive interpretive methodology. Purposive nonprobability sampling was used to gain access to individuals who could comment on the knowledge objectives of the study. Data was collected using focus group discussions with cultural leaders, and semi-structured interviews with traumatized individuals. All interviews were audio-recorded, transcribed, translated and analyzed using interpretive phenomenological analysis. The findings indicated that traumatic experiences and the coping strategies are influenced by a number of cultural factors. Participants’ understanding of traumatic experiences and symptoms relied heavily on normative traditional African cultural understandings, but explanations also utilized monotheistic (from Islam and Christianity) worldviews. It was also evident that not all explanations were purely spiritual and events and symptoms were also explained using a natural/scientific framework. Some aspects of this system indicated parallels with the Western cognitive understanding of traumatic stress symptoms. The Mole-Dagbon did not focus naturally on explaining the events and symptoms and in the current sample such explanations were often deferred to authoritative individuals in the society (especially the soothsayers from the Traditional African Religion). However, there was an easy focus on coping with the symptoms after a traumatic event and in this last aspect there was a great degree of agreement between participants. A clear hierarchy of coping emerged with community and family social support being considered the most important aspect. Irrespective of religious affiliation, individuals also considered a visit to the soothsayer and completing prescribed rituals as important in the process. Even where an individual did not wish to include this practice from African Traditional Religion because of religious affiliation, they acknowledged the existence and effectiveness of these practices. Finally, it was thought important that a traumatized individual consult a religious leader for counselling (again irrespective of the actual religion). While there were elements of cognitive understanding and a recognition of counselling by religious leaders, Western based treatment modalities were not mentioned as options for the treatment of the symptoms of PTSD. Practitioners that come into contact with the Mole-Dagbon may need to use collaborative treatment strategies that respects and utilizes cultural treatment strategies for PTSD. One interesting element that needs further exploration is whether the cognitive understandings of the Mole-Dagbon can be used in a cognitive therapeutic paradigm. Even though these cognitive appraisals are present in explaining symptoms, there are no direct cultural remedies that rely on them.