Fifty Years After Nigerian Civil War: Social Support Is Associated with PTSD Symptoms Through Increased Self-Efficacy Among Biafran Veterans

Abstract

The Nigerian Civil War (or Nigerian-Biafran War, 1967–1970) was fought between the Nigerian federal government and the defunct Republic of Biafra. Biafra recruited young men and boys (child soldiers) to fight the war, but little attention has been given to understanding the mental health outcomes of the War on Biafran veterans. Although there are few studies on social support in relation to post-traumatic stress disorder (PTSD) symptoms in this older veteran population, the mechanism through which social support influences PTSD has not received much attention. Hence, we investigated whether self-efficacy explains the association between social support and PTSD symptoms in a sample of Biafran War veterans. They were recruited from the Veterans’ association in south-east Nigeria (N = 250; M_age = 71.33 years, SD = 7.11), and completed self-report measures of social support, self-efficacy, and PTSD symptoms. Results showed that veterans with greater social support (β = −.49, p < .001) and high self-efficacy reported less PTSD symptoms (β = −.55, p < .001). Above all, social support predicted decreased PTSD symptoms risk through increased self-efficacy, 95% CI [−0.53, −0.29]. By implication, social support may be associated with lower PTSD symptoms because it enhances efficacy beliefs, and thereby leads to less PTSD symptoms.

Keywords

Biafran War outcome assessment self-efficacy social support trauma veterans

Get full access to this article

View all access options for this article.

References

Abada

Michael Omeh

Hezekiah Okoye

Remigius . (2020). Separatist agitation by the Indigenous People of Biafra (IPOB), and National Question in Nigeria. Journal of Public and International Affairs, 2(1), 9.

Abel

Sonter

F. S.

Dami

B. E.

Dagona

Z. K.

(2019). Combat exposure and self-efficacy predicting psychological distress among military personnel exposed to Boko-Haram insurgency: The moderating role of unit support. Open Access Journal of Addiction and Psychology, 2(2), 1–7. https://doi.org/10.33552/OAJAP.2019.02.000532

Adamek

M. E.

Chane

Kotecho

M. G.

(2020). Family and kin care of elders in sub-Saharan Africa. In Maharaj

(Ed.), Health and care in old age in Africa (pp. 61–77). Routledge.

American Psychiatric Association. (2013). Diagnostic and statistical manual for mental disorders (5th ed.).

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

Anongo

Abel

Dami

Ogbole

(2019). Post-deployment social support predicting successful adjustment among Nigerian military returnees from Boko-Haram Insurgency. Open Access Journal of Addiction and Psychology, 2(2), 1–6. https://doi.org/10.33552/OAJAP.2019.02.000533

Asogwa

(2010). The role of social support and gender on depression among retirees (Project report). Department of Psychology, University of Nigeria.

Atuonwu

C. I.

(2021). The role of age grade system in peace building in Ohafia. AIPGG Journal of Humanities and Peace Studies, 2(2), 1–22.

Ayodele

E. E.

(1998). Evaluation of correlates of mathematics anxiety [Unpublished MSc thesis, Department of Psychology, University of Lagos].

10.

Bandura

(1997). Self-efficacy: The exercise of control. Freeman.

11.

Bartone

P. T.

Roche

(2024). Sex differences in hardiness, coping, and health in new West Point cadets. Military Psychology, 36(5), 516–524. https://doi.org/10.1080/08995605.2023.2220643

12.

Benight

C. C.

Bandura

(2004). Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behaviour Research and Therapy, 42(10), 1129–1148. https://doi.org/10.1016/j.brat.2003.08.008

13.

Benight

C. C.

Harper

M. L.

(2002). Coping self-efficacy perceptions as a mediator between acute stress response and long-term distress following natural disasters. Journal of Traumatic Stress, 15(3), 177–186. https://doi.org/10.1023/A:1015295025950

14.

Blackburn

Owens

G. P.

(2015). The effect of self efficacy and meaning in life on posttraumatic stress disorder and depression severity among veterans. Journal of Clinical Psychology, 71(3), 219–228. https://doi.org/10.1002/jclp.22133

15.

Blais

R. K.

Tirone

Orlowska

Lofgreen

Klassen

Held

Stevens

Zalta

A. K.

(2021). Self-reported PTSD symptoms and social support in U.S. military service members and veterans: A meta-analysis. European Journal of Psychotraumatology, 12(1), 1851078. https://doi.org/10.1080/20008198.2020.1851078

16.

Bourne

(2015). Nigeria: A new history of a turbulent century. Bloomsbury Publishing.

17.

Brewin

C. R.

Andrews

Valentine

J. D.

(2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748–766. https://doi.org/10.1037/0022-006X.68.5.748

18.

Brown

A. D.

Kouri

N. A.

Rahman

Joscelyne

Bryant

R. A.

Marmar

C. R.

(2016). Enhancing self-efficacy improves episodic future thinking and social-decision making in combat veterans with posttraumatic stress disorder. Psychiatry Research, 242, 19–25. https://doi.org/10.1016/j.psychres.2016.05.026

19.

Canada

K. E.

Smith

A. J.

Peters

(2020). Mental health, social support, and coping among military veterans: The moderating role of arrests. Military Behavioral Health, 8(3), 265–273. https://doi.org/10.1080/21635781.2020.1742820

20.

Cervenka

(1972). A history of the Nigerian War 1967–1970. Onibonoje Press.

21.

Chen

Liu

Zhao

(2024). Impact of army morale on suicidal ideation: The mediating role of grit and the moderating role of social support in a Chinese Navy population. Military Psychology, 36(2), 148–157. https://doi.org/10.1080/08995605.2022.2151814

22.

Cohen

Wills

T. A.

(1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310

23.

Copeland

L. A.

Finley

E. P.

Rubin

M. L.

Perkins

D. F.

Vogt

D. S.

(2023). Emergence of probable PTSD among U.S. veterans over the military-to-civilian transition. Psychological Trauma: Theory, Research, Practice, and Policy, 15(4), 697–704. https://doi.org/10.1037/tra0001329

24.

Cribben

(2020, November 26). Delayed onset PTSD and VA disability benefits. CCK Law. https://cck-law.com/blog/delayed-onset-ptsd-va-disability-benefits/

25.

Dami

B. E.

Abel

Haruna

Samuel

(2018). Combat exposure and PTSD among military combatants in North East Nigeria. Journal of Psychology & Clinical Psychiatry, 9(4), 400. https://doi.org/10.15406/jpcpy.2018.09.00558

26.

Ebimgbo

S. O.

Atama

C. S.

Igboeli

E. E.

Obi-keguna

C. N.

Odo

C. O.

(2022). Community versus family support in caregiving of older adults: Implications for social work practitioners in South-East Nigeria. Community, Work & Family, 25(2), 152–173. https://doi.org/10.1080/13668803.2021.1926222

27.

Ellison

J. M.

Colvonen

P. J.

Haller

Norman

S. B.

Angkaw

A. C.

(2019). Examining the relation between PTSD and insomnia on aggression. Military Psychology, 31(3), 241–250. https://doi.org/10.1080/08995605.2019.1598220

28.

Erikson

(1950). Childhood and society (1st ed.). Norton.

29.

Ezenagu

(2017). Leadership styles in the management of Igbo cultural heritage in pre-European era. OGIRISI: A New Journal of African Studies, 13, 22–45. https://doi.org/10.4314/og.v13i1.2

30.

Ezeokana

Bernard

Nnedum

Dare

(2011). Influence of traumatization and category of “Biafran–Nigerian” civil war veterans on posttraumatic stress disorder (PTSD) among war survivors. Journal of Basic and Applied Scientific Research, 1(10), 1480–1483.

31.

Fatunmole

(2022, October 22). Brain drain: Number of psychiatrists in Nigeria drops from 300 in 2021 to 200. Retrieved May 7, 2022, from https://www.icirnigeria.org/brain-drain-number-of-psychiatrists-in-nigeria-drops-from-300-in-2021-to-200/

32.

Forsyth

(2015). The Biafra story: The making of an African legend. Penguin Books.

33.

Gaba

(2008, September). Map of the secessionist state of the Republic of Biafra (1967–1970) as in May 1967. Retrieved on June 13, 2024, from https://commons.wikimedia.org/wiki/File:Biafra_independent_state_map-en.svg

34.

Gettings

R. D.

Kirtley

Wilson-Menzfeld

Oxburgh

G. E.

Farrell

Kiernan

M. D.

(2022). Exploring the role of social connection in interventions with military veterans diagnosed with post-traumatic stress disorder: Systematic narrative review. Frontiers in Psychology, 13, 873885. https://doi.org/10.3389/fpsyg.2022.873885

35.

Hayes

A. F.

(2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3rd ed.). Guilford Press.

36.

Hong

Mreydem

H. W.

Abou Ali

B. T.

Saleh

N. O.

Hammoudi

S. F.

Lee

Ahn

Park

Hong

Suh

Chung

(2022). Mediation effect of self-efficacy and resilience on the psychological well-being of Lebanese people during the crises of the COVID-19 pandemic and the Beirut explosion. Frontiers in Psychiatry, 12, 733578. https://doi.org/10.3389/fpsyt.2021.733578

37.

Hou

Zhang

Song

Zhang

Cai

Liu

Dong

Deng

(2020). Self-efficacy and fatigue among non-frontline health care workers during COVID-19 outbreak: A moderated mediation model of posttraumatic stress disorder symptoms and negative coping. PLoS One, 15(12), e0243884. https://doi.org/10.1371/journal.pone.0243884

38.

Bentler

P.M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.

39.

Ifeagwazi

C. M.

Abiama

E. E.

Chukwuorji

J. C.

(2012). Self-reported mental health status of a sample of Biafran war veterans. International Journal of Research in Arts and Social Sciences, 4, 176–189.

40.

Ifeagwazi

C. M.

Chukwuorji

J. C.

(2013). Self-esteem and age as predictors of mental health among Biafran war veterans and nonveterans. International Journal of Communication, 15, 207–222.

41.

Ifeagwazi

C. M.

Chukwuorji

J. C.

(2015). Influence of social support on posttraumatic stress disorder symptoms among disabled and non-disabled Biafran War Veterans. International Journal of Research in Arts and Social Sciences, 8(1), 192–204.

42.

Ikezue

C. E.

Ezeah

(2017). Recurrent conflicts among migrant fulani herdsmen and indigenous communities of southern Nigeria: A review of literature. International Journal of Health and Social Inquiry, 3(1), 331.

43.

Jeste

D. V.

Pender

V. B.

(2022). Social determinants of mental health: Recommendations for research, training, practice, and policy. JAMA Psychiatry, 79(4), 283–284. https://doi.org/10.1001/jamapsychiatry.2021.4385

44.

Jukić

Lukinac

A. M.

Požgain

Talapko

Jukić

Filaković

(2020). The role of perceived social support in assessing posttraumatic stress disorder and mental health-related quality of life in veterans. Healthcare, 8(4), 396. https://doi.org/10.3390/healthcare8040396

45.

Kamdar

Khan

Brostow

D. P.

Spencer

Roy

Sisson

Hundt

N. E.

(2023). Association between modifiable social determinants and mental health among post-9/11 veterans: A systematic review. Journal of Military, Veteran and Family Health, 9(3), 8–26. https://doi.org/10.3138/jmvfh-2022-0025

46.

Kanu

I. A.

(2015, November 25). Igwebuike as an Igbo-African philosophy of education. 4th International Conference on Law, Education and Humanities (ICLEH’15), November 25-26, 2015 Paris, France.

47.

Keeling

Barr

Atuel

Castro

C. A.

(2020). Symptom severity, self-efficacy and treatment-seeking for mental health among US Iraq/Afghanistan military veterans. Community Mental Health Journal, 56(7), 1239–1247. https://doi.org/10.1007/s10597-020-00578-8

48.

Keen

S. M.

Kutter

C. J.

Niles

B. L.

Krinsley

K. E.

(2008). Psychometric properties of PTSD Checklist in sample of male veterans. The Journal of Rehabilitation Research and Development, 45(3), 465–474. https://doi.org/10.1682/JRRD.2007.09.0138

49.

King

Taft

King

Hammond

Stone

(2006). Directionality of the association between social support and posttraumatic stress disorder: A longitudinal investigation. Journal of Applied Social Psychology, 36, 2980–2992. doi: 10.1111/j.00219029.2006.00138.x

50.

Lakey

Cohen

(2000). Social support and theory. In Cohen

Underwood

L. G.

Gottlieb

B. H.

(Eds.), Social support measurement and intervention: A guide for health and social scientists (pp. 29–52). Oxford University Press.

51.

LaRocca

M. A.

Scogin

F. R.

Hilgeman

M. M.

Smith

A. J.

Chaplin

W. F.

(2018). The impact of posttraumatic growth, transformational leadership, and self-efficacy on PTSD and depression symptom severity among combat veterans. Military Psychology, 30(2), 162–173. https://doi.org/10.1080/08995605.2018.1425073

52.

Larsen

S. E.

(2023). PTSD and the family [general information]. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/professional/treat/specific/ptsd_family.asp

53.

Lawson

N. R.

(2014). Posttraumatic stress disorder in combat veterans. JAAPA, 27(5), 18. https://doi.org/10.1097/01.JAA.0000446228.62683.52

54.

Levin

Nenninger

Freundlich

Glatt

Sokol

(2024). How future self-continuity mediates the impact of job loss on negative mental health outcomes among transitioning veterans. Military Psychology, 36(5), 491–503.https://doi.org/10.1080/08995605.2023.2215697

55.

Liu

Jia

Liu

Zhai

(2023). Peer victimization and subjective well-being among Chinese adolescents: Moderated mediation by forgiveness and self-esteem. Journal of Interpersonal Violence, 38(11–12), 7355–7382. https://doi.org/10.1177/08862605221145721

56.

MacEachron

Gustavsson

(2012). Peer support, self-efficacy, and combat-related trauma symptoms among returning OIF/OEF veterans. Advances in Social Work, 13(3), Article 3. https://doi.org/10.18060/2391

57.

Mahoney

C. T.

Lynch

S. M.

Benight

C. C.

(2021). The indirect effect of coping self-efficacy on the relation between sexual violence and PTSD symptoms. Journal of Interpersonal Violence, 36(21–22), 9996–10012. https://doi.org/10.1177/0886260519881525

58.

Mastrocola

S. S.

Flynn

D. P.

(2017). Peer emotional support, perceived self-efficacy, and mental health morbidities among student-veterans at a public university. The Journal of Continuing Higher Education, 65(3), 187–198. https://doi.org/10.1080/07377363.2017.1368776

59.

Matthieu

M. M.

Carbone

J. T.

(2020). Collective action among US veterans: Understanding the importance of self-efficacy, collective efficacy, and social support. Journal of Community Psychology, 48(6), 1985–1996. https://doi.org/10.1002/jcop.22397

60.

Mirchandani

(2021). The relationship among social support, self-efficacy and resilience. The International Journal of Indian Psychology, 9(3), 1560–1576. https://doi.org/10.25215/0903.144

61.

Morison

Benight

C. C.

(2022). Trauma coping self-efficacy mediates associations between adult attachment and posttraumatic stress symptoms. Frontiers in Psychology, 13, 799608.

62.

Mota

Tsai

Kirwin

P. D.

Harpaz-Rotem

Krystal

J. H.

Southwick

S. M.

Pietrzak

R. H.

(2016). Late-life exacerbation of PTSD symptoms in us veterans: Results from the National Health and Resilience in Veterans Study. The Journal of Clinical Psychiatry, 77(3), 10211. https://doi.org/10.4088/JCP.15m10101

63.

Nanavati

H. D.

Arevalo

Memon

A. A.

Lin

(2023). Associations between posttraumatic stress and stroke: A systematic review and meta-analysis. Journal of Traumatic Stress, 36(2), 259–271. https://doi.org/10.1002/jts.22925

64.

National Center for PTSD. (2018, February 22). DSM-5 criteria for PTSD. https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp

65.

Nilaweera

Phyo

A. Z. Z.

Teshale

A. B.

Htun

H. L.

Wrigglesworth

Gurvich

Freak-Poli

Ryan

(2023). Lifetime posttraumatic stress disorder as a predictor of mortality: A systematic review and meta-analysis. BMC Psychiatry, 23(1), 229. https://doi.org/10.1186/s12888-023-04716-w

66.

Norris

F. H.

Baker

Murphy

Kaniasty

(2005). Social support mobilization and deterioration after Mexico’s 1999 flood: Effects of context, gender, and time. American Journal of Community Psychology, 36, 15–28. https://doi.org/10.1007/s10464-005-6230-9

67.

Norris

F. H.

Kaniasty

(1996). Received and perceived social support in times of stress: A test of the social support deterioration deterrence model. Journal of Personality and Social Psychology, 71, 498–511. https://doi.org/10.1037/0022-3514.71.3.498

68.

Nwangwu

(2023). Neo-Biafra separatist agitations, state repression and insecurity in south-east, Nigeria. Society, 60(1), 40–53. https://doi.org/10.1007/s12115-022-00782-0

69.

Nwaubani

A. T.

(2020). Remembering Nigeria’s Biafra war that many prefer to forget—BBC News [News]. British Broadcasting Corporation (BBC News). https://www.bbc.com/news/world-africa-51094093

70.

Obuekwe

J. A. O.

(2015). The Umunna experience to dispute resolution in traditional Africa: The Igbo experience. In Ifechukwu

J. M.

Okenimkpe

(Eds), Proceedings of international conference on conceptualizing African approach management 2000 (pp. 197–210). University of Lagos, Nigeria.

71.

Oghojafor

B. E. A.

Alaneme

G. C.

Kuye

O. L.

(2013). Indigenous management thoughts, concepts and practices: The case of the Igbos of Nigeria. https://ir.unilag.edu.ng/handle/123456789/6303

72.

Ojo

J. S.

Oyewole

Aina

(2023). Forces of terror: Armed banditry and insecurity in North-west Nigeria. Democracy and Security, 19, 319–346. https://doi.org/10.1080/17419166.2023.2164924

73.

Okechukwu

C. E.

(2020). Shortage of psychiatrists: A barrier to effective mental health-care delivery in Nigeria. International Journal of Noncommunicable Diseases, 5, 22–23. https://doi.org/10.4103/jncd.jncd_1_20

74.

Okwuosa

Nwaoga

C. T.

Uroko

(2021). The post-war era in Nigeria and the resilience of Igbo communal system. Jàmbá, 13(1), 1–12. https://doi.org/10.4102/jamba.v13i1.867

75.

Oyeweso

(1992). Perspectives on the Nigerian civil war. Campus Press Ltd.

76.

Oyewole

Aina

Ojo

J. S.

(2022). Wings over flies. The RUSI Journal, 167(4–5), 92–103. https://doi.org/10.1080/03071847.2022.2153076

77.

Ozer

E. J.

Best

S. R.

Lipsey

T. L.

Weiss

D. S.

(2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129(1), 52–73. https://doi.org/10.1037/0033-2909.129.1.52

78.

Pietrzak

R. H.

Johnson

D. C.

Goldstein

M. B.

Malley

J. C.

Southwick

S. M.

(2009). Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom. Depression and Anxiety, 26(8), 745–751. https://doi.org/10.1002/da.20558

79.

Plake

B. S.

Parker

C. S.

(1982). The development and validation of a revised version of the Mathematics Anxiety Rating Scale. Educational and Psychological Measurement, 42(2), 551–557. https://doi.org/10.1177/001316448204200218

80.

Pollmann

J. B.

Nielsen

A. B. S.

Andersen

S. B.

Karstoft

K.-I.

(2022). Changes in perceived social support and PTSD symptomatology among Danish army military personnel. Social Psychiatry and Psychiatric Epidemiology, 57(7), 1389–1398. https://doi.org/10.1007/s00127-021-02150-5

81.

Possemato

McKenzie

McDevitt-Murphy

M. E.

Williams

J. L.

Ouimette

(2014). The relationship between postdeployment factors and PTSD severity in recent combat veterans. Military Psychology, 26(1), 15–22. https://doi.org/10.1037/mil0000027

82.

Proescher

Aase

D. M.

Passi

H. M.

Greenstein

J. E.

Schroth

Phan

K. L.

(2022). Impact of perceived social support on mental health, quality of life, and disability in post–9/11 U.S. military veterans. Armed Forces & Society, 48(1), 115–135. https://doi.org/10.1177/0095327X20919922

83.

Russell

D. W.

Benedek

D. M.

Naifeh

J. A.

Fullerton

C. S.

Benevides

Ursano

R. J.

Russell

C. A.

Forsten

R. D.

Cacciopo

J. T.

(2016). Social Support and mental health outcomes among U.S. Army special operations personnel. Military Psychology, 28(6), 361–375. https://doi.org/10.1037/mil0000114

84.

Sarason

B. R.

Sarason

I. G.

Gurung

R. A. R.

(2001). Close personal relationships and health outcomes: A key to the role of social support. In Sarason

B. R.

Duck

(Eds.), Personal relationships: Implications for clinical and community psychology (pp. 15–41). John Wiley & Sons Ltd.

85.

Sarason

I. G.

Levine

H. M.

Basham

R. B.

Vamp

Sarason

B. R.

(1983). Social support theory, research and application. Martinus Njihoff Publishers.

86.

Sarason

I. G.

Sarason

B. R.

(Eds.). (1985). Social support: Theory, research and applications. Martinus Nijhoff Publishers.

87.

Schwarzer

Knoll

(2007). Functional roles of social support within the stress and coping process: A theoretical and empirical overview. International Journal of Psychology, 42, 243–252. https://doi.org/10.1080/00207590701396641

88.

Sheehy

K. A.

Hruska

Waldrep

E. E.

Pacella-LaBarbara

M. L.

George

R. L.

Benight

C. C.

Delahanty

D. L.

(2023). The mediating role of coping self-efficacy on social support and PTSD symptom severity among injury survivors. Anxiety, Stress & Coping, 36, 770–780. https://doi.org/10.1080/10615806.2023.2199208

89.

Sherer

Maddux

J. E.

Mercandante

Prentice-Dunn

Jacobs

Rogers

R. W.

(1982). The Self-Efficacy Scale: Construction and validation. Psychological Reports, 51(2), 663–671. https://doi.org/10.2466/pr0.1982.51.2.663

90.

Shirley

D. M.

Metz

A. J.

Hinkson

K. D.

Jr. Drake-Brooks

M. M.

Taylor

J. M.

Artman

S. E.

Burningham

Bryan

C. J.

(2022). Academic performance of college student servicemembers and veterans: The influence of emotion regulation, self-efficacy, and PTSD symptom severity. Journal of Veterans Studies, 8(1), 86–203. https://doi.org/10.21061/jvs.v8i1.314

91.

Shorr

(2021). Posttraumatic stress disorder in Biafra war survivors [PhD, The Chicago School of Professional Psychology]. ProQuest Dissertations and Theses. https://www-proquest-com-s.web.bisu.edu.cn/docview/2519671068/abstract/66253618D34E4F5APQ/1

92.

Smith

A. J.

Benight

C. C.

Cieslak

(2013). Social support and postdeployment coping self-efficacy as predictors of distress among combat veterans. Military Psychology, 25(5), 452–461. https://doi.org/10.1037/mil0000013

93.

Smith

A. J.

Felix

E. D.

Benight

C. C.

Jones

R. T.

(2017). Protective factors, coping appraisals, and social barriers predict mental health following community violence: A prospective test of social cognitive theory. Journal of Traumatic Stress, 30(3), 245–253. https://doi.org/10.1002/jts.22197

94.

Solomon

Mikulincer

(1990). Life events and combat-related posttraumatic stress disorder: The intervening role of locus of control and social support. Military Psychology, 2(4), 241–256. https://doi.org/10.1207/s15327876mp0204_4

95.

Tamunomiete

D. S.

(2006). Prevalence and functional impairment in PTSD among Nigerians [MSc thesis, Department of Psychology, University of Nigeria, Nsukka].

96.

Thomas

M. L.

Kaufmann

C. N.

Palmer

B. W.

Depp

C. A.

Martin

A. S.

Glorioso

D. K.

Thompson

W. K.

Jeste

D. V.

(2016). Paradoxical trend for improvement in mental health with aging: A community-based study of 1,546 adults aged 21–100 years. The Journal of Clinical Psychiatry, 77(8), e1019–e1025. https://doi.org/10.4088/JCP.16m10671

97.

Tsai

Harpaz-Rotem

Pietrzak

R. H.

Southwick

S. M.

(2012). The role of coping, resilience, and social support in mediating the relation between PTSD and social functioning in veterans returning from Iraq and Afghanistan. Psychiatry: Interpersonal and Biological Processes, 75(2), 135–149. https://doi.org/10.1521/psyc.2012.75.2.135

98.

Uchendu

(2007). Recollections of childhood experiences during the Nigerian civil war. Africa, 77(3), 393–418. https://doi.org/10.3366/afr.2007.0063

99.

Uwaegbute

K. I.

Nweze

S. N.

Chukwuma

O. G.

(2022). “May God bless Nnamdi Kanu wherever he is”: Biafran separatist nationalism in Nigeria and the emerging roles of Igbo Christian leaders. African Studies Quarterly, 21(3), 21–38.

100.

Weathers

F. W.

Litz

B. T.

Herman

D. S.

Huska

J. A.

Keane

T. M.

(1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Presented at the Annual Convention of the International Society for Traumatic Stress Studies, San Antonio, TX, United States.

101.

Webermann

A. R.

Dardis

C. M.

Iverson

K. M.

(2022). The role of general self-efficacy in intimate partner violence and symptoms of posttraumatic stress disorder among women veterans. Journal of Traumatic Stress, 35(3), 868–878. https://doi.org/10.1002/jts.22794

102.

Welsh

J. A.

Olson

J. R.

Perkins

D. F.

(2019). Gender differences in post-deployment adjustment of air force personnel: The role of wartime experiences, unit cohesion, and self-efficacy. Military Medicine, 184(1–2), e229–e234. https://doi.org/10.1093/milmed/usy261

103.

Hou

Lin

Yan

Zhang

Liang

Yang

Zhang

Lang

(2022). Exploring links between Chinese military recruits’ psychological stress and coping style from the person-environment fit perspective: The chain mediating effect of self-efficacy and social support. Frontiers in Psychology, 13, 996865.

104.

Xue

Tang

Liu

Kang

Wang

Zhang

(2015). A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. PLoS One, 10(3), e0120270. https://doi.org/10.1371/journal.pone.0120270

105.

Xue

(2023). Childhood Sexual abuse and associated suicidal ideation and attempts among gay and bisexual men in China: A moderated mediation model. Journal of Interpersonal Violence, 38(3–4), 2881–2909. https://doi.org/10.1177/08862605221104528

106.

Zalta

A. K.

Tirone

Orlowska

Blais

R. K.

Lofgreen

Klassen

Held

Stevens

N. R.

Adkins

Dent

A. L.

(2021). Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis. Psychological Bulletin, 147(1), 33–54. https://doi.org/10.1037/bul0000316

107.

Zhou

Bai

Fan

(2021). Impacts of internet-based interventions for veterans with PTSD: A systematic review and meta-analysis. Frontiers in Psychology, 12, 711652.