Trauma Exposure and Its Association With Mental Health Outcome and Psychosocial Wellbeing among Residents and Idps in Axum During the Northern Ethiopian Conflict.
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Date
2026
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Addis Ababa Uinverstiy
Abstract
Traumatic events have a well-established impact on mental health which often leads
to psychological distress and impairment. However, in the context of the northern
Ethiopian conflict (November 2020–November 2022 G.C), the mental health
consequences for affected communities particularly in Axum is not studied well.
Objectives:
This study assessed the association of trauma exposure with mental health outcomes
and psychosocial well-being among residents and IDPs in Axum during the northern
Ethiopian conflict.
Methods:
A community-based cross-sectional study was conducted in August 2025 with 515
participants (340 permanent residents and 175 internally displaced persons) selected
through multi-stage systematic sampling. Data were collected using standardized
instruments, including the Harvard Trauma Questionnaire (HTQ), GHQ-12, WASSS,
HESPER, Brief COPE, and the Oslo Social Support Scale, all translated into Tigrigna.
Multiple linear regression analysis was used to identify factors associated with PTSD
severity.
Results:
Trauma exposure was nearly universal (99.8%), with 54% of participants reporting
eight or more traumatic events. The prevalence of probable PTSD was 41.9%, and
74.6% reported significant psychological distress. Functional impairment due to
emotional distress was reported all or most of the time by 31.5% of participants.
Culturally recognized symptoms such as hopelessness, inability to help others, and
meaning-making struggles were showed the strongest statistical association with
PTSD severity (β = 0.586, p < 0.001). Social support was poor in 77.5% of participants.
Avoidant coping was strongly associated with worse outcomes (β = 0.191, p < 0.001),
whereas emotion-focused coping showed a protective effect. Internally displaced
persons had significantly higher PTSD scores than permanent residents. Food related
problem (67.6%) and inadequate shelter (59.0%) were the most frequently reported
serious needs.
Conclusions:
The findings show a considerable burden of trauma and significant mental health
consequences among the study population in Axum. Culturally recognized
symptoms of distress are found to be fundamental to the expression of distress
and require specific focus in both assessment and intervention. Any community
interventions should include psychosocial care and address basic needs assessment
and prioritize internally displaced populations.
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Keywords
Cultural symptoms of trauma, Northern Ethiopian conflict, trauma, psychological distress, IDPs.