As the Islamic State of Iraq and Syria (ISIS) stormed Iraq and attempted to conquer the country in 2014, its members committed genocide against the Yazidi population, a Kurdish religious minority. Men were systematically executed. Women were captured, forced into sexual slavery and repeatedly raped, beaten, sold and locked away.
What are the long-term psychological effects of the conditions these women endured? Following severe trauma, people may develop post-traumatic stress disorder (PTSD).
Recently, specific diagnostic criteria were suggested for another psychiatric disorder following trauma, i.e., complex post-traumatic stress disorder (C-PTSD). Whereas PTSD typically occurs following a single traumatic event, C-PTSD is typically associated with prolonged trauma where one's destiny is under another's control and escape – from captivity, for example -- is unfeasible.
As opposed to PTSD, which can be triggered by trauma reminders, C-PTSD is conceived to be a more deeply-rooted disorder that affects the very core of one's self-organization.
A comprehensive study led by Bar-Ilan University researchers and published in World Psychiatry showed that a very high percentage of female Yazidi former ISIS captives suffered from C-PTSD (>50%) in addition to others with PTSD (23%).
The women, all in their twenties, were surveyed over a two-month period in four refugee camps.
"This main finding of over 50% C-PTSD prevalence cannot be emphasized enough, as PTSD and C-PTSD require different therapeutic interventions," says Dr. Yaakov Hoffman, of the Interdisciplinary Department of Social Sciences at Bar-Ilan University, who led the study. Focusing solely on PTSD interventions is inadequate. With that in mind, the Bar-Ilan University team is planning to set up a training program for Kurdish mental health workers.
Another important finding of the research is the greater sensitivity of victims with C-PTSD to post-ISIS conditions. Although ISIS no longer poses a threat to them, they still feel less safe than others, and their current living conditions may exacerbate their symptoms.
Hoffman therefore emphasizes that "NGO's working with such victims need to be particularly sensitive not only to the unique Yazidi culture but also to the creation of an environment that is perceived by the former captives as protective, both on objective and subjective levels."
This study required extensive cooperation between three different countries (Israel, Germany and Kurdistan) by a multidisciplinary group from psychology, psychiatry, life sciences, brain science, Arabic, and communications.
In addition to the Bar-Ilan group leading the study, the team included authors from Ariel and Haifa Universities, as well as researchers from Luftbrücke Irak, Germany and the Erbil Psychiatric Hospital/Emma Organization for Human Development in Kurdistan.
The authors are further advancing Israeli-Kurdish academic cooperation both in the formation of suitable training programs, as well as conducting additional research designed to illuminate basic issues relevant to interventions on the ground.