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Social Science & Medicine  Volume 75, Issue 3, August 2012, Pages 548–554  Haunted by ghosts: Prevalence, predictors and outcomes of spirit possession experiences among former child soldiers and war-affected civilians in Northern Uganda

Frank Neunera, , , Anett Pfeifferb, Elisabeth Schauer-Kaiserb, Michael Odenwaldc, Thomas Elbertc, Verena Ertla

a Bielefeld University, Department of Psychology, Postbox 100131, 33501 Bielefeld, Germany

b Vivo Uganda, Gulu, Uganda

c University of Konstanz, Konstanz, Germany

Available online 21 April 2012

Phenomena of spirit possession have been documented in many cultures. Some authors have argued that spirit possession is a type of psychopathology, and should be included as a category in diagnostic manuals of mental disorders. However, there are hardly any quantitative studies that report the prevalence of spirit possession on a population level and that provide evidence for its validity as a psychopathological entity.

In an epidemiological study that was carried out in 2007 and 2008 with N = 1113 youths and young adults aged between 12 and 25 years in war-affected regions of Northern Uganda we examined the prevalence, predictors and outcomes of cen, a local variant of spirit possession.

Randomly selected participants were interviewed using a scale of cen, measures of psychopathology (PTSD and depression) as well as indicators of functional outcome on different levels, including suicide risk, daily activities, perceived discrimination, physical complaints and aggression.

We found that cen was more common among former child soldiers then among subjects without a history of abduction. Cen was related to extreme levels of traumatic events and uniquely predicted functional outcome even when the effects of PTSD and depression were controlled for.

Our findings show that a long-lasting war that is accompanied by the proliferation of spiritual and magical beliefs and propaganda can lead to high levels of harmful spirit possession. In addition, we provide evidence for the incremental validity of spirit possession as a trauma-related psychological disorder in this context.

Highlights

► Cross-sectional survey on spirit possession and mental health with adolescents and young adults in war-affected Northern Uganda. ► Spirit possession is a common phenomenon among former child soldiers but also widespread among other war-affected adolescents and young adults. ► High levels of spirit possession can be viewed as psychopathology as it correlates with dysfunction in various domains.

Keywords

• Uganda;
• Spirit possession;
• Child soldiers;
• War;
• Children;
• Mental health