الفهرس 
Trauma and Post-Traumatic Stress DisorderOnly 14 pages are availabe for public view
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Abstract
vegetable vendor Mohammed Bouazizi sparked the Arab Spring. Within a few months, a wave of protest had swept away the despots of Tunisia, Egypt and Libya. Since then protests have been keeping the region, which has until recently been viewed as having stable authoritarian regimesand as being largely resistant to democratization, on edge.
At the beginning of 2011, protests and unrest broke out in almost every Arab country. The only countries that have thus far managed to avoid such problems are the Gulf monarchies of Qatar and, experiencing only marginal protests, the United Arab Emirates (U.A.E.), both of which guarantee their populations a worry-free life bankrolled by oil income.
The Arab Spring did not come out of left field. In most of the region’s countries there have been The Arab Spring did not come out of left field. In most of the region’s countries there have been demonstrations and strikes protesting social hardships and despotism for years; since 2000, these protests have increasingly developed into transnational movements. Their demands were to remove the ruling regimes aiming to have better life through good economy, political reforms and social justice.
Moreover, the causes varied from country to country but mostly derived from domestic issues such as: a lack of democracy, human rights violations, wide-spread corruption, economic decline, unemployment, extreme poverty, rising food prices, and a number of demographic factors, such as a large percentage of educated and dissatisfied young people and the centralized systems that marginalize parts of the population outside capital cities. In some countries protests were aimed at the displacement of the regime, whereas in others demonstrations demanded the improvement of living conditions while leaving the principal foundations of the state unchallenged. Accordingly, the ruling elite responded to the protesters differently: from introducing top-down reforms and making efforts to ’buy’ social peace to repression and armed violence.
However, governments have been overthrown in four countries: Tunisia, Egypt, Libya, and Yemen. Tunisian President Zine El Abidine Ben Ali fled the country in January 2011 in the wake of the uprisings. In Egypt, President Hosni Mubarak resigned in February 2011 after the Tahrir Square protests, ending his30-year presidency. Libyan leader Muammar Gaddafi was overthrown after massive domestic revolts and international military intervention and was killed on October 20, 2011. Yemeni President Ali Abdullah Sale resigned and his successor Abdal-Rabah Mansour Al-Hadi formally replaced him in February 2012.Protests in Syria demanding the ousting of President Bashar Al-Assad began in March2011 and have rapidly developed into a nationwide uprising. The demonstrations have resulted in an ongoing, violent conflict - in fact a civil war - between Assad loyalist and opposition forces.
The extended use of force and the violent repression of protestors by security forces in the countries of revolution resulted in thousands of killed protestors and large amounts -not probably counted- of injuries and subsequently disabilities. This violent repression didn’t succeed to stop the move of the protestors towards their targets.
Due to the spread of violence in the region. The need to understand Post-Traumatic Stress Disorder (PTSD) and mental health comorbidities of trauma has never been greater in the Middle East than now. The spread of revolutions throughout the region has resulted in atrocities and the rising of psychiatric problems.
Our Study aimed to estimate the incidence of psychiatric morbidity among victims of violence in Arab spring revolutions (Egypt, Libya, Tunisia, Syria, and Yemen). Furthermore, to appraise the association/ relation between the severity of trauma and severity of psychiatric morbidity (PTSD) among victims of violence in Arab revolutions. Also the study aimed to assess the psychiatric sequelae to trauma quantitatively / qualitatively among victims of violence in Arab revolutions in mentioned countries.
We examined the 100 subjects of the victims of Arab revolutions (48 subjects from Egypt, 32 from Syria and 20 from Tunisia) using:
1- Structured Clinical Interview for DSM-IV (SCID I).
2- The Structured Clinical Interview for DSM-IV axis II disorders (SCID II).
3- Posttraumatic Diagnostic Scale (PDS).
4- Disability Rating Scale.
5- Sheet for Sociodemographic data.
Regarding the Sociodemographic data, the marital statuses were distributed as 54% of the study populations were singles, 18% were engaged, 24% were married, and 4% were divorced Overall, 4% of the study populations have finished primary school, 8% have finished preparatory school, while the high Rates were 40% among those who have finished secondary school, and those who have finished high education. For those who finished their postgraduate studies it was 8%.
Overall, 44% of the study populations have average housing style, followed by 24% have high average housing style, 22% have poor housing style and only 10% have luxurious housing style. On the other hand, 34% of study subject have their monthly income hardly adequate, followed by 28% have their monthly income adequate. 22% have their monthly income inadequate, and 16% adequate with ease. Finally, The highest percentages among study subjects are Private sector employer and business (30%) each, followed by partial time students, Governmental employer, and unemployed subjects (12%) each. The lowest % are full time student & retired subjects (2%) each.
Moreover, Assessment of Subjects using SCID I that 62% of the subjects have positive PTSD, 32% of the subjects have positive Depression, 28% of the subjects have positive GAD (Generalized Anxiety Disorder), 26% of the subjects have Substance abuse, 22% of the subjects have substance dependence, , 16% of the subjects have positive dysthymia, 12% of the subjects have positive panic disorder, 6% of the subjects have positive social phobia, 4% of the subjects have positive Schizophrenia, and 4% of the subjects have positive hypochondriasis, 2% of the subjects have positive BDD, 2% of the subjects have positive somatization disorder, 2% of the subjects have positive BAD I, 2% of the subjects have positive cyclothymic disorder.
Regarding the Assessment of personality among the subjects of the sample, it was found that the most common traits among the groups were paranoid traits (56%), Histrionic traits (52%), narcissistic traits (40%), obsessive traits (38%) , antisocial traits (26%), passive aggressive traits (24%), Schizotypal traits (20%), Depressive traits(18%), Borderline traits (16%), Dependent traits (8%), Avoidant traits (6%), and Schizoid traits (2%).
Regarding the personality disorders, it was found that the most common was Borderline personality disorder (18%), histrionic personality disorder (8%), narcissistic personality disorder (6%), paranoid personality disorder (6%), obsessive personality disorder (4%), antisocial personality disorder (2%), schizotypal personality disorder (2%), and passive aggressive personality disorder (2%).
Furthermore, using post-traumatic diagnostic scale (PDS), the highest percentage of overall injuries is Locomotors (32%), followed by Witness Trauma (20%), followed by Gunshot (18%), Torture & Ocular were (10%) and followed by miscellaneous injuries present by (8%).
Regarding the severity of PTSD, the results showed (10%) with moderate severity, (32%) moderate to severe, (22%) had severe PTSD.
Regarding functional impairment, (16%) showed mild functional impairment, (46%) showed moderate functional impairment, (22%) had severe functional impairment.
Finally, Assessment of severity of disability using disability rating scale (DRS), it was found that Regarding the severity of disability of the Overall subjects, 46% of the subjects had no disability, 16% had partial disability, 12% of the subjects had moderate disability, 14% had moderately severe disability, and 12% had severe disability.
from the above mentioned, we can conclude that the exposure to traumatic events of political origin resulted in high rates of psychiatric morbidities among the victims of Arab revolutions. The different types of personality traits and disorders of our sample can be an evidence for the wide people participation in the Arab revolutions. Also we can understand the massive and extended use of force by the security forces in the participating countries resulted in high rates of injuries and disabilities.
We recommend that research work in the same field must continue and further studies should be conducted among the victims of violence in the Middle East. Also more studies are needed at the field of
psychotraumatology in our countries to provide proper understanding to our reaction to trauma as most of the literature is discussed and obtained from western point of view.