TREMBLAY ET AL.: ASSESSING MENTAL HEALTH OUTCOMES 449 ASSESSING MENTAL HEALTH OUTCOMES OF POLITICAL VIOLENCE AND CIVIL UNREST IN PERU

Background: Sustained political violence (SPV) may have long-term effects. Aims: To assess mental and residual effects of exposure to SPV. To validate a post-traumatic stress disorder (PTSD) assessment tool in Quechua-speaking Peru. Method: Survey of 373 individuals aged 15 and over using the General Health Questionnaire (GHQ-12), Hopkins Symptom Checklist (HSCL-25) and a Trauma Questionnaire (TQ), derived from the Harvard Trauma Questionnaire. Sociodemographics were recorded. Reliability was assessed. Data reduction used factor analysis and modelling multiple regressions. Results: A quarter of the sample had symptoms compatible with PTSD. Ques-tionnaire reliability ranged from 0.81 to 0.89. Factor analysis confi rmed high construct validity for TQ and HSCL-25. Modelling showed a strong association of PTSD-related symptoms and expressions of distress with the degree of exposure to SPV, especially among returnees. Conclusions: Long-term consequences of exposure to SPV take the form of PTSD, anxiety and depressive disorders, and culturally formulated expressions of distress. Some implications for clinicians are discussed. Key words: local idioms of distress, long-term consequences, political violence, post-traumatic stress disorde