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Adherence to childhood religious affiliation and suicide intentions in women exposed to the violence of the 1994 Genocide against the Tutsi in Rwanda

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Abstract

Purpose

To examine the association between adherence to childhood religious affiliations and serious suicide intentions in 371 women exposed to the 1994 Genocide against the Tutsi in Rwanda.

Methods

Participants were randomly sampled in 2011 from households in the Southern Province of Rwanda. Trained interviewers gathered information on socio-economic background, genocide-related trauma exposure, Major Depressive Episode (MDE) and suicide intentions (assessed with the Mini International Neuropsychiatric Interview), and Posttraumatic Stress Disorder (PTSD) (assessed with the PTSD Checklist-Civilian version).

Results

In this predominantly Christian sample, 62.8% (233/371) had adhered to their childhood religious affiliation. Adherence was associated with lower odds of serious suicide intentions (OR 0.321, 95% CI 0.13–0.78, P < 0.01) independent of socio-economic factors, court-designated victim status, trauma exposure, MDE, and PTSD; that association held following consideration of specific denomination.

Conclusion

Women who adhere to their childhood religious affiliation may be less likely to have serious suicide intentions following major catastrophes. Whether that association is attributable to stronger connections with lost and remaining family and friends, or greater faith in the church as a facilitator of reconciliation and coping, requires further study.

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Data availability

Data and material are available from author (RN) upon request.

References

  1. Bonelli R, Dew RE, Koenig H, Rosmarin D, Vasegh S (2012) Religious and spiritual factors in depression: review and integration of the research. Depress Res Treat. https://doi.org/10.1155/2012/962860

    Article  PubMed  PubMed Central  Google Scholar 

  2. Colucci E, Martin G (2008) Religion and spirituality along the suicidal path. Suicide Life-Threat 38:229–244

    Article  Google Scholar 

  3. McCullough M, Larson D (1999) Religion and depression: a review of the literature. Twin Res 2:126–136

    Article  CAS  PubMed  Google Scholar 

  4. Dervic K, Oquendo MA, Grunebaum MF, Ellis S, Burke AK, Mann JJ (2004) Religious affiliation and suicide attempt. Am J Psychiatry 161:2303–2308

    Article  PubMed  Google Scholar 

  5. Jacobs M, Miller L, Wickramaratne P, Gameroff MJ, Weissman MM (2012) Family religion and psychopathology in children of depressed mothers: ten-year follow-up. J Affect Disord 136:320–327

    Article  PubMed  Google Scholar 

  6. Kasen S, Wickramaratne P, Gameroff MJ, Weissman MM (2012) Religiosity and resilience in persons at high risk for major depression. Psychol Med 42:509–551

    Article  CAS  PubMed  Google Scholar 

  7. Miller L, Warner V, Wickramaratne P, Weissman M (1997) Religiosity and depression: ten-year follow-up of depressed mothers and offspring. J Am Acad Child Adolesc Psychiatry 36:1416–1425

    Article  CAS  PubMed  Google Scholar 

  8. Neeleman J, Halpern D, Leon D, Lewis G (1997) Tolerance of suicide, religion and suicide rates: an ecological and individual study in 19 Western countries. Psychol Med 27:1165–1171

    Article  CAS  PubMed  Google Scholar 

  9. Stack S, Lester D (1991) The effect of religion on suicide ideation. Soc Psychiatry Psychiatr Epidemiol 26:168–170

    Article  CAS  PubMed  Google Scholar 

  10. Barel E, Van Ijzendoorn MH, Sagi-Schwartz A, Bakermans-Kranenburg MJ (2010) Surviving the holocaust: a meta-analysis of the long-term sequelae of a genocide. Psychol Bull 136:677–698

    Article  PubMed  Google Scholar 

  11. Farhood L, Dimassi H, Lehtinen T (2009) Exposure to war-related traumatic events, prevalence of PTSD, and general psychiatric morbidity in a civilian population from Southern Lebanon. J Transcult Nurs 17:333–340

    Article  Google Scholar 

  12. Galea S, Maxwell AR (2009) Methodological challenges in studying the mental health consequences of disasters. In: Neria Y, Galea S, Norris FH (eds) Mental health and disasters. Cambridge University Press, New York, pp 579–593

    Chapter  Google Scholar 

  13. Des Forges A (1999) Leave none to tell the story: genocide in Rwanda. Human Rights Watch, New York

    Google Scholar 

  14. Prunier G (1995) The Rwanda crisis: history of a genocide. Columbia University Press, New York

    Google Scholar 

  15. Smith DN (1998) The psychocultural roots of genocide: legitimacy and crisis in Rwanda. Amer Psychol 53:743–753

    Article  CAS  Google Scholar 

  16. Munyandamutsa N, Nkubamugisha PM, Gex-Fabry M, Eytan A (2012) Mental and physical health in Rwanda 14 years after the genocide. Soc Psychiatry Psychiatric Epidemiol 47:1753–1761

    Article  Google Scholar 

  17. Pozen J, Neugebauer R, Ntaganira J (2014) Assessing the Rwanda experiment: popular perceptions of gacaca in its final phase. Int J Transit Justice 8:31–52

    Article  Google Scholar 

  18. Rieder H, Elbert T (2013) Rwanda—lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners, and their children. Confl Health. http://www.conflictandhealth.com/content/7/1/6

  19. Rubanzana W, Hedt-Gauthier BL, Ntaganira J, Freeman MD (2014) Exposure to genocide and risk of suicide in Rwanda: a population-based case-control study. J Epidemiol Commun Health. https://doi.org/10.1136/jech-2014-204307

    Article  Google Scholar 

  20. Rugema L, Mogren I, Ntaganira J, Gunilla K (2013) Traumatic episodes experienced during the genocide period in Rwanda influence life circumstances in young men and women 17 years later. BMC Public Health. https://doi.org/10.1186/1471-2458-13-1235

    Article  PubMed  PubMed Central  Google Scholar 

  21. Helm L, Schaal S (2014) Rates and predictors of mental stress in Rwanda: investigating the impact of gender, persecution, readiness to reconcile and religiosity via a structural equation model. Int J Ment Health Syst. https://doi.org/10.1186/1752-4458-8-37

    Article  Google Scholar 

  22. Fujii LA (2009) Killing neighbours: web of violence in Rwanda. Cornell University Press, Ithaca, New York

    Google Scholar 

  23. Jefremovas V (1995) Acts of human kindness. Afr Stud Rev 23:28–31

    Google Scholar 

  24. Patte D (2010) The Cambridge dictionary of Christianity. Cambridge University Press, New York

    Book  Google Scholar 

  25. Pew Forum on Religion and Public Life. Tolerance and tension: Islam and Christianity in sub-Saharan Africa. www.pewforum.org/2010/04/15/executive-summary-islam-and-christianity-in-sub-saharan-africa/. Accessed 15 Apr 2010

  26. McCullum H (1995) The angels have left us: the Rwanda tragedy and the churches. World Council of Churches (WCC) Publications, Geneva

  27. Rights A (1995) Rwanda: death, despair, and defiance, rev. African Rights, London

    Google Scholar 

  28. Banyanga JDA, Björkqvist K (2017) The dual role of religion regarding the Rwandan 1994 genocide: both instigator and healer. J Afr Stud Dev 3:1–12

    Google Scholar 

  29. Schliesser C (2018) From a “theology of genocide” to a “theology of reconciliation”? On the role of Christian churches in the nexus of religion and genocide in Rwanda. Religions. https://doi.org/10.3390/rel9020034

    Article  Google Scholar 

  30. Neeleman J, Lewis G (1999) Suicide, religion, and socioeconomic conditions: an ecological study in 26 countries, 1990. J Epidemiol Commun Health 53:204–210

    Article  CAS  Google Scholar 

  31. Fisher RJ (2001) Social-psychological processes in interactive conflict analysis and reconciliation. In: Abu-Nimer M (ed) Reconciliation, justice, and coexistence: theory and practice. Lexington Books, New York, pp 25–45

    Google Scholar 

  32. Lawrence RE, Oquendo MA, Stanley V (2016) Religion and suicide risk. Arch Suicide Res. https://doi.org/10.1080/13811118.2015.1004494

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lester D (2017) Does religiosity predict suicidal behavior? Religions. https://doi.org/10.3390/rel8110238

    Article  Google Scholar 

  34. Stack S (1983) The effect of religious commitment on suicide: a cross-national analysis. J Health Soc Behav 24:362–374

    Article  CAS  PubMed  Google Scholar 

  35. Pescosolido BA, Georgianna S (1989) Durkheim, suicide, and religion: toward a network theory of suicide. Am Sociol Rev 54:33–48

    Article  CAS  PubMed  Google Scholar 

  36. Sebarenzi J, Mullane LA (2009) God sleeps in Rwanda: a journey of transformation. Atria books, New York

    Google Scholar 

  37. Irivuzumugabe E, Lawrence TD (2009) My Father, maker of the trees: how I survived the Rwandan genocide. Baker, Bloomington

    Google Scholar 

  38. Patel V, Araya R, Chatterjee S, Chisolm D, Cohen A, De Silva M, Hosman C, McGuire H, Rojas G, van Ommeren M (2007) Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet 370:991–1005

    Article  PubMed  Google Scholar 

  39. Sweetland AC, Belkin GS, Verdeli H (2014) Measuring depression and anxiety in sub-Saharan Africa. Depress Anxiety 31:223–232

    Article  PubMed  Google Scholar 

  40. Nowrojee B (1996) Shattered lives: sexual violence during the Rwandan genocide and its aftermath. Human Rights Watch, New York

    Google Scholar 

  41. Lecrubier Y, Sheehan DV, Weiller E, Amorim P, Bonora I, Harnett Sheehan K, Janavs J, Dunbar GC (1997) The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 12:224–231

    Article  Google Scholar 

  42. Roaldset JO, Linaker OM, Bjørkly S (2012) Predictive validity of the MINI suicidal scale for self-harm in acute psychiatry: a prospective study of the first year after discharge. Arch Suicide Res 16:287–302

    Article  PubMed  Google Scholar 

  43. Roos L, Sareen J, Bolton JM (2013) Suicide risk assessment tools, predictive validity findings, and utility today: time for a revamp? Neuropsychiatry 3:1–13

    Article  Google Scholar 

  44. Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA (1996) Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther 34:669–673

    Article  CAS  PubMed  Google Scholar 

  45. Pham PM, Weinstein HM, Longman T (2004) Trauma and PTSD symptoms in Rwanda: implications for attitudes towards justice and reconciliation. JAMA 292:602–612

    Article  CAS  PubMed  Google Scholar 

  46. Forbes D, Creamer M, Biddle D (2001) The validity of the PTSD Checklist as a measure of symptomatic change in combat-related PTSD. Behav Res Ther 9:977–986

    Article  Google Scholar 

  47. IBM SPSS Statistics for Macintosh, version 24.0

  48. Norko MA, Freeman D, Phillips J, Hunter W, Lewis R, Viswanathan R (2017) Can religion protect against suicide? J Nerv Ment Dis 205:9–13

    Article  PubMed  Google Scholar 

  49. Williamson C (2014) Posttraumatic growth and religion in Rwanda: individual well-being vs. collective false consciousness. Ment Health Relig Cult 17:946–955

    Article  PubMed  PubMed Central  Google Scholar 

  50. Stack S, Kposowa AJ (2011) Religion and suicide acceptability: a cross-national analysis. J Sci Study Relig 50:289–306

    Article  PubMed  Google Scholar 

  51. Bellah RN, Madsen R, Sullivan WM, Swidler A, Tipton SM (1985) Habits of the heart: individualism and commitment in American life. University of California Press

    Google Scholar 

  52. Tubergen V, Frank M, te G, Wout U, (2005) Denomination, religious context, and suicide: Neo-Durkheimian multilevel explanations tested with individual and contextual data. Am J Sociol 111:797–823

    Article  Google Scholar 

  53. Schaal S, Weierstall R, Dusingizemungu J-P, Elbert T (2012) Mental health 15 years after the killings in Rwanda: imprisoned perpetrators of the genocide against the Tutsi versus a community sample of survivors. J Trauma Stress 25:446–453

    Article  PubMed  Google Scholar 

  54. Halbwachs M (1978) The causes of suicide. Free Press, New York

    Google Scholar 

  55. Torgler B, Schaltegger CA (2014) Suicide and religion: new evidence on the differences between Protestantism and Catholicism. J Sci Study Relig 53:316–340

    Article  Google Scholar 

  56. Van Poppel F, Day LH (1996) A test of Durkheim’s theory of suicide without committing the “ecological fallacy.” Am Sociol Rev 61:500–508

    Article  Google Scholar 

  57. Kelleher MJ, Chambers D, Corcoran P, Williamson E, Keeley HS (1998) Religious sanctions and rates of suicide worldwide. Crisis 19:78–86

    Article  CAS  PubMed  Google Scholar 

  58. Kendler KS, Lui XQ, Gardner CO, McCullough ME, Larson D, Prescott CA (2003) Dimensions of religiosity and their relationship to lifetime psychiatric and substance use disorders. Am J Psychiatry 160:496–503

    Article  PubMed  Google Scholar 

  59. Serneels P, Verpoorten M (2015) The impact of armed conflict on economic performance: evidence from Rwanda. J Conflict Resolut 59:555–592

    Article  Google Scholar 

  60. Koster M (2008) Fragmented lives: reconstructing rural livelihoods in post-genocide Rwanda (Dissertation). Wageningen University, NL

    Google Scholar 

  61. Kubai A (2007) Post-genocide Rwanda: the changing religious landscape. Exchange 36:198–214

    Article  Google Scholar 

  62. Bizimana JD (2001) L’Église et le Génocide au Rwanda: les Pères Blancs et le Négationnisme. L’Harmattan, Paris

    Google Scholar 

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Funding

Funding was obtained from the Ruth and David Levine Foundation, anonymous donor.

Author information

Authors and Affiliations

  1. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA

    Stephanie Kasen

  2. Division of Epidemiology, New York State Psychiatric Institute, New York, USA

    Stephanie Kasen & Richard Neugebauer

  3. Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

    Joseph Ntaganira

  4. Department of Clinical Psychology, College of Medicine and Health Sciences, Centre for Mental Health, University of Rwanda, Kigali, Rwanda

    Vincent Sezibera

  5. Center for Global Justice and Human Rights, New York University School of Law, New York, USA

    Joanna Pozen

  6. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA

    Richard Neugebauer

  7. Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, USA

    Richard Neugebauer

Authors
  1. Stephanie Kasen
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  2. Joseph Ntaganira
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  3. Vincent Sezibera
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  4. Joanna Pozen
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  5. Richard Neugebauer
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Corresponding author

Correspondence to Stephanie Kasen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

The Institutional Review Boards of Columbia University and New York State Psychiatric Institute, and the Rwandan National Ethics Committee, approved study consent procedures and research protocol. Interviewers fluent in Kinyarwanda had a 4-year college/university psychology degree and 1 or more years of field/clinical experience. Study investigators (RN, others) provided instruction on approved consent procedures and administering the interview protocol in the 2 weeks prior to the study. Only potential participants who understood the consent form and procedures were eligible for study entry; interviewers read the form to nonliterate participants who indicated their consent by a mark that was witnessed.

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Kasen, S., Ntaganira, J., Sezibera, V. et al. Adherence to childhood religious affiliation and suicide intentions in women exposed to the violence of the 1994 Genocide against the Tutsi in Rwanda. Soc Psychiatry Psychiatr Epidemiol 56, 1761–1769 (2021). https://doi.org/10.1007/s00127-021-02058-0

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