Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession.
Tobias Hecker, Lars Braitmayer, Marjolein Van Duijl
European Journal of Psychotraumatology November 19, 2015 DOI: 10.3402/ejpt.v6.29126 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic literature review Peer reviewed |
|---|---|
| Sample size | 917 |
| Population | Patients with symptoms of possessive trance disorders in low- and middle-income countries |
| Topics | PTSD |
| Keywords | Dissociative disorders Trauma exposure Mental health gap Trauma-related disorders Spirit possession Possessive trance disorder |
| Citations | 50 |
| Key findings | The review of 917 patients from 14 low- and middle-income countries indicates that possessive trance disorder occurs worldwide and suggests a strong relationship between trauma exposure and spirit possession, with high prevalence rates especially in postwar areas of African countries. The authors argue that this topic remains neglected in mental health and psychosocial intervention programs. |
Abstract
Background: We present a literature review on trauma exposure and spirit possession in low- and middle-income countries (LMICs). Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013-2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states.
Objective: The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs.
Methods: Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients' sociodemographic characteristics, and its relation to traumatic experiences.
Results: The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries.
Conclusions: More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this systematic literature review.
Comparable studies
Other narrative reviews on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelic Psychiatry's Brave New World. | 2020 | Review | |
| Reviewing the Potential of Psychedelics for the Treatment of PTSD | 2020 | Review | |
| Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. | 2016 | Review | |
| MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? | 2018 | Review | |
| Clinical applications of hallucinogens: A review. | 2016 | Review |
Citations in the library
Cited by 16
- Pathological spirit possession as a cultural interpretation of trauma-related symptoms. Psychological Trauma: Theory, Research, Practice and Policy July 1, 2016
- Differential executive functioning in the topology of Spirit possession or dissociative disorders: an explorative cultural study. BMC Psychiatry December 2, 2019
- Cultural Presentations of Dissociation: The Case of Possession Trance Experiences Journal of Trauma & Dissociation September 17, 2020
- Trapped Between Theological and Medical Notions of Possession: A Case of Possession Trance Disorder With a 3-Year Follow-Up Frontiers in Psychiatry May 26, 2022
- Polish Catholics Attribute Trauma-related Symptoms to Possession: Qualitative Analysis of Two Childhood Sexual Abuse Survivors. Journal of child sexual abuse 2022
and 11 more in the library
Cites 13
- Spirit Possession Revisited: Beyond Instrumentality Annual Review of Anthropology October 1, 1994
- Spirits and social reconstruction after mass violence: rethinking transitional justice. African Affairs 2010
- Religion, Altered States of Consciousness, and Social Change Review of Religious Research 1976
- Haunted by ghosts: prevalence, predictors and outcomes of spirit possession experiences among former child soldiers and war-affected civilians in Northern Uganda. Social Science & Medicine August 1, 2012
- Dissociative symptoms and reported trauma among patients with spirit possession and matched healthy controls in Uganda. Culture, Medicine, and Psychiatry June 1, 2010
and 8 more in the library