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Case Study of PTSD in Ghana Armed Forces Personnel

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1.1 Background to the Study

According to The League of Nations was the first major organisation established after the First World War for conflict resolutions. Following the failure of the League of Nations to avert the Second World War, the United Nations Organisation (UNO) was established in 1945 to replace it. The United Nations (UN) is an international organisation, which among other things, aims to maintain international peace and security and to take collective and preventive measures to ensure global peace

( Rikhe, 1983).

The need for peaceful co-existence and resolution of conflicts and wars necessitated the introduction of third party involvement in conflict resolution mechanisms in the nineteen century. The third party approach to settlement of conflicts and wars is practiced primarily by the UN, regional and sub-regional organisations through Peacekeeping Operations (PKO). Peacekeeping is defined as “the process of mediation, conciliation, negotiation and the management of conflict in a bid to bring peace in an area of conflict, violence or hostilities”. Peacekeeping involves the deployment of a neutral force (UN, Regional or Sub-regional body) in the field, with military, civil police and civilian personnel, in order to stabilize or dampen a conflict situation and provide viable opportunities for pacific resolution of conflicts. It entails peace-making and peace-building (Maj Agyemang-Bioh, 2000). In peace-making, an effort to settle the conflict through mediation, negotiation, conciliation and other forms of peaceful settlement is made using diplomatic action. Peace-building on the other hand, is “action-like”; it includes the identification and support of all measures and structures which will promote peace and build the needed trust and healthy interactions among former enemies; in order to avoid a relapse into conflict or recurrence of the hostilities. Thus peace-building is a social change through socio-economic development, rehabilitation and reconstruction; it actively seeks to eliminate the likelihood of direct or indirect violence in the conflict area, with the object of preventing further war and then to obviate any distress signal in the community (Ibid).

The complex nature of modern conflicts and approaches to dealing with such conflicts gave birth to the term Peace Support Operations (PSO). Peace Support Operations are multifunctional operations in which impartial military activities are designed to create a secure environment and to facilitate the efforts of the civilian elements of the mission to create a self sustaining peace (Institute of Security Studies, 2000).   The concept of PSO refers to ‘the military, diplomatic, economic and humanitarian activities carried out in order to achieve long-term peace settlement and reinstate political and socio-economic stability to  a conflict or disaster situation (United Kingdom Joint Warfare Publication, 3-50). The terms Peacekeeping and Peace Support Operations are however, used interchangeably in this paper since both terminologies refer to the same concept. Additionally, the role of the peacekeeper has not changed significantly with the shift from PKO to PSO. 

The first UN conflict resolution in Africa was in 1960 following the crisis in the Congo, now Democratic Republic of Congo (DRC).  Thereafter, the UN focused attention on all troubled spots in order to check crises before they escalated. It also encouraged the formation of regional and sub-regional bodies such as the Organisation of African Unity (OAU), now the African Union (AU), Economic Community of West African States (ECOWAS) and Southern African Development Community (SADC) to complement her efforts. This is in line with Article 53 of the UN Charter on regional organisations, which states that, ‘the Security Council should encourage associations or agencies that promote peace at regional level (Rikhe, 1983).

Since its initial intervention in Congo in 1960, the Ghana Armed Forces' has been involved in complex peacekeeping operations; from the civil wars in Rwanda, the Liberian and Sierra Leonean conflicts and the Ivorian conflicts, almost all commencing within the 1990s. All these conflicts were characterised by extreme cases of human rights violations and other violent crimes which have claimed so many lives and caused so much pain and suffering. In Liberia, Ghana was among the five leading member states of ECOWAS which deployed troops before the UN Security Council belatedly sanctioned it (Erskine (Lt Gen), (2000). Currently, the Ghana Armed Forces is providing contingents for United Nations peace support operations in Cote d'Ivoire, Liberia, the Democratic Republic of Congo, Sudan, and Lebanon.  A total of 3,250 troops are deployed for peace support operations in the five listed missions. As at 2008, Ghana was the sixth largest contributor of uniformed personnel to UN Peacekeeping (United Nations Factsheet, 2008). Participation in these operations exposes military personnel to traumatic incidents.

Since the twentieth century, a lot of changes have taken place in both the manner in which peacekeeping operations are executed and the circumstances to which the peacekeeping soldier is exposed to risk. Firstly, not only has peacekeeping operations increased in terms of frequency but they have also undergone a metamorphosis with regard to the manner in which they are conducted. It has been argued that previously peacekeeping soldiers were responsible for monitoring and observing cease-fire agreements between formally belligerent states (Liebenberg et al, 1997). Others contend that the 1990s witnessed conflicts where parties did not comply with peace agreements and/or disobeyed the rules of war (Olonisakin, 1998). He also refers to situations where peacekeeping soldiers themselves were viciously attacked. The nature of conflict also changed. In the pas,t conflict was characterised by being mainly inter-state, but today intra-state conflict is more prevalent (Nkiwane, 2000; Cilliers, 1999). Another indication of the changing nature of peacekeeping is illustrated in the roles that today's peacekeeping soldiers have to fulfill. The classic roles of the peacekeeping soldier to monitor the implementation of an honourable agreement between two or more parties in conflict; to act unarmed and guard a distinctly marked observation post, or to patrol a demilitarised cease-fire line, have become the exception rather than the rule (Potgieter, 1995). Thus, the evolving nature of peacekeeping duty in itself suggests that today peacekeeping soldiers are faced with new psychological challenges (Litz et al, 1997), and that it is no longer unusual for contemporary peacekeeping missions to include exposure to traditional war-zone experiences (Orsillo et al, 1998). The above conditions have the effect of increasing the stress levels of the peacekeeper.

The ability to cope with stress is intrinsically related to psychological and material resources (Lazarus and Folkman, 1984), which are likely to be adversely affected by repeated traumatisation experienced during conflicts. Experience and appraisal of trauma tends to be related to both poverty (Muldoon, 2003) and social identity (Haslam et al, 2004). The most common psychological consequence of war and conflict is post-traumatic stress disorder (PTSD). The resulting stress has beenassociated with reduced cognitive, emotional, and behavioralperformance (Mitchell and Dyregov, 1993) and may negatively affect work performance (Paine, 1992).These findings have implications for both the career path ofthe worker and the efficiency and productivity of organizations. From the social identification perspective, the world may appear to be a frightening place and the trauma victim can feel powerless, helpless and incompetent. But in the interpersonal realm, the family is really affected. Post-traumatic stress can cause the sufferer to become emotionally withdrawn and distant from family members. People affected can become overly needy and dependent, or outrageously demanding and impatient. Most of them can revert back to old habits like smoking or drinking, or become a newly hatched adolescent and engage in reckless, sometimes life threatening hobbies.

PTSD is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened (Muldoon, (2003). Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. These traumatic experiences could be caused by reasons such as near-death, serious physical injury, serious accident, violence, war, torture, any event that causes extreme fear, a horrifying event, or when one feels an extreme sense of helplessness (Ibid).

PTSD can be categorized into four types depending on the length of time it takes for the disorder to appear and the amount of time it is present. These include; firstly, Acute Stress Disorder, symptoms of these occur within four weeks of the traumatic experience and lasts between two days and four weeks; secondly, Acute Post-Traumatic Stress Disorder, with symptoms lasting for more than four weeks; thirdly, Delayed Onset Post-Traumatic Stress Disorder, where symptoms appear years after the traumatic experience; and finally Chronic Post-Traumatic Stress Disorder where symptoms last for over three months with the symptoms disappearing for a few days and then reappearing.

The major symptoms of PTSD include: exaggerated startle response, loss of memory (forgetfulness), sleep disorders (nightmares and waking up suddenly during the night), flashbacks or images of the traumatic incident that keeps coming back to haunt you, hyper vigilance (very similar to, but not paranoia), hypersensitivity, extreme irritability, anger over petty issues with violent outbursts, possessiveness, extreme nervousness and anxiety, muscle aches and pains for no apparent reason, unexplained fear, low self-esteem and lack of confidence (Mitchell and Dyregov, 1993).

PTSD is categorized as 'Intrusion' when the symptoms appear suddenly and happen when memories of a past traumatic incident keep coming back as flashbacks. These flashbacks could be induced by a variety of triggers such as smell, sight, or sound. Once the flashback is triggered, it is almost impossible to stop because the incident seems real with all the emotions involved. Nightmares are a good example of this. PTSD is categorized as 'Avoidance' when a PTSD sufferer consciously or unconsciously tries to prevent remembering anything related to the traumatic experience. This may involve avoiding those close to you, or those you work with, causing misery to yourself and those close to you. PTSD is categorized as 'Hyper arousal' when the symptoms are as a result of stimulated nerves and hormones. One could experience severe insomnia, and not remember the entire traumatic experience. During this phase one will have very poor concentration and will get irritated easily (Thompson and Gignac, 2000a). PTSD can be treated. However, if left untreated, PTSD could remain lifelong, damaging one's relations with others and causing one several ailments, both physically and mentally (Solomon et al, 1996).

1.2 Statement of the Problem

Post Traumatic Stress Disorder (PTSD) is common among people who have served in the military or any of the security or law enforcement agencies. The involvement and exposure of military personnel to combat and combat related situations expose them to risks which tend to affect them physically, mentally and emotionally. Some military occupations are more likely to witness traumatic events than others and thus be at greater risk. These occupations include frontline combat unit, combat engineers and medical personnel. It is often these same professionals or trades that are tasked repeatedly for peace support operations (Gignac, 2000).

The fundamental components of combat power of the Armed Forces include the equipment and the personnel who carry out the combat roles. Therefore, it is important that all armed forces maintain a high state of personnel readiness (United Kingdom Doctrine for Joint and Multinational Operations-JWP 0-10). However, participation in combat and combat related activities exposes the military to stressful conditions.

Over the years, the Ghana Armed Forces (GAF) have been exposed to battlefield hazards through their participation in peace support operations including the  Economic Community of West African States Monitoring Group (ECOMOG) operations in Liberia, The United Nations Mission in Sierra Leone (UNAMSIL), the United Nations Interim Force in Lebanon (UNIFIL), the United Nations Mission in Liberia (UNMIL), the United Nations Mission in the Democratic Republic of Congo (MONUC), the United Nations Mission in La Cote I'Voire (UNOCI), and until recently, the United Nations Mission in Chad (MINURCAT). Exposure to such hazards of war in most cases result in mental and emotional tensions, injuries and death.  These situations usually result in what is referred to as stress on the part of the service personnel. It is therefore necessary that serious attention is paid to the problem of stress among participants of peace support operations. This research will therefore investigate and examine social identification and post-traumatic stress symptoms among participants of peace support operation, with the GAF as a case study.

1.3 Justification of the Study

The military plays an important role in a nation's development. They provide a congenial atmosphere for the overall development of a nation. Military personnel as a core element of the security services therefore need sound mind and body to be able to perform their duties effectively and efficiently. It is therefore important that attention is paid to the psychological and emotional needs of the military. Effective handling of post-traumatic stress related problems among personnel of the GAF will enhance their efficiency and productivity both at home and during peace support operations outside the country.The study will help come out with relevant information and recommendations that will help in assisting personnel who are affected by post-traumatic stress in the course of discharging their duties. It will also help reduce the incidence of PTSD among peacekeepers. This will help boost the morale of the personnel of the GAF both at home and on international peace support operations.

1.4 Research Questions

The study will attempt to find answers to the following questions:

  • What are the symptoms of post-traumatic stress disorders among personnel of the GAF?
  • What are the effects of peace support operations on post-traumatic stress disorder and social identification?
  • Which are the populations that are affected by post-traumatic stress disorders in the GAF?
  • Is there a relationship between post-traumatic stress and the strength of social identification?


This research which is a case study of Social Identification and Post-Traumatic Stress Symptoms among personnel of the Ghana Armed Forces is a  qualitative research project hence the researcher largely employs the use of qualitative research design to include both primary and secondary data. Qualitative research is exploratory in nature and encompasses a range of philosophies, research designs and specific techniques including in-depth qualitative interviews; participant and non-participant observation; focus groups; document analyses; and a number of other methods of data collection (Pope and Mays, 2006). The primary data was collected from live interviews, focus group discussions and questionnaire administration. A total sample size of two hundred (200) was used for the study.  This comprised of interviews with thirty individuals, thirty persons in focus groups of six and one hundred and forty questionnaire which were administered to randomly selected personnel of the Ghana Armed Forces. The secondary data were gathered from books, journals, articles, dissertations, and published and unpublished thesis. 

1.6 Objectives of the Study

The study has four-fold objectives. These are to:

  • Identify and examine the symptoms of post-traumatic stress disorders among personnel of the GAF;
  • Examine and analyze the effects of peace support operations on post-traumatic stress disorder and social identification;
  • Examine and analyze the prevalent group of post-traumatic stress disorders in the Ghana Armed Forces; and
  • Examine and analyze the relationship between post-traumatic stress and the strength of social identification.

1.6 Hypothesis

The research hypotheses used in this study is tailored to suit a qualitative methodology that is interpretative rather than statistical.

1.6.1 Alternative Hypotheses

  • There are symptoms of post-traumatic stress disorders among personnel of the GAF.
  • Peace support operations have effect on post-traumatic stress and social identification.
  • Post-traumatic stress disorders affect people of a particular group in the GAF.
  • There is a relationship between post-traumatic stress and the strength of social identification.

1.6.2 Null Hypotheses

  • There are no symptoms of post-traumatic stress disorders among personnel of the GAF.
  • Peace support operations do not have effect on post-traumatic stress and social identification.
  • Post-traumatic stress disorders affect every group in the GAF.
  • There is no relationship between post-traumatic stress and the strength of social identification.

1.5 Limitations

The research was limited in terms of data collection. Military personnel are generally sceptical about accepting their stress situations, largely due to the existing stigmatization associated with combat stress and PTSD.

Nevertheless, the researcher's status as a member of the GAF provided an insight into some of the issues relating to social identification and PTSD. The researcher further interacted with colleagues and other military personnel involved in post peace support operations to gain further insights into issues raised in the research.

1.6 Organization of Study

The study is organized into five chapters. An introduction of the entire study is captured in Chapter one. Chapter two presents a review of the relevant literature. Chapter three outlines the methods of data collection while an analysis and interpretation of data and results is covered in chapter four. The fifth chapter is devoted to the summary of findings, conclusions and recommendations.




This chapter provides the theoretical framework for the research.  It considers the views of some writers on Peace Support Operations and how they impact on social identity, stress and related concepts.  The study of these concepts will help in understanding the social identification and post-traumatic stress symptoms in post peace support operations among Ghanaian peacekeepers.

2.2 Social Identification and related Theories

2.2.1 Social Identification

Social identification is the process by which an aspect of self- image is developed based on in-group preference or ethnocentrism and a perception of belonging to a social or cultural group. (APA, Thesaurus of Psychological Index Terms, 8th ed).

2.2.2 Theories of Social Identification

Several theories have been formulated to explain how threats or stress affect social identification. Three of the well known theories are explained below: The Integrated Threat Theory

The theory of Integrated Threat was first identified by Walter and Cookie Stepan, when they attempted to explain how a group's prejudiceswere created by threats from other groups. These threats are said tobe present anytime"one group's actions, beliefs, or characteristics challenge the goal attainment or well being of another group" (Riek, Mania, & Gaertner, 2006).An individual group may feel threatened by another which is utilizing resources it needs to achieve its goals or to sustain its status as a group. These resources may be tangible, such as money or materials, or intangible, such as status, power or knowledge (Ibid). "When resources are scarce, the group whichis threatened by the lack of resources finds itself motivated to compete for the resources in order to maintain its identity as a group or to achieve its goals" (Ibid). This competitionpromotes negative attitudes towards those in the group utilizing the resources (Aberson & Gaffney, 2008).

The two groups in competition over resources can be described as the in-group and the out-group. The in-group can be described as the group of people with whom an individual categorizes himself/herself with. Members of an in-group feel a sense of commitment to the group and gain greater esteem from their sense of belonging to the group (Redmond, 2010). The out-group can be described as any group outside of an individual's in-group and a group that can be a potential rival/competitor for resources (Ibid). The in-group is the group which feels threatened, and the out-group is the group which is posing a threat to the in-group (Kendall, 1998).

Intergroup threats contribute to conflict because they influence behaviors, perceptions, and emotions. An appraisal of threat can evoke strong negative emotions, including that of fear, rage, anger, resentment, frustration, contempt and insecurity. In addition, perceptions of threat reduce emotional empathy for members of the out-group. All of these negative emotions combined with the lack of empathy felt for the other group, can literally bring people to a breaking point. Social Identity Theory

Social Identity Theory focuses on the relationship between self-concept and group behavior (Hogg and Terry, 2001). The social identity theory was proposed by Henri Tajfel as a result of work he was doing in the 1970's concerning "categorization and social perception, intergroup behavior, and the pursuit of social psychological understanding of the causes of prejudice and intergroup conflict" (Abrams and Hogg, 1999). He believed that there was "discontinuity between how people behaved when they related to others on an intergroup basis as opposed to an interpersonal or individual basis" and sought to explain the behavior of people in group situations (Abrams and Terry, 2001). Tajfel identified three components of social identity, self-conceptualization, group self-esteem, and commitment to the group, which when met, lead a person to feel connected to their in-group. As a result, all other groups become out-groups and are rivals for status and resources as well as a source for comparison. This can lead to discrimination in favour of the in-group or against other out-groups as well as stereotyping and prejudice when a perceived threat occurs (Redmond, 2009).

According to the Social Identity Theory, "social identity and intergroup behavior is guided by the pursuit of evaluative positive social identity through positive intergroup distinctiveness, which in turn is motivated by the need for positive self-esteem" (Hogg & Terry, 2001). In other words, a person's behavior will be affected by their positive association with their in-group, when their self-esteem and/or status are elevated by that association. Central to this theory are three components identified by Tajfel: self-categorization, group self-esteem, and group commitment. Self-Categorization

Self-categorization refers to a person's belief that he/she belongs to a group. A person must categorize or identify him or herself as a member of a group in order to have their self-esteem elevated through association with the group. According to this theory, categorization "sharpens intergroup boundaries by producing group-distinctive stereotypical and normative perceptions and actions and assigns people, including self, to the contextually relevant category" (Ibid). In addition, self-categorization can reduce "uncertainty about themselves and others and about how they and others may or ought to behave in specific social contexts" (Ibid). "The core of an identity is the categorization of the self as the occupant of a role" (Stets & Burke, 2000). By assigning roles to individuals that are self-categorized as being part of a group, individuals can derive meanings and expectations associated with their roles, and as a result, are able to create values based standards that motivate and guide behavior. Group Self-Esteem

Group self-esteem refers to the positive self-esteem or self-identity gained through membership in a group. In order to categorize one's self as a member of a group, membership in the group must hold some value for the person such as improvement in their status or positive personal identity through the association with the group. The theory suggests that people have a need to "see themselves in a positive light in relation to relevant others" (Hogg and Terry, 2001) and that this can be achieved in a group context through "making comparisons between in-group and relevant out-groups in ways that favour the in-group" (Ibid). Group Commitment

Group commitment refers to the strength of the commitment a person feels to their in-group. This is important because if an individual believes they can move into a higher status group, this person will be "unlikely to show much solidarity or engage in much direct intergroup competition" and will instead attempt to "disidentify and gain psychological entry to the dominant group" (Ibid).

When a person identifies him or herself with a group, gains a positive self-esteem through the group, and feels committed to the group, the person will be motivated to "maintain the group and their memberships in the group" (Redmond, 2009). There can also be adverse consequences, however, to an individual over-identifying with a group. When a person becomes too attached to a group, it can lead to stereotyping and the degradation of out-groups as well as overdependence, antisocial behavior, decreased creativity, and a decreased sense of self for the individual (Hogg & Terry, 2001). As a result of being too attached, the lines that once separated the individual identity from that of the group may become blurred. If this loss of individuality takes place, it may result in a decreased ability to create an independent self concept apart from the group. Social Dominance Theory

The Social Dominance Theory originated in an attempt to combine the more classical theories of social behaviour such as Marxism, and more contemporary theories such as Social Identity Theory into a unified behavioral model to explain bias in group behavior (Sidanius & Pratto, 1999).The Social Dominance Theory is based on the idea that in virtually all societies, group-based hierarchies are formed in which both dominant and subordinate groups co-exist. As is naturally the case, the dominant group(s), referred to as having "positive social value" in the group structure; has access to rights and privileges that are denied to subordinate group(s) because their (negative) social value and ability to bring to bear power and resources are limited (Ibid).

A principledistinction between Social Dominance Theory and similargroup-based social theories, such as Social Identity Theory, is that group members are not only motivated to protect the group to preserve their social status, but feel compelled to justify their group behavior (dominant or subordinate) through ahierarchicalsystem represented through the following omponents:Legitimizing Myths, Trimorphic Structure, and Social Dominance Orientation (Redmond, 2009). Legitimizing Myths

Dambrun, et al.(2009)upholds Sidanius and Pratto's contention that both dominant and subordinate groups strive to sustain group-based hierarchies by the development of opposing ideologies that promote, or attenuate group inequality and domination;" otherwise referred to as "legitimizing myths." In other words, social groups play off each other through "social policies" to maintain the group hierarchy but are motivated to do so for different reasons. The differences between these reasons are referred to as "behavioral asymmetry" (Redmond, 2009).

Asymmetry occurs when the dominant group wishes to maintain their positive social status, yet the subordinate group wishes to climb the proverbial ladder and participate in the myriad advantages of the dominant social group. As selfish as we are, social groups are not fully inclusive. These groups seek to maintain their social status by justifyingbehaviors through mitigating perceived gaps in social status. This is accomplished through legitimizing myths - in the form of perceived negative stereotypes, values and beliefs against the opposing groups.

“Legitimizing myths consist of attitudes, values, beliefs stereotypes, and ideologies that provide moral and intellectual justification for the social practices that distribute social value within the social system” (Sidanius and Pratto, 1999). Legitimizing myths can be broken down into two distinct groups: hierarchy-enhancing legitimizing myths (HELM) and hierarchy-attenuating legitimizing myths (HALM). HELM's not only organize individual, group, and institutional behavior in ways that sustain dominance, they often lead subordinates to collaborate with dominants in the maintenance of oppression (Pratto et al, 2006). Trimorphic Structure of Group-Based Hierarchies

Our predisposition to join groups is an essential element of Social Dominance Theory that assumes a trimorphic structure of group-based social hierarchy in which members are stratified into social groups based on characteristics related to the following three structures (Sidanius and Prato, 1999):

  1. Age - A biologically-based system where adults are classified as socially higher (valued) than younger people.
  2. Gender - Another biologically-based system in which males are classified as socially higher than women.
  3. Arbitrary set -Group-based hierarchies determineits orderbased on a virtually limitless set of factors including personal preferences, religion, beliefs, class, ethnicityor values.The age and gender systems are fixed in terms of their applicability to social groups. In other words, these stratification systems extend to all social systems as members invariably fall into a range of either group.

The inclusion (or exclusion) of membership within the arbitrary set system however, is dependent upon the factor(s) applied to the group. For example, a social group based on ethnicity or religion will include a very specific subset of participants to the exclusion of all others.

For these reasons, the arbitrary set system represents the most dynamic group-based social hierarchy. This system has the potential to be the most inclusive (and positive) in terms of being socially constructive, as well as the most exclusive, or socially destructive. Dominance Orientation

To better predict social group bias, Social Dominance Orientation (SDO) was developed to measure the extent to which individuals manifest discriminatory behaviors(Sidanius and Prato, 1999). SDO is defined as "the degree to which individuals desire and support group-based hierarchy and the domination of 'inferior' groups by 'superior' groups" (Ibid).

2.2. Concepts of Stress and Post Traumatic Stress Disorder

2.2.1. Combat/Traumatic Stress

Stress is a word that is often used to cover a whole range of feelings and emotions. There are many varying definitions of stress. Some researchers distinguish between eustress (when something changes for the better) and distress (when something changes for the worse). Others use stress to cover anxiety. In a military environment stress is often related to fear. “Stress is a response to pressure or a threat that may exceed an individual's ability to cope with it.” According to Colonel (DR) Orokpo (2004) of the Nigerian Army Medical Corps, Combat stress is the mental, emotional or physical tension, strain or distress resulting from exposure to combat or combat related conditions.   The United Nations Department of Peacekeeping Operations (UNDPKO) identifies three forms of stress in its materials for PKO trainers:

  • Basic stress.
  • Cumulative Stress.
  • Critical Traumatic Stress (Traumatic Stress)

Basic stress comes from daily discomfort and fatigue, including homesickness, and problems with colleagues, and as such is ‘normal' and manageable. Cumulative Stress arises when basic stress is not relieved and when individuals feel overwhelmed by responsibilities or stressful environments on a repeated basis. “When it goes unnoticed, or when it is not well managed, cumulative stress can result in a burnout (UNDPKO, 2003). Critical Traumatic Stress is brought on by an experience beyond the range of ‘normality'. This may be a traffic accident, humanitarian or natural disaster, or scenes of extreme violence, or loss of life. The repetition of such events does not usually reduce the stress but compound it.

Salas (1996) analyzes battlefield stress in a 4-Phase model. According to him, phase one involves the identification of environmental stressors in which a soldier normally finds himself.  Phase 2 involves the appraisal of the stressors.  If the evaluation process generates perception of chaos or confusion and disorder, and the individual feels unable to correct the situation, the uncertainty phase of stress and Fog of War will result. Phase 3 is the performance expectation phase. Performance expectation decreases due to perceptions of powerlessness and weakening effects of stress.  Phase 4 is the stress outcome phase.   The stress outcome in phase 4 is likely to be experienced as fog of war. 

Salas' model highlights   the place of the individual soldier in identifying stressors and appraising them.  It also brings to fore the adverse effects of stress on performance. These effects vary with individuals. To maximise performance, a commander must always make an appraisal of stress reactions of his men (ibid).

The America Psychiatric Association in conjunction with the United States (US) Army developed a model focusing on combat stress. The model addressed combat stress behaviour as a generic term which covers the full range of behaviours in combat, from highly positive to very negative behaviours. According to this model, positive combat stress is that degree of stress which is necessary to sustain and improve tolerance to stress without overstraining and disrupting the human system. Some levels of stress are helpful and even necessary to health. Insufficient stress leads to physical and/or mental weakness.  A moderate response to stress actually improves performance and leads to positive combat behaviours in soldiers. Some of the positive combat stress behaviours include unit cohesion, loyalty to leaders, sense of mission, alertness, increased tolerance to hardship, pains, discomfort and injuries and heroic act. Thus, the binding force that keeps soldiers together in mission and leads to acts of extreme courage, unbelievable strengths, deliberate self-sacrifice despite dangers and death are induced by positive combat stress with strong social identification. Inherent sound military training, wise personnel policies and good leadership activate the moderate level of stress needed in operations (Unoneme, 2008).

Apart from the positive stress behaviours, the US model of   combat stress behaviours also identified dysfunctional combat stress behaviours.  These include misconduct stress behaviours and battle fatigue.  Misconduct stress behaviours range from minor breaches of unit orders or regulations to serious violations of law of Armed Conflict in operations.  These occur when soldiers are under extreme combat stress.  Such negative behaviours include alcohol and drug abuse, looting, rape, torture and brutality.  Battle fatigue, on the other hand, is the distress and impaired performance that come from reactions to operational situations.  Combat fatigue behaviours include fear, anger, rage, carelessness, erratic actions, immobility, total exhaustion, loss of skills and memories, impaired vision and depression (Unoneme, 2008).

Both misconduct stress behaviours and battle fatigue behaviours can be prevented by stress control measures by combat stress control team.  All forms of combat stress not adequately managed may result in PTSD. Adequate combat stress preventive measures could help to prevent or minimize subsequent PTSD.  An important preventive measure for PTSD is routine after-action debriefing in small groups.  If properly debriefed, soldiers will often not develop clinical PTSD or misconduct stress behaviours (ibid).

2.2.2. Pre-operation Management of Stress

A commander must start the management of stress during the preparations for an operational deployment. A number of factors should be well thought-out. The first factor is realistic training, which simulates combat conditions as closely as possible. Men who are subjected to stressful conditions in training, should experience less stress later in combat or comparable circumstances. Clausewitz once said: “It is of first importance that the soldier high or low should not have to encounter in war things which seen for the first time set him in terror or perplexity”. Exposure to unpleasant pictures would also immune troops slightly to first sight of injury and boost their confidence in dealing with casualties. The second factor for the management of stress is unit cohesion, possibly best described as ethos. Members of a cohesive group provide comfort and support for each other and that helps to reduce the effects of a shocking environment or experience (Bercx, 2004). Another factor of stress management is establishing good communication between the commander and his subordinates. Uncertainty and ambiguity are among the greatest sources of stress. The commander must train his men to expect the unexpected and he must train himself to pass on information, to keep all those around him informed and up to date with developments. Troops have a thirst for information when tensions and dangers increase. If soldiers have confidence in their leaders at all levels, if leaders are honest and straight and if the chain of command is open to a degree of discussion and debate then there is the feeling of some ownership in the course of events to be helpful in getting soldiers to understand the context in which they are risking their lives for the betterment of others or a cause.

2.2.3. Management of Stress During Operations

Management of stress and the wellbeing of the soldiers in a unit is the ultimate responsibility of the Commanding Officer (CO). Commanding an operational unit means leading military personnel. That leadership becomes even more important when it has to be demonstrated under extra pressure (Kets de Vries, 1987). Leadership means winning the hearts and minds of others in order to achieve a common purpose. ‘One wins the hearts of the people first by winning their trust, respect and confidence in one as a leader. Secondly, by making them wanted, valued, listened to, recognized: by generating feelings of excitement and involvement: by giving them a pride in their organization. One wins the minds of people by giving them clear directions and expectations and from distinct boundaries of territory, authority and responsibility to work within' (Hollington, 1994). All leaders should be in a position to screen for mental trouble. They should identify those who need help and deal with any problems  immediately, instead of having to deal with them later after redeployment and returning home

(Rijken, 2004).

Commanders can help address the problem of stress by paying attention to the warning signs of combat stress. Perhaps, a basic understanding of the chemistry of stress would be helpful to commanders and personnel alike.

2.3 Chemistry of Stress

Doctor Hans Selye , a pre-eminent  authority on stress, explained   the chemistry of stress using the  3 stages in stress response.  At the alarm stage, which is the first stage, the body recognizes the stress and prepares for action, either to fight or escape.  The Endocrine glands release hormones that increase heartbeat and respiration, elevate blood sugar, increase perspiration, dilate the pupils and slow the digestive process. In the second stage, which is the resistance stage, the body repairs any damage caused by the reaction to the alarm.  However, if the stress continues, the body remain alert and cannot repair the damages (Unoneme, 2008).

As the resistance continues, the third stage which is Exhaustion, sets in, and a stress-related disorder might result.  According to psychologists, prolonged stress leads to the malfunction of the limbic system. This is the component of the brain that is responsible for the control of human emotional experiences such as depression, excitement and fear.   As the limbic system malfunctions, supplies of blood, to relevant organs, cells and systems are affected.  This will lead to temporary damage of the affected area and eventually to permanent damage or death if prolonged (Berkun, 1989). An understanding of the chemistry of stress would assist military commanders to appreciate stress reactions of their troops. This could also help them to ensure that troop's stress reactions are checked adequately to prevent serious damage to their systems.

2.4 The Reality of Combat Stress in the Military

According to Binneveld (1997), the systems associated with combat stress reactions have existed for centuries.  Although PTSD and other combat stress related reactions in the military had been in existence for a long time, they were not acknowledged or recognized by many commanders as serious effect of military operation that needed special attention.

Speaking on the effect of operations on military personnel in 2003, General Peter Cosgrove, the Chief of the Australian Defence Force, said:“As military operations evolve in a changing world, so   too our understanding evolves of the effects of operations on our personnel.  Understanding stress will enable us prepare ourselves for the stress of operational deployments and help to limit any negative impact on the lines and wellbeing of our most valuable assets - the men and women of the Australian Defence Forces, our  past and future veterans” (Ibid).

Dean (1997) also observed the growing acceptance of the need to prevent the detrimental impact of combat stress within many Western military organisations.  This interest in preventing serious stress reactions stems from a number of concerns. He identified the concerns to include operational effectiveness, humane regard for the wellbeing of personnel retention and legal considerations such as compensation (Ibid).

According to Kidson (1993), symptoms of PTSD can also manifest after decades of involvement in operations. His study on Australian outpatient veterans of World War II disclosed that 45 percent were found to have active   PTSD 46 years after the war (Ibid). It is therefore necessary to monitor the health status of military personnel involved in combat or combat related operations, even after retirement from the service.

It is generally thought that conventional war has a greater impact on service personnel than operations other than War. This notion however is beginning to be challenged.  Research by Schade (1997) indicates that there is growing evidence that the stress of peace support operations can be as psychologically damaging as conventional warfare.  This was collaborated by  Mylle (1997), who observed that while many peace support operations  may be qualitatively different from warfare, the end result in terms of psychological impact are almost similar. He observed that many stressors common in the military are present in all operational deployment.  These include separation from family, harsh environmental conditions and organizational tensions (Unoneme, 2008) 

A research by Pygsley (1998) on New Zealand peacekeeping personnel suggest that peace support operations may result in even more stress and frustration than conventional combat.  Ambiguity about the role of military personnel, constraints on the use of force even when faced with threats, constraints on active involvement even when witnessing atrocities and tactical negotiation in threatening situations are some stressors associated with peace support missions (Pygsley, 1998),

A study of Australian Soldiers by Ward (1997) revealed that 15 months after return from a peace support mission in Somalia, nearly 20 percent had significant level of psychiatric morbidity.  The observed symptoms included lack of initiative, restlessness, concentration difficulties, decline in work performance and suicide attempts.  The study noted that, in spite of these problems, most soldiers were reluctant to seek any form of assistance (Ward, 1997),

Reluctance to admit psychological difficulties seems to be a universal trait in military forces.  It is likely to be profound in the GAF where awareness of stress and its related problems are still very low.  Issues of combat stress and PTSD are not given the needed attention by the military authorities. This is evidenced by the fact that troops are always deployed on peace support operations without a military or (at least) a medical psychologist. Additionally no proper stress management is given to troops on their return from peace support operations. It is important for both troops and the military authorities to develop the right attitude towards acknowledging and combating stress. Commanders at all levels could increase stress awareness in their various establishments and commands.  Effort should be made to employ military or medical psychologists to accompany troops embarking on peace support operations. On return from those operations, the troops should be made to go through post peace support operations examination and education.

2.5. Factors Affecting Reactions to Stress

Many factors affect the ability to withstand stress and one of them is age. Occupational therapist Major Stacie Caswell, of a combat stress unit attached to the military hospital in Mosul, commented that the US Army in Iraq now has, “older soldiers coming in - up to 41 years old - and that is causing its own problems. They have difficulty dealing with the physical impact of the war and also interacting with the younger men (Beaumont, 2009). In a very different environment, the Japanese found a similar problem through their participation in the United Nations Operation in Mozambique (UNOMOZ) in 1993. The commander of the first contingent, found that the younger members of the contingent were much better able to physically and mentally deal with the harsh operating, and living environments, and were far more flexible in communication patterns, including in absorbing languages used in their UN camps (mainly English and Portuguese). Without a designated translator, and dependent upon the Portuguese and Italians for utilities, food, water, and general security, the roles which the  older contingent members could actually perform were limited, yet the demands of the military hierarchy to maintain the classic ‘pyramid' of command dictated their presence (Col Nakano, 2007).

Another stress factor that has become a problem for many militaries is the degree to which reserve personnel have been utilized. As noted above, many Western militaries have relied upon reservists throughout the past 15 years for niche skills in PKO. The US relied upon the 353rd Civil Affairs Command, US Army Reserve for managing many of the post-conflict re-construction projects in Kosovo in 1999, with the Command's reservist staff of bankers, fund managers, lawyers and other specialists being perfectly suited to perform such tasks. 96% of US Civil Affairs personnel are reservists (US Joint Chiefs of Staff, 2003). The problems stemmed from most of the staff being removed from their civilian occupations for months on end, creating family stresses, but also significant economic hardship as Army salaries were often a fraction of those earned in their civilian positions.

Most Civil Affairs personnel were working in positions essentially similar to those in civilian life, but for many reservists their military roles in PKO were in stark contrast to their regular occupations, and thus the levels of stress higher. In Iraq, the British Army has increasingly deployed junior reservist soldiers to fill its depleted ranks. A regular Army Captain commented that of the reserves he commanded in Iraq, the military experience of some was impressive, whereas others were rather ‘green', “in the case of one junior soldier, four weekends and a two week battle camp...prior to mobilization.” He also commented that this soldier was involved in many high intensity combat ‘contacts', and upon return to the United Kingdom (UK) would have limited psychological and welfare assistance from the military. “I personally feel that we used that young man to his utter limit on the very minimum of training and investment,” and that if, “he has any problems how will they manifest themselves, and who will care for him? Where is the duty of care in this case? (Curry, 2007).  There is a common view that military commanders and politicians are underestimating the personal stresses on reserve personnel and the care that they shall require in the future, as well as the equivalent forms of support for their families that regular troops receive: all too often reserve families are left quite isolated and forced to rely upon mainstream media for information, a cause of significant concern when casualties have become so common-place (Stewart, 2007).  Furthermore, those reserve personnel who have served in multiple missions, as has been common in the 1990s and since 11 September 2001, have found that upon return to civilian life they have not only to suffer the problems of civilian-readjustment but also have frequently suffered in promotion terms, with many resigning from the reserves in case their careers are threatened. There have been many instances also of the employment protection provisions of re-serve service being avoided, with reservists being made redundant within months of their return, it being made clear that their past, and anticipated future, absences are costs that commercial concerns cannot afford to bear(Mervin, 20s05).



3.0 Introduction

This chapter addresses the methodology used in the research. The chapter focuses on the research design, research setting, data collection and analysis techniques employed to achieve the goal and objectives of this research.

3.1 Research Design

Prior to the study, authority was sought from the appropriate authorities of the Ghana Armed forces for their consent for the study to be carried out. Personnel were accordingly informed before the commencement of the research.  Respondents were counseled on the relevance of the study and why they should voluntarily cooperate with the researcher.  A simple random sampling technique was used in selecting the sample, from the various groups. This gave each worker an equal opportunity to be included in the study. A comparative descriptive study was employed in assessing the effect of social identification and post-traumatic stress in post peace support operations within the GAF.

3.2 Research Setting

The research was conducted on personnel of the GAF from the 66 Artillery Regiment, Ho; 1 Infantry Battalion, Tema; 5 Battalion of Infantry, Burma Camp; 2 Battalion of Infantry, Takoradi; 4 Battalion of Infantry, Kumasi; 3 Battalion of Infantry, Sunyani; Eastern Naval Command, Tema and Air Force Station, Accra. The Ghana Armed Forces consists of 3 services namely the Ghana Army, Ghana Navy and  Ghana Air Force, all operating under a Joint Service General Headquarters. The GAF is headed by the Chief of the Defence Staff with the President of the Republic as the Commander-in-Chief. The roles of the GAF include the defence of the nation against external aggression; to support the Government's foreign policy objectives; and to assist the Government in the maintenance of internal security. The 3 Services are deployed into Commands with units having operational responsibilities in the 10 regions of Ghana.

The GAF in conjunction with other security agencies have been able to provide and continues to provide the Nation with a peaceful and congenial atmosphere for national development.

Aside contributing to maintain peace in Ghana, the GAF has been instrumental in maintaining and restoring peace in war torn countries across Africa and sometimes beyond the African continent through peace support operations. The UN has often relied on the GAF to conduct peace support operations in countries as diverse as Rwanda, Kosovo, and Lebanon. Currently, Ghana contributes troops to peace support operations in the Democratic Republic of Congo, Liberia, Cote I'Voire, Lebanon and until recently Chad

3.3 Sources of Data

The study is empirical and explorative in nature and therefore the information presented was based on primary and secondary data.

3.3.1 Primary Data

Primary data are useful for current studies as well as for future studies. The methods used for primary data collection were observation method, personal interview, telephone survey and mail survey (Panneerselvam, 2010). Self-administered questionnaires, consultations and informal personal interviews was combined to form the primary data, a situation termed triangulation by Saunders, Lewis and Thornhills (1997).   Personal interviews was used to triangulate the questionnaire, probing further, where necessary, unclear responses on the questionnaire. The reason for this combination was to give opportunity to respondents to express their own views on questions that may be considered sensitive or unclear to elicit the right responses from the respondent. It was also to help get responses to unanswered questions on the questionnaire.

3.3.2 Secondary Data

Secondary data refers to data collected from sources which have been already created for the purpose of first-time use and future uses (Panneerselvam, 2010).  Secondary information was collected from various documents such as books, newsletters, reports, magazines, journals, daily newspaper, internet, as well as from existing literature to understand social identification and its theories, post-traumatic stress, causes and symptoms, its effect on personnel of the GAF.

3.4 Population and Sampling Techniques

The research could not cover the population of the entire GAF due to time constraint in relation to the large number of such population.   In the light of this therefore, a sample size of 200 respondents was selected. This comprised of interviews with thirty individuals, thirty persons in focus groups of six and one hundred and forty questionnaire which were administered to personnel of the GAF. Twenty respondents each were selected from the 66 Artillery Regiment, Ho; 1 Infantry Battalion, Tema and 5 Battalion of Infantry located at Burma Camp, whilst fifteen respondents each were  selected from the 2 Battalion of Infantry, Takoradi; 4 Battalion of Infantry, Kumasi and 3 Battalion of Infantry, Sunyani. The Eastern Naval Command (Navy), Tema and Air Force Station, Accra provided sixteen and nineteen respondents each.

This sample size was carefully selected using the cluster sampling technique. Under this method, the total population is divided into some recognizable sub-divisions which are termed as clusters and a simple random sample of these clusters is drawn and then the survey of each and every unit in the selected cluster is made (Mustafa, 2010).

Within the selected cluster, a random sampling of personnel who have ever participated in international peacekeeping/peace support operation was made. According to Pattern, “Random sampling is the form applied when the method of selection assures each individual or element in universe an equal chance of being chosen”. In the words of WM Harper, “A random sample is a sample selected in such a way that every item in the population has an equal chance of being included” (ibid). The cluster and sampling were done with a view of gathering credible data from those who might have either experienced post traumatic stress disorder or witnessed it from a close colleague in operation.

3.5 Data Collection Instrument

Data collection is the systematic recording of information (Egger and Capri, 2008). Collecting data is a series of interrelated activities aimed at gathering good information to answer emerging research questions (Creswell, 1998).

Questionnaire, focus group discussions and interviews were the main research instruments. The interview was conducted for the forces personnel. An interview designed questionnaires was used to gather the individual's views on the effect of social identification and post-traumatic stress in post peace support operations within the GAF and what they think can be done to solve the problem. The questionnaire contained two sections. The first section captured the respondent's demographic data and how long they had been serving in the GAF. These included Age, Sex and educational level, Arm of Service and category (whether an officer or other rank), number of peace support operations attended and how long they served on those operations. This was to help the researcher to know the background of the respondents. The second section was on the respondent's knowledge of social identification and post-traumatic stress, its effect and what could be done to combat it.

3.6 Data Analysis

The two main computer based software of Statistical Programme for Social Sciences (SPSS) and Microsoft Excel were adopted in running the information gathered through the interviews, questionnaire and transcribed focused group discussions. The principal investigator coded all questionnaires before their administration. All one hundred and forty (140) questionnaires were screened to clarify vague or inconsistent response information. Completed questionnaires were sorted out, collated and cleaned. Cross validation and consistency checks were done. Data collected were summarized and illustrated using bar-charts and frequency distribution tables used for sample data grouping. Statistical Package for Social Sciences (SPSS) was used to create the database as well as for the statistical analysis. The results were presented in tables showing proportions of the distribution of the characteristics.



4.0 Introduction

This chapter presents an in-depth analysis of the results of the data gathered from interviews conducted, focus group discussions held, observations made, questionnaires and review of documents. An analysis of the views, opinions and perceptions gathered from the field is presented. Additionally, data from project documents and other sources is reviewed and analyzed. The study sought to assess social identification and post-traumatic stress symptoms in post-peace support operations.

The study has four-fold objectives. These are to:

  • Identify and examine the symptoms of post-traumatic stress disorders among personnel of the GAF;
  • Examine and analyze the effects of peace support operations on post-traumatic stress disorder and social identification;
  • Examine and analyze the prevalent group of post-traumatic stress disorders in the Ghana Armed Forces; and
  • Examine and analyze the relationship between post-traumatic stress and the strength of social identification.

The data was analysed using descriptive statistics and the analysis was based on the objectives of the study which also served as a framework for the analysis. The findings were presented in tables, graphs and pie charts.

4.1 Socio-Demographic Profile

Table 1 Sex of Respondent




Valid Percent

Cumulative Percent


























Source: Fieldwork, 2011

Table 1 and figure 1 above show the sex distribution of the respondents. 75% of the respondents were males and 22% were females. However, 2.1% of the respondents did not disclose their sex.

Table 2 Age of Respondent

Age of Respondent



Valid Percent

Cumulative Percent


20-24 years





25-29 years





30-34 years





35-39 years





40 years and above










Source: Fieldwork, 2011

Table 2 and figure 2 above show the age distribution of respondents. 48.6% of the respondents were within the age group, 35-39 years, 27.9% of them were within the age group, 25- 29 years, 20% of the respondents were within the age group 30- 34 years, 2.9% were within the age group, 20 - 24 years and 0.7% of them were forty years and above.


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Table 3 Educational Background of Respondent

Educational Qualification



Valid Percent

Cumulative Percent