Page 136 - GHES-3-2

Global Health Economics and
Sustainability
The impact of PTSD on memory and cognition

2.4. Procedure The writing manual was applied on the 4 day and
th
The ERRA was provided with consent forms and other over the next 3 days; the adolescents were requested to
necessary details in advance in Islamabad a few weeks write about their deepest reflections, notions, and ideas
before the study commenced in Mansehra. Additional for 15 min. Once they were done, they were instructed to
information was obtained from ERRA on discrete staple their pages together (if more than one) and deposit
reconstruction sectors such as housing, education, health their pages in a box at the back of the room. At the end
care, environmental, livelihood, transportation, power of every session, the participants were reminded that their
generation, social protection, telecommunication, and thoughts were private and they did not need to talk to their
disaster risk reduction. Subsequently, the Mansehra office colleagues about what they had written. Each session was
of ERRA organized two different groups (B, and C) of followed by biscuits and juice in the open courtyard.
adolescents aged 13-15 for this particular study. Each The Rivermead Behavioral Memory Test was reapplied
group comprised 15 adolescents and each encompassed to both groups 1 day after the writing manual sessions were
ten boys and five girls. completed. The next day, the PTSD self-assessment test
st
The 1 day at the Mansehra location was spent getting was also read ministered to both groups.
to know the adolescents, who were briefed about the The same procedure was applied in the same manner
nature of the study and were informed that anything they to group A in Islamabad. Notably, however, group A was
wrote during the study would remain confidential. This tested after groups B and C, and the environment/setting
assurance was provided to help them feel comfortable about differed for the control group A from the setting previously
participating in the study. Notably, the two groups B and C described for groups B and C.
were segregated for the duration of the study to avoid any An individual scoring system was designed for each
disruption to the study and avoid variations in the results. activity because the study was executed on a small scale
The separation of the groups was also important because and results were required for comparative purposes. The
two groups were instituted instead of one only to account
for any variations in the results. PTSD questionnaire comprised 24 yes/no. Therefore,
one point was awarded for each “yes” answer. Given the
The study was conducted solely in Urdu. Each group questionnaire characteristics, the higher the score, the
was handled separately throughout the experiment, at stronger the respondent’s PTSD symptoms. The subsets
different times every day. A quiet room with 20 tables of the Rivermead Memory Test were scored separately
and chairs served as the setting for the study so that the and the results depended on how accurately an individual
participants could focus on their work without being able performed on each part of the test. The subsets included
to see the responses tendered by other participants. Two remembering an appointment, recollecting a short route
members of the ERRA team were also always present (immediately and after a delay), recalling a belonging,
throughout the study to ensure that the participants felt remembering to deliver a message, recalling images,
comfortable, help if they needed assistance, or answer any orientations, and stories (immediately and after a
questions. Each participant was given two pencils and one delay), remembering names, and recognizing faces. The
eraser. The PTSD self-assessment test was given to both Rivermead test scoring was converted to 100 maximum
groups on the 2 day. points to maintain reliability; thus, each subtest was
nd
Thereafter, the respondents were given a break of accorded a maximum of 8.33 achievable points.
1 week from the study. This interruption was intentional:
the writing manual sessions can be emotionally draining 3. Results
for some participants, and the researcher did not wish to A total of 45 participants aged between 13 and 15 years
overwhelm the adolescents. The Rivermead Behavioral participated in the present study. However, males and
Memory Test was administered after the 7-day break. This females were not equally represented (66.6% of the
test took 20 – 30 min to complete. Each participant was participants were male, and 33.3% were female).
assigned a number and respondents were asked to always Tables 1-3 list the results obtained for each group
use the same number and not write their names on their (A, B, and C) on the PTSD questionnaire before (PTSD I)
different tests. The pages were also precoded to make up and after (PTSD II) the writing manual was applied.
for any human errors committed by the participating
adolescents in inscribing their numbers on their pages. Tables 4-6 present the results of the Rivermead
This encoding ensured confidentiality and each participant Behavioral Memory Test for each group (A, B, and C)
inscribed the same number on every form to facilitate the before (Memory I) and after (Memory II) the writing
calculation of the results. manual was applied.

Volume 3 Issue 2 (2025) 128 https://doi.org/10.36922/ghes.5121