In brief
A 2015 study of 200 University of Baghdad nursing students found 63. 0% screened positive for some level of PTSD on an adapted Davidson Trauma Scale, with first-year students and Baghdad residents showing the highest symptom levels; the authors recommend coping-skills and stress-management training for affected...
What this article is about
Quick Answer
A 2015 study of 200 University of Baghdad nursing students found 63.0% screened positive for some level of PTSD on an adapted Davidson Trauma Scale, with first-year students and Baghdad residents showing the highest symptom levels; the authors recommend coping-skills and stress-management training for affected students.
Student takeaways
Key Takeaways
- 63.0% of the 200 surveyed nursing students showed some level of PTSD symptoms on the adapted Davidson Trauma Scale: 29.0% low, 21.5% medium, and 12.5% high; 37.0% showed no PTSD symptoms.
- Of the 63.0% of students who screened positive for PTSD, 35.0% of the overall sample were female students with symptoms, indicating trauma symptoms affected both male and female students in this population.
- 21.5% of students with PTSD symptoms were age 24 or older, suggesting older students in the sample also carried significant symptom burden.
- First-stage (first-year) nursing students showed the highest proportion with PTSD (18.0%) compared to students in the other three academic stages.
- 42.0% of students who lived in Baghdad showed PTSD symptom levels, a higher proportion than students residing outside the city, pointing to a residency-related association with symptom burden.
Student summary
Why This Research Matters
Posttraumatic Stress Disorder (PTSD) is a psychological and emotional reaction that can develop after a person experiences, witnesses, or is exposed to a traumatic event — a natural disaster, wartime combat, torture, murder, serious harm, assault, or a violent attack. This 2015 study, published in the Kufa Journal for Nursing Sciences by Maan H. Ibrahim Al-Ameri, looked at how common PTSD symptoms were among undergraduate nursing students at the College of Nursing, University of Baghdad — a setting shaped by years of armed conflict and instability in Iraq.
The researcher used an observational design and collected data between December 4, 2013 and May 17, 2014. A non-probability sample of 200 students, drawn from all four stages (years) of the nursing program, completed a two-part questionnaire. The first part gathered demographic information: gender, age, academic stage, and place of residence. The second part used 17 items adapted from the Davidson Trauma Scale (DTS), a self-report tool built around DSM-IV diagnostic criteria for PTSD that asks respondents to rate the frequency and severity of trauma-related symptoms. Data were analyzed with descriptive statistics (frequencies, percentages, distributions) and inferential tests (correlation coefficient, chi-square, and independent t-test) to see whether PTSD levels were linked to demographic characteristics.
The results were striking: 63.0% of the nursing students showed some level of PTSD — 29.0% at a low level, 21.5% at a medium level, and 12.5% at a high level. Only 37.0% of participants showed no PTSD symptoms at all. Looking more closely at who was affected, 35.0% of all participants with some level of PTSD were female (out of the 63.0% total affected), and 21.5% of those with PTSD were age 24 or older. Among the four academic stages, first-stage (first-year) students had the highest proportion showing PTSD, at 18.0%. Residency also mattered: 42.0% of students living in Baghdad itself showed PTSD symptoms, compared with those living outside the city. The author concluded that more than half of the sample was age 22 or older, about half were male, and most lived in Baghdad — and that a high percentage of these students carried some degree of trauma-related symptoms. The study's recommendation was direct: nursing students affected by these symptoms should be offered coping-skills and stress-management training, including relaxation sessions, as part of their education.
Why does this matter for a nursing student today, especially in Canada? Even if you have never lived through war, this study is a useful lens for thinking about how life stress, prior trauma, and ongoing environmental stressors can affect a learner's mental health and, by extension, their capacity to study, practise safely, and care for others. Iraqi nursing students in this era were training while living amid conflict-related violence, displacement, and loss — an extreme version of the 'background stress load' that any nursing program should be alert to. The finding that first-year students showed the highest PTSD proportion is also worth sitting with: entering a rigorous, emotionally demanding profession can itself interact with pre-existing trauma, even before clinical placements begin.
As you read this study, keep the numbers in context. This is a single-site, single-country, non-probability sample of 200 students assessed with a 17-item adapted screening tool, not a clinical diagnostic interview — so '63.0% with PTSD' reflects screening-level symptom endorsement, not confirmed psychiatric diagnoses. The findings describe University of Baghdad nursing students during a specific and unusually stressful period (2013–2014, coinciding with escalating conflict in the region) and should not be generalized to nursing students elsewhere, including Canada, without caution. Still, the core message — that nursing programs cannot assume their students are psychologically unaffected by trauma exposure, and that screening plus coping-skills support can be built into curricula — travels well across contexts. It is a reminder that self-care and mental health support are part of professional readiness, not an afterthought.
Source abstract
Study Overview
Background: Posttraumatic Stress Disorder (PTSD) is a term applied to psychological and emotional disturbance that develops after experiencing, witnessing or being exposed to a traumatic event. The event may involve actual or threatened death, serious physical injury or threat to physical integrity such as a natural disaster, wartime combat, torture, murder, severe harm to oneself or others, rape, and violent attack or an assault.
Objectives: To determine the infliction levels of Posttraumatic Stress Disorder (PTSD) among the students in the college of Nursing/ University of Baghdad, and to find out the relationship between these levels and some demographic characteristics.
Methodology: Observational design study of undergraduate nursing students has been achieved in December 4th, 2013 to the May 17th, 2014 in order to identify the Post-traumatic Stress Disorder in all stages in the College of Nursing University of Baghdad. A non-probability of two hundred students in all four stages of the college of Nursing/ University of Baghdad was recruited. To meet the study objectives a questionnaire was constructed. This questionnaire consisted of two parts: firstly, four demographic characteristics: gender, age, stage, and residency; and 17 items represent Davidson Trauma scale-DSM-IV for diagnosing and measuring levels of PTSD within the civilians. Data were analyzed by applying: descriptive statistical analysis: frequencies and percentages and distribution; and inferential analysis: Correlation Coefficient, Chi-squire, and independent t-test.
Results: The study indicates that the majority of the students (63.0%) has PTSD: low (29.0%), medium (21.5%), and high (12.5%); and only 37.0% of them have no PTSD. The results indicate that 35.0% of the participants who have different levels of PTSD (63.0%) are female; and 21.5% of those who have PTSD are in age group (≥ 24); for the stages: the first stage shows having more PTSD (18.0%) than the other stages; and finally, 42.0% of those who live in Baghdad have levels of PTSD than those who do not live in Baghdad.
Conclusions: The results of present study indicated that more than half of participated students were at age 22 years and more old; half of them were male students; and the majority live in Baghdad. The study showed that a high percentage of those students have had PTSD in different levels.
Recommendations: The present study recommends that students are to be advised to learn some coping strategies and stress managements by attending training and relaxation sessions.
Evidence appraisal
Main Findings
- 63.0% of the 200 surveyed nursing students showed some level of PTSD symptoms on the adapted Davidson Trauma Scale: 29.0% low, 21.5% medium, and 12.5% high; 37.0% showed no PTSD symptoms.
- Of the 63.0% of students who screened positive for PTSD, 35.0% of the overall sample were female students with symptoms, indicating trauma symptoms affected both male and female students in this population.
- 21.5% of students with PTSD symptoms were age 24 or older, suggesting older students in the sample also carried significant symptom burden.
- First-stage (first-year) nursing students showed the highest proportion with PTSD (18.0%) compared to students in the other three academic stages.
- 42.0% of students who lived in Baghdad showed PTSD symptom levels, a higher proportion than students residing outside the city, pointing to a residency-related association with symptom burden.
Practice transfer
Clinical Relevance
- Nursing programs, particularly in conflict-affected or high-stress regions, should consider routine mental health screening for trauma symptoms among incoming and enrolled students, not just clinical patients.
- Because first-year students showed the highest proportion of PTSD symptoms in this sample, targeted orientation-stage mental health support may help students transition into demanding nursing curricula.
- The study's recommendation for coping-strategy and stress-management training (including relaxation sessions) suggests such interventions could be integrated into nursing curricula as a structured, not optional, component.
- Faculty and clinical instructors should be aware that student residency and demographic background may correlate with trauma symptom levels, informing more individualized academic and pastoral support.
- Screening tools like the Davidson Trauma Scale can help nursing programs identify students who may benefit from referral to counseling or mental health services before symptoms affect academic or clinical performance.
Faculty notes
Educational Relevance
This 2015 article by Maan H. Ibrahim Al-Ameri, published in the Kufa Journal for Nursing Sciences, reports an observational study measuring Posttraumatic Stress Disorder (PTSD) symptom levels among undergraduate nursing students at the College of Nursing, University of Baghdad, and examining associations with demographic variables. Data collection ran from December 4, 2013 to May 17, 2014, a period of significant instability and violence in Iraq, making the study population's trauma exposure plausibly high and context-relevant rather than incidental.
Methodologically, the author recruited a non-probability sample of 200 students spanning all four stages (academic years) of the nursing program. The instrument was a two-part questionnaire: four demographic items (gender, age, stage, residency) plus 17 items adapted from the Davidson Trauma Scale (DTS), a validated DSM-IV-based self-report measure of PTSD symptom frequency and severity that has demonstrated good internal consistency, test-retest reliability, and diagnostic discrimination in other validation studies (though this study does not report re-validating the instrument in this specific population). Analysis combined descriptive statistics (frequencies, percentages) with inferential techniques — correlation coefficient, chi-square, and independent t-test — to explore relationships between PTSD level and demographic characteristics.
The headline finding is that 63.0% of students screened positive for some level of PTSD symptoms (29.0% low, 21.5% medium, 12.5% high), versus 37.0% with no symptoms. Demographic breakdowns showed 35.0% of affected students were female, 21.5% were age 24 or older, first-stage (first-year) students had the highest affected proportion (18.0%) relative to other stages, and 42.0% of students residing in Baghdad itself showed PTSD levels compared to non-Baghdad residents. The author's conclusion emphasizes the high overall symptom burden and recommends that affected students be offered coping-strategy and stress-management training, including relaxation sessions.
For classroom use, this article works well as a compact case study in cross-cultural mental health screening within nursing education, and in the limits of screening-tool findings. Discussion should distinguish symptom-level screening results (using an adapted 17-item scale) from confirmed clinical PTSD diagnoses — the abstract does not report a diagnostic interview or clinical confirmation step, nor does it report reliability/validity statistics for the adapted DTS in this specific sample. The non-probability sampling method and single-institution setting limit generalizability, and the study's demographic subgroup percentages (e.g., '35.0% female with PTSD') are reported in a way that mixes proportions of the whole sample and proportions within the affected group, which is worth having students untangle carefully as a critical-appraisal exercise. The study also predates more recent, standardized PTSD instruments and DSM-5 criteria (it uses DSM-IV-based criteria), which instructors may want to flag when discussing currency of findings for present-day practice.
Pedagogically, this article supports discussion of: the mental health needs of nursing students in conflict-affected regions; how curricular and student-support structures might screen for and respond to trauma symptoms; the appropriate cautious interpretation of self-report screening data; and comparative discussion of how Canadian nursing programs address student mental health, stress management, and trauma-informed pedagogy relative to the more resource-constrained context described here. It also offers a bridge to broader curricular content on trauma-informed care, both for students' own wellbeing and for their future patients.
Critical appraisal
Limitations
- The study used a non-probability sampling method at a single institution, which limits how far the 63.0% PTSD figure can be generalized to other nursing programs or countries.
- The 17-item measure was described as adapted from the Davidson Trauma Scale for this study; the abstract does not report reliability or validity statistics confirming the adapted version performed comparably to the original instrument in this population.
- PTSD levels were determined through self-report screening rather than a structured clinical diagnostic interview, so reported percentages reflect symptom screening results, not confirmed clinical diagnoses.
Classroom use
Discussion Questions
- What might explain why 63.0% of the nursing students in this sample screened positive for some level of PTSD symptoms during this particular period in Iraq?
- How does the timing of data collection (December 2013–May 2014, a period of escalating conflict in Iraq) help explain the study's findings, and how might results differ if collected during a calmer period?
- Why might first-stage (first-year) nursing students in this study have shown the highest proportion of PTSD symptoms compared to more senior students?
- What is the difference between a validated screening instrument like the Davidson Trauma Scale identifying likely PTSD symptoms and a clinical diagnosis of PTSD, and why does that distinction matter when interpreting this study's 63.0% figure?
- How might residency in Baghdad itself, versus outside the city, plausibly relate to differences in trauma exposure and reported PTSD symptom levels?
- What ethical and practical considerations should nursing faculty weigh when screening students for PTSD symptoms as part of a research study or curriculum requirement?
- How could nursing programs operationalize the study's recommendation to teach coping strategies and stress management, and what would effective relaxation-session content look like?
- In what ways might untreated PTSD symptoms in nursing students affect their clinical performance, patient safety, or long-term career retention in nursing?
- How might findings from this 2013–2014 Iraqi nursing student sample compare to what we might expect from nursing students in Canada or other lower-conflict settings, and what would you want to know before making that comparison?
- What additional data (e.g., prior trauma history, exposure to specific traumatic events, mental health service use) would help researchers better understand the causes behind this population's high PTSD symptom levels?
Knowledge check
Quiz
1. What percentage of nursing students in this study showed some level of PTSD symptoms?
- 37.0%
- 63.0%
- 29.0%
- 12.5%
Rationale: The abstract states: 'the majority of the students (63.0%) has PTSD: low (29.0%), medium (21.5%), and high (12.5%); and only 37.0% of them have no PTSD.'
2. What instrument was used to measure PTSD in this study?
- The Impact of Event Scale
- 17 items adapted from the Davidson Trauma Scale-DSM-IV
- The PTSD Checklist for DSM-5 (PCL-5)
- The Beck Depression Inventory
Rationale: The abstract states the questionnaire included '17 items represent Davidson Trauma scale-DSM-IV for diagnosing and measuring levels of PTSD within the civilians.'
3. How many nursing students were recruited for this study?
- 100
- 150
- 200
- 250
Rationale: The abstract states: 'A non-probability of two hundred students in all four stages of the college of Nursing/ University of Baghdad was recruited.'
4. Over what time period was data collected for this study?
- December 4, 2013 to May 17, 2014
- January 2015 to June 2015
- March 2012 to September 2012
- December 2013 to December 2014
Rationale: The abstract states the study 'has been achieved in December 4th, 2013 to the May 17th, 2014.'
5. Which academic stage of nursing students showed the highest proportion with PTSD?
- Second stage
- Third stage
- Fourth stage
- First stage
Rationale: The abstract states: 'for the stages: the first stage shows having more PTSD (18.0%) than the other stages.'
6. What proportion of students living in Baghdad showed PTSD symptom levels, according to the study?
- 21.5%
- 29.0%
- 42.0%
- 63.0%
Rationale: The abstract states: 'finally, 42.0% of those who live in Baghdad have levels of PTSD than those who do not live in Baghdad.'
7. Which statistical methods were used for inferential analysis in this study?
- Correlation Coefficient, Chi-square, and independent t-test
- ANOVA and multiple regression
- Factor analysis and structural equation modeling
- Kaplan-Meier survival analysis
Rationale: The abstract states data were analyzed using 'inferential analysis: Correlation Coefficient, Chi-squire, and independent t-test.'
8. What was the study's design?
- Randomized controlled trial
- Observational design study
- Systematic review
- Qualitative phenomenological study
Rationale: The abstract states: 'Observational design study of undergraduate nursing students has been achieved... in order to identify the Post-traumatic Stress Disorder in all stages.'
9. What did the study recommend for students showing PTSD symptoms?
- Immediate withdrawal from the nursing program
- Referral to psychiatric hospitalization
- Learning coping strategies and stress management through training and relaxation sessions
- Mandatory medication for all affected students
Rationale: The abstract states: 'The present study recommends that students are to be advised to learn some coping strategies and stress managements by attending training and relaxation sessions.'
10. Which of the following is a key limitation of this study's design?
- It used a probability random sample from multiple countries
- It relied on a clinical diagnostic interview rather than self-report
- It used a non-probability sample at a single institution during a specific, unusually stressful period
- It included a randomized control group for comparison
Rationale: The abstract describes a 'non-probability' sample of 200 students at one college (University of Baghdad) collected during December 2013–May 2014, a period of regional conflict, limiting generalizability.
Study cards
Flashcards
What is Posttraumatic Stress Disorder (PTSD), as defined in this study?
A psychological and emotional disturbance that develops after experiencing, witnessing, or being exposed to a traumatic event, such as actual or threatened death, serious injury, natural disaster, combat, torture, murder, rape, or violent assault.
Where was this study conducted?
The College of Nursing, University of Baghdad, in Iraq.
What was the study's design?
An observational design study of undergraduate nursing students.
Over what dates was data collected?
December 4, 2013 to May 17, 2014.
How many students were recruited, and how?
Two hundred students were recruited using a non-probability sampling method, drawn from all four stages of the nursing program.
What instrument measured PTSD in this study?
A questionnaire including 17 items adapted from the Davidson Trauma Scale-DSM-IV, used to diagnose and measure PTSD levels.
What demographic characteristics were collected alongside PTSD measures?
Gender, age, academic stage, and residency.
What statistical methods were used for descriptive analysis?
Frequencies, percentages, and distributions.
What statistical methods were used for inferential analysis?
Correlation Coefficient, Chi-square, and independent t-test.
What overall percentage of students showed some level of PTSD?
63.0% of the students showed some level of PTSD.
How were PTSD levels broken down among affected students?
29.0% low, 21.5% medium, and 12.5% high.
What percentage of students showed no PTSD symptoms?
37.0% of students showed no PTSD.
What proportion of the sample with PTSD were female?
35.0% of the total sample who had PTSD were female.
What age group among those with PTSD was highlighted in the results?
21.5% of those with PTSD were age 24 or older.
Which academic stage had the highest proportion of students with PTSD?
The first stage (first-year students), at 18.0%.
What residency-related finding did the study report?
42.0% of students living in Baghdad showed PTSD levels, higher than those living outside the city.
What did the study conclude about the overall demographic profile of participants?
More than half were age 22 or older, about half were male, and the majority lived in Baghdad.
What was the study's main recommendation?
That students be advised to learn coping strategies and stress management through training and relaxation sessions.
Why is the historical context of Iraq (2013-2014) relevant to interpreting this study?
The data collection period coincided with escalating conflict and instability in Iraq, which likely contributed to high trauma exposure and PTSD symptom levels among students.
What is a key limitation to keep in mind when interpreting the 63.0% PTSD figure?
It reflects self-report screening on an adapted instrument at a single institution with a non-probability sample, not confirmed clinical diagnoses from a structured interview.
Search-ready answers
Frequently asked questions
What percentage of nursing students had PTSD in this University of Baghdad study?
63.0% of the 200 surveyed nursing students showed some level of PTSD symptoms (29.0% low, 21.5% medium, 12.5% high), while 37.0% showed no PTSD symptoms.
What tool was used to measure PTSD in nursing students in this study?
The researchers used a questionnaire with 17 items adapted from the Davidson Trauma Scale-DSM-IV, a validated self-report screening tool for PTSD symptoms based on DSM-IV diagnostic criteria.
How many nursing students participated in this PTSD study?
A non-probability sample of 200 undergraduate students from all four stages of the College of Nursing, University of Baghdad, participated.
When was this PTSD study among Iraqi nursing students conducted?
Data were collected from December 4, 2013 to May 17, 2014, a period of significant conflict and instability in Iraq.
Which nursing students had the highest rate of PTSD symptoms in this study?
First-stage (first-year) nursing students showed the highest proportion with PTSD symptoms, at 18.0%, compared to students in the other three academic stages.
Did where students lived affect their PTSD symptom levels?
Yes. The study found that 42.0% of students living in Baghdad showed PTSD symptom levels, a higher proportion than students residing outside the city.
What did this study recommend for nursing students with PTSD symptoms?
The study recommended that affected students be advised to learn coping strategies and stress management techniques through training and relaxation sessions.
Is the Davidson Trauma Scale a clinical diagnosis of PTSD or a screening tool?
It is a self-report screening tool based on DSM-IV criteria; a positive screen indicates likely PTSD symptoms but is not the same as a formal clinical diagnosis made through a structured interview.
Can these findings be generalized to nursing students outside Iraq, such as in Canada?
Caution is needed. The study used a non-probability sample from a single institution during an unusually stressful conflict period in Iraq, so findings describe that specific context and should not be assumed to apply directly to nursing students in more stable settings.
Where was this study published and who conducted it?
It was published in the Kufa Journal for Nursing Sciences (2015) by Maan H. Ibrahim Al-Ameri, examining PTSD among students at the College of Nursing, University of Baghdad.