Association between witnessing traumatic events and psychopathology in the South African Stress and Health Study

Social psychiatry - Tập 50 - Trang 1235-1242 - 2015
Lukoye Atwoli1,2, Jonathan Platt3, David R. Williams4, Dan J. Stein2, Karestan C. Koenen3
1Department of Mental Health, School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya
2Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
3Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
4Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, USA

Tóm tắt

The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders. Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders. Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders. Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected.

Tài liệu tham khảo

Al-Krenawi A, Graham JR, Kanat-Maymon Y (2009) Analysis of trauma exposure, symptomatology and functioning in Jewish Israeli and Palestinian adolescents. Br J Psychiatry 195(5):427–432. doi:10.1192/bjp.bp.108.050393 American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Press, Washington, DC Amone-P’olak K, Ovuga E, Croudace TJ, Jones PB, Abbott R (2014) The influence of different types of war experiences on depression and anxiety in a Ugandan cohort of war-affected youth: the WAYS study. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-014-0873-5 Atwoli L, Stein DJ, Williams DR, McLaughlin KA, Petukhova M, Kessler RC, Koenen KC (2013) Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study. BMC Psychiatry 13:182. doi:10.1186/1471-244X-13-182 Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D (2009) The health and health system of South Africa: historical roots of current public health challenges. Lancet 374(9692):817–834. doi:10.1016/s0140-6736(09)60951-x Dinan BA, McCall GJ, Gibson D (2004) Community violence and PTSD in selected South African townships. J Interpers Violence 19(6):727–742. doi:10.1177/0886260504263869 Hackett M (2009) Commentary: trauma and female inmates: why is witnessing more traumatic? J Am Acad Psychiatry Law 37(3):310–315 (pii: 37/3/310) Haro JM, Arbabzadeh-Bouchez S, Brugha TS, de Girolamo G, Guyer ME, Jin R, Kessler RC (2006) Concordance of the composite international diagnostic interview version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. Int J Methods Psychiatr Res 15(4):167–180 Hirschowitz R, Orkin M (1997) Trauma and mental health in South Africa. Soc Indic Res 41(1–3):169–182. doi:10.1023/a:1006804603660 Jewkes R, Abrahams N (2002) The epidemiology of rape and sexual coercion in South Africa: an overview. Soc Sci Med 55(7):1231–1244 Kadra G, Dean K, Hotopf M, Hatch SL (2014) Investigating exposure to violence and mental health in a diverse urban community sample: data from the South East London Community Health (SELCoH) Survey. PLoS One 9(4):e93660. doi:10.1371/journal.pone.0093660 Kaminer D, Grimsrud A, Myer L, Stein DJ, Williams DR (2008) Risk for post-traumatic stress disorder associated with different forms of interpersonal violence in South Africa. Soc Sci Med 67(10):1589–1595. doi:10.1016/j.socscimed.2008.07.023 Karam EG, Fayyad J, Karam AN, Melhem N, Mneimneh Z, Dimassi H, Tabet CC (2014) Outcome of depression and anxiety after war: a prospective epidemiologic study of children and adolescents. J Trauma Stress 27(2):192–199. doi:10.1002/jts.21895 Kessler RC, Ustun TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13(2):93–121 Khalfani AK, Zuberi T (2001) Racial classification and the modern census in South Africa, 1911–1996. Race Soc 4:161–176 Norman R, Matzopoulos R, Groenewald P, Bradshaw D (2007) The high burden of injuries in South Africa. Bull World Health Organ 85(9):695–702 (pii: S0042-96862007000900015) Pietrzak RH, Whealin JM, Stotzer RL, Goldstein MB, Southwick SM (2011) An examination of the relation between combat experiences and combat-related posttraumatic stress disorder in a sample of Connecticut OEF-OIF veterans. J Psychiatr Res 45(12):1579–1584. doi:10.1016/j.jpsychires.2011.07.010 Romito P, Grassi M (2007) Does violence affect one gender more than the other? The mental health impact of violence among male and female university students. Soc Sci Med 65(6):1222–1234 Silove D (1999) The psychosocial effects of torture, mass human rights violations, and refugee trauma: toward an integrated conceptual framework. J Nerv Ment Dis 187(4):200–207 Slopen N, Williams DR, Seedat S, Moomal H, Herman A, Stein DJ (2010) Adversities in childhood and adult psychopathology in the South Africa Stress and Health Study: associations with first-onset DSM-IV disorders. Soc Sci Med 71(10):1847–1854. doi:10.1016/j.socscimed.2010.08.015 StataCorp. (2011) Stata Statistical Software: release 12. StataCorp LP, College Station Terreblanche S (2002) A history of inequality in South Africa, 1652–2002. University of Natal Press and KMM Review Publishers, Pietermaritzburg Warren AM, Foreman ML, Bennett MM, Petrey LB, Reynolds M, Patel S, Roden-Foreman K (2014) Posttraumatic stress disorder following traumatic injury at 6 months: associations with alcohol use and depression. J Trauma Acute Care Surg 76(2):517–522. doi:10.1097/TA.0000000000000110 Willett JB, Singer JD (1993) Investigating onset, cessation, relapse, and recovery: why you should, and how you can, use discrete-time survival analysis to examine event occurrence. J Consult Clin Psychol 61(6):952–965 Williams DR, Herman A, Kessler RC, Sonnega J, Seedat S, Stein DJ, Wilson CM (2004) The South Africa Stress and Health Study: rationale and design. Metab Brain Dis 19(1–2):135–147 Williams SL, Williams DR, Stein DJ, Seedat S, Jackson PB, Moomal H (2007) Multiple traumatic events and psychological distress: the South Africa stress and health study. J Trauma Stress 20(5):845–855. doi:10.1002/jts.20252