Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-23T21:47:48.531Z Has data issue: false hasContentIssue false
  • English
  • Français

Exposure to violence and mental health of adolescents: South African Health and Well-being Study

Published online by Cambridge University Press:  02 January 2018

Stephen A. Stansfeld ,
Catherine Rothon ,
Jayati Das-Munshi ,
Cathy Mathews ,
Arlene Adams ,
Charlotte Clark  and
Crick Lund
Stephen A. Stansfeld*
Affiliation:
Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, UK
Catherine Rothon
Affiliation:
St George's University of London, London, UK
Jayati Das-Munshi
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK
Cathy Mathews
Affiliation:
Health Systems Research Unit, Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
Arlene Adams
Affiliation:
Department of Student Affairs, University of Cape Town, Cape Town, South Africa
Charlotte Clark
Affiliation:
Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, UK
Crick Lund
Affiliation:
Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
*
Stephen A. Stansfeld, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK. Email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background

Material and social environmental stressors affect mental health in adolescence. Protective factors such as social support from family and friends may help to buffer the effects of adversity.

Aims

The association of violence exposure and emotional disorders was examined in Cape Town adolescents.

Method

A total of 1034 Grade 8 high school students participated from seven government co-educational schools in Cape Town, South Africa. Exposure to violence in the past 12 months and post-traumatic stress disorder (PTSD) symptoms were measured by the Harvard Trauma Questionnaire, depressive and anxiety symptoms by the Short Moods and Feelings Questionnaire and the Self-Rating Anxiety Scale.

Results

Exposure to violence was associated with high scores on depressive (odds ratio (OR)=6.23, 95% CI 4.2–9.2), anxiety (OR=5.40, 95% CI 2.4–12.4) and PTSD symptoms (OR=8.93, 95% CI 2.9–27.2) and increased risk of self-harm (OR=5.72, 95% CI 1.2–25.9) adjusting for gender and social support.

Conclusions

We found that high exposure to violence was associated with high levels of emotional disorders in adolescents that was not buffered by social support. There is an urgent need for interventions to reduce exposure to violence in young people in this setting.

Type
Paper
Information
BJPsych Open , Volume 3 , Issue 5 , September 2017 , pp. 257 - 264
Copyright
Copyright © The Royal College of Psychiatrists 2017

Footnotes

Declaration of interest

None.

References

1 Patel, V, Flisher, A, Hetrick, S, McGorry, P. Mental health of young people: a global public-health challenge. Lancet 2007; 369: 1302–13.CrossRefGoogle ScholarPubMed
2 Fatori, D, Bordin, IA, Curto, BM, de Paula, CS. Influence of psychosocial factors on the trajectory of mental health problems from childhood to adolescence: a longitudinal study. BMC Psychiatry 2013; 13: 31.Google Scholar
3 Kilpatrick, DG, Ruggiero, KJ, Acierno, R, Saunders, BE, Resnick, HS, Best, CL. Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. J Consult Clin Psychol 2003; 71: 692–700.Google Scholar
4 Fairbank, JA, Fairbank, DW. Epidemiology of child traumatic stress. Curr Psychiatry Rep 2009; 11: 289–95.CrossRefGoogle ScholarPubMed
5 Fowler, PJ, Tompsett, CJ, Braciszewski, JM, Jacques-Tiura, AJ, Baltes, B. Community violence: a meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Dev Psychopathol 2009; 21: 227–59.CrossRefGoogle ScholarPubMed
6 Zinzow, HM, Ruggiero, KJ, Resnick, H, Hanson, R, Smith, D, Saunders, B, et al. Prevalence and mental health correlates of witnessed parental and community violence in a national sample of adolescents. J Child Psychol Psychiatry 2009; 50: 441–50.Google Scholar
7 Bach, JM, Louw, D. Depression and exposure to violence among Venda and Northern Sotho adolescents in South Africa. Afr J Psychiatry 2010; 13: 25–35.Google Scholar
8 Bruwer, B, Govender, G, Bishop, M, Williams, DR, Stein, D, Seedat, S. Association between childhood adversities and long-term suicidality among South Africans from the results of the South African Stress and Health study: a cross-sectional study. BMJ Open 2014; 4: e004644.Google Scholar
9 Liang, H, Flisher, AJ, Lombard, C. Bullying, violence, and risk behaviour in South African school students. Child Abuse Negl 2007; 31: 161–71.CrossRefGoogle ScholarPubMed
10 Beardslee, WR, Gladstone, TRG, O’Connor, EE. Developmental risk of depression: experience matters. Child Adolesc Psychiatric Clin N Am 2012; 21: 261–78.CrossRefGoogle ScholarPubMed
11 Myer, L, Stein, DJ, Grimsrud, A, Seedat, S, Williams, DR. Social determinants of psychological distress in a nationally-representative sample of South African adults. Soc Sci Med 2008; 66: 1828–40.CrossRefGoogle Scholar
12 Andrews, AR, Jobe-Shields, L, López, CM, Metzger, IW, de Arellano, MA, Saunders, B, et al. Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence. Soc Psychiatry Psychiatr Epidemiol 2015; 50: 1223–34.Google Scholar
13 Das Munshi, J, Lund, C, Mathews, C, Clark, C, Rothon, C, Stansfeld, SA. Mental health inequalities in adolescents growing up in post-apartheid South Africa: cross sectional survey, SHaW Study. PLoS One 2016; 11: e0154478.CrossRefGoogle ScholarPubMed
14 Fagg, J, Curtis, S, Stansfeld, S, Congdon, P. Psychological distress among adolescents, and its relationship to individual, family and area characteristics in East London. Soc Sci Med 2006; 63: 636–48.Google Scholar
15 Rothon, C, Stansfeld, SA, Mathews, C, Kleinhans, A, Clark, C, Lund, C, et al. Reliability of self report questionnaires for epidemiological investigations of adolescent mental health in Cape Town, South Africa. J Child Adolesc Ment Health 2011; 23: 119–28.Google Scholar
16 Coovadia, H, Jewkes, R, Barron, P, Sanders, D, McIntyre, D. The health and health system of South Africa: historical roots of current public health challenges. Lancet 2009; 374: 817–34.Google Scholar
17 Ward, C, Flisher, AJ, Zissis, C, Muller, M, Lombard, C. Measuring adolescents’ exposure to violence and related PTSD symptoms: reliability of the Harvard Trauma Scale with South African adolescents. J Child Adolesc Ment Health 2004; 16: 31–7.Google Scholar
18 Mollica, RF, Caspi-Yavin, Y, Bollini, P, Truong, T, Tor, S, Lavelle, J. The Harvard Trauma Questionnaire: validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis 1992; 180: 111–6.CrossRefGoogle ScholarPubMed
19 Angold, A, Costello, EJ, Messer, SC, Pickles, A, Winder, F, Silver, D. Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int J Methods Psychiatr Res 1995; 5: 237–49.Google Scholar
20 Balázs, J, Miklósi, M, Keresztény, A, Hoven, CW, Carli, V, Wasserman, C, et al. Adolescent subthreshold-depression and anxiety: psychopathology, functional impairment and increased suicide risk. J Child Psychol Psychiatry 2013; 54: 670–7.Google Scholar
21 Zimet, GD, Dahlem, NW, Zimet, SG, Farley, GK. The multidimensional scale of perceived social support. J Pers Assess 1988; 52: 32–41.Google Scholar
22 Flisher, AJ, Parry, CDH, Evans, J, Muller, M, Lombard, C. Substance use by adolescents in Cape Town: prevalence and correlates. J Adolesc Health 2003; 32: 38–65.Google Scholar
23 Stansfeld, SA, Haines, MM, Booy, R, Taylor, S, Viner, R, Head, J, et al. Health of Young People in East London: The RELACHS Study 2001 . TSO (The Stationery Office), 2003.Google Scholar
24 Akaike, H. Factor analysis and AIC. Psychometrika 1987; 52: 317–32.CrossRefGoogle Scholar
25 Seedat, S, Nyamai, C, Njenga, F, Vythilingum, B, Stein, DJ. Trauma exposure and post-traumatic stress symptoms in urban African schools. Survey in Cape Town and Nairobi. Br J Psychiatry 2004; 184: 169–75.CrossRefGoogle Scholar
26 Cunningham, RM, Ranney, M, Newton, M, Woodhull, W, Zimmerman, M, Walton, MA. Characteristics of youth seeking emergency care for assault injuries. Pediatrics 2014; 133: e96–105.Google Scholar
27 Lambert, SF, Nylund-Gibson, K, Copeland-Linder, N, Ialongo, NS. Patterns of community violence exposure during adolescence. Am J Community Psychol 2010; 46: 289–302.CrossRefGoogle ScholarPubMed
28 Ford, JD, Elhai, JD, Connor, DF, Frueh, BC. Poly-victimisation and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. J Adolesc Health 2010; 46: 545–52.Google Scholar
29 Macdonald, A, Danielson, CK, Resnick, HS, Saunders, BE, Kilpatrick, DG. PTSD and comorbid disorders in a representative sample of adolescents: the risk associated with multiple exposures to potentially traumatic events. Child Abuse Neglect 2010; 34: 773–83.Google Scholar
30 Meinck, F, Cluver, LD, Boyes, ME, Mhlongo, EL. Risk and protective factors for physical and sexual abuse of children and adolescents in Africa: a review and implications for practice. Trauma Violence Abuse 2015; 16: 81–107.Google Scholar
31 Meinck, F, Cluver, LD, Boyes, ME. Household illness, poverty and physical and emotional child abuse victimisation: findings from South Africa's first prospective cohort study. BMC Public Health 2015; 15: 444.Google Scholar
32 Goldner, J, Gross, IM, Richards, MH, Ragsdale, BL. The relation of severity and type of community violence exposure to emotional distress and problem behaviors among urban African American adolescents. Violence Vict 2015; 30: 432–49.Google Scholar
33 Holt, MK, Espelage, DL. A cluster analytic investigation of victimization among high school students: are profiles differentially associated with psychological symptoms and school belonging? J Appl School Psychol 2003; 19: 81–98.Google Scholar
34 Zona, K, Milan, S. Gender differences in the longitudinal impact of exposure to violence on mental health in urban youth. J Youth Adolesc 2011; 40: 1674–90.Google Scholar
35 Harpham, T, Snoxell, S, Grant, E, Rodriguez, C. Common mental disorders in a young urban population in Colombia. Br J Psychiatry 2005; 187: 161–7.CrossRefGoogle Scholar
36 Atwoli, L, Stein, DJ, Williams, DR, McLaughlin, KA, Petukhova, M, Kessler, RC, et al. Trauma and posttraumatic stress disorder in South Africa: an analysis from the South African Stress and Health Study. BMC Psychiatry 2013; 13: 182.Google Scholar
37 Norman, R, Schneider, M, Bradshaw, D, Jewkes, R, Abrahams, N, Matzopoulos, R et al. Interpersonal violence: an important risk factor for disease and injury in South Africa. Popul Health Metr 2010; 32: 1–12.Google Scholar
38 Seedat, M, Van Niekerk, A, Jewkes, R, Suffla, S, Ratele, K. Violence and injuries in South Africa: prioritising an agenda for prevention. Lancet 2009; 374: 1011–22.Google Scholar
39 Mayosi, BM, Lawn, JE, van Niekerk, A, Bradshaw, D, Abdool Karim, SS, Coovadia, HM, et al. Health in South Africa: changes and challenges since 2009. Lancet 2012; 380: 2029–43.Google Scholar
40 Ward, CL, Artz, L, Berg, J, Boonzaier, F, Crawford-Browne, S, Dawes, A, et al. Violence, violence prevention, and safety: a research agenda. S Afr Med J 2012; 102: 215–8.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.