Multiple traumatic events and psychological distress: The South Africa stress and health study

Abstract

Using nationally representative data from South Africa, we examine lifetime prevalence of traumas and multiple traumas (number of events). Employing multiple regression analysis, we study sociodemographic risk of trauma, and the association between trauma and distress. Results indicate most South Africans experience at least one traumatic event during their lives, with the majority reporting multiple. Consistent variation in risk is evident for gender and marital status but not other sociodemographics. Trauma is positively related to high distress, and findings also support a cumulative effect of trauma exposure. Individuals with the most traumas (6+) appear at five-times greater risk of high distress. This study highlights the importance of considering traumatic events in the context of other traumas in South Africa.

Reported exposure to trauma among adult patients referred for psychological services at the Free State Psychiatric Complex, Bloemfontein

“…Multiple trauma exposure was found for 43.8% of the total number of study participants. This correlates with findings of Williams et al (2007) noting that 55.6% of an South African sample reported multiple traumatic events.…”

“…The group presented with predominantly mood disorders, and the presence of diagnostic morbidities and co-morbidities of anxiety, personality pathology (cluster B disorders or traits) as well as substance-related disorders was also observed. A high incidence of reported lifetime trauma exposure among psychiatric patients were seen, which correlates with findings at other South African study sites (Williams et al, 2007), and general population estimates (Atwoli et al, 2013). The nature of trauma exposure most frequently involved the traumatic death or injury of a loved one (37.0%), which correlates with the population-based exposure of 39.2% to this PTE (Atwoli et al, 2013).…”

“…Different traumatic stressors have been associated with different response patterns; post-traumatic stress disorder (PTSD), for example, is diagnosed ten times more frequently following rape than after experiencing natural disaster (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995;Kopel & Friedman, 1997). Williams et al (2007) have also emphasised the importance of considering traumatic events in the context of other traumas, taking into account the cumulative effect of trauma exposure and the graded relationship between multiple traumatic events and distress. This is especially relevant in the South African setting, where the average person with a history of trauma exposure experienced 4.3 of such occurrences on average (Atwoli et al, 2013).…”

Enrolling HIV-positive adolescents in mental health research: A case study reflecting on legal and ethical complexities

“…[15] Mental health disorders occur with increased frequency among HIV-positive children and adolescents in developed contexts. [12,19,20] In LMICs there is a paucity of research on this population and mental health outcomes. Studies in Western countries, measuring the association between HIV and mental health outcomes in adolescents, are not always comparable with black African populations, where adolescents are subjected to multiple additional risks and vulnerabilities.…”

“…[19] There is a higher prevalence of HIV infection among orphans due to AIDS causes than among non-orphans and orphans of non-AIDS causes, together with earlier sexual debut, an increased risk of intergenerational sex, and increased family violence and exploitation. [10,[34][35][36][37] OVCY are increasingly recognised as a special population for HIV risk and transmission.…”