Posttraumatic stress disorder among adolescents in Brazil: a cross-sectional study

Abstract

Background The frequency of trauma and different types of violence exposure in urban areas and their effects on the mental health of adolescents in developing countries are poorly investigated. Most information about traumatized young people comes from war scenarios or disasters. This study aimed to determine the prevalence of PTSD in trauma-exposed students in a low-resource city of the state of Rio de Janeiro, Brazil. The effects of sociodemographic and individual and family factors in the development of PTSD were also investigated. Methods Through multi-stage cluster sampling, 862 adolescents (Mage = 15 years old, 65% female) from public and private schools in the city of São Gonçalo were selected for the study. Self-rating structured questionnaires were applied to assess sociodemographic profile, exposure to physical and psychological violence (family, school, community), sexual abuse, social support, social functional impairment, resilience, and posttraumatic stress disorder. The data were grouped in blocks regarding sociodemographic, individual, family, and community variables. For statistical analysis, chi-square, Fisher’s exact test, and logistic regression were performed. Results The PTSD prevalence was 7.8% among adolescents. Boys were exposed to significantly higher number of events of community violence, while girls to family violence. The adjusted odds ratio (OR) for PTSD were statistically significant for age (OR, 1.45, [95% CI, 1.043–2.007]), social functional impairment (OR, 4.82, [95% CI, 1.77–13.10]), severe maternal physical violence (OR, 2.79, [95% CI, 0.79–9.93]), psychological violence by significant people (OR, 3.96, [95% CI, 1.89–8.31]) and a high number of episodes of community violence (OR, 3.52, [95% CI, 1.47–8.40). Conclusions There was a high prevalence of PTSD within this population associated with exposure to violence. Not only physical, but also psychological violence contributed to PTSD. The results also raise awareness to the differences in life trajectories between boys and girls regarding violence. These differences need to be better understood in order to enable the development of effective preventative interventions. Treating and preventing mental health disorders presents a challenge for countries, especially those with a lower degree of social and economic development and high community violence.

The Relationship Between Social Support and Internet Addiction Among Chinese Adolescents During the COVID-19 Pandemic: A Multiple Mediation Model of Resilience and Post-Traumatic Stress Disorder Symptoms

“…47 Individuals with high resilience are less prone to developing PTSD symptoms, 31 reducing their risk of later developing of Internet addiction. 48 We therefore proposed that social support can lead to higher levels of resilience and, in turn, reduce PTSD symptoms, thus decreasing vulnerability to Internet addiction (Hypothesis 4).…”

Tonic Immobility is Associated with PTSD Symptoms in Traumatized Adolescents

“…For example, more than half of the sample have seen a dead body in their neighbourhood, and almost half have witnessed shootings or someone being beaten up, shot or killed. 42 In addition, high levels of physical violence, sexual violence and psychological violence have also been reported. 43 In this context, a large proportion of Brazilian adolescents growing up in urban communities with ongoing violence might also be particularly vulnerable to developing PTSD.…”

Exploring exposure to intertwined community violence among Uruguayan adolescents using a mixed‐method approach

“…Enhancing our understanding of young people's ECV in South America is particularly necessary, given the high prevalence of violence and the limited knowledge of its scope and impact (Avanci et al, 2021; Muggah & Aguirre Tobón, 2018). All the youth in our sample—drawn from underprivileged, high‐crime urban neighborhoods—reported multiple events of ECV, indicating that this is a chronic stressor in their lives.…”

“…Several individual, family, school, and neighborhood factors moderate or buffer the mental health impact of ECV (Affrunti et al, 2018; Ozer et al, 2017; Tache et al, 2018). Despite the accumulation of evidence on ECV and its consequences, samples have mainly been drawn from Western, high‐income countries, particularly the United States (Avanci et al, 2021; Fry et al, 2018). It is unclear whether findings can be generalized to low‐ and middle‐income countries (LMIC), where urban violent crime, especially homicide, is more prevalent (United Nations Office on Drugs and Crime, 2014) and community violence tends to be more ubiquitous, chronic, and persistent across life contexts (Donenberg et al, 2020).…”

“…In a study of 300 adolescents living in Bogotá, Colombia, Cuartas and Roy (2019) found that indirect exposure to local homicides predicted mental health problems. In a sample of 862 adolescents living in socioeconomically vulnerable neighborhoods in São Gonçalo, Brasil, the most frequently reported violent event was seeing a dead body (Avanci et al, 2021).…”