Posttraumatic Stress Symptoms as a Mediating Factor on the Effects of Exposure to Community Violence Among Children in Cape Town, South Africa

Abstract

Research conducted over the past 20 years has linked exposure to violence to posttraumatic stress disorder (PTSD) in children both in the United States and South Africa, but very little research has investigated PTSD as a mediating variable between exposure to violence and other problems. The purpose of the current research was to determine if PTSD acts as a mediating variable between exposure to violence and depression, and exposure to violence and aggressive and violent behavior at school among a sample of 247 South African children. Regression analysis suggested that PTSD mediated the effects of exposure to violence on depression, whereas the effect of exposure to violence on aggression and violent behavior was only direct. The findings are discussed in terms of their implications for intervention and treatment.

Perpetuating the cycle of violence in South African low-income communities: attraction to violence in young men exposed to continuous threat

“…PTSD rates in adolescents from the low-income areas of South Africa have been found to be between 20 and 25% (Seedat, Nyamai, Njenga, Vythilingum, & Stein, 2004 ; Suliman et al, 2009 ), which is at least three times the rates of European and North American adolescents (Kessler, Sonnega, Bromet, Hughes, & Nelson, 2005; Perkonigg, Kessler, Storz, & Wittchen, 2000 ). Sexually abused boys are at higher risk of later becoming sexual abusers themselves (Aebi et al, 2015 ), and those who have witnessed violence against their mothers are more likely to become perpetrators of intimate partner violence (Hotaling & Sugarman, 1986 ) and community violence (Jewkes & Abrahams, 2002 ; Shields, Nadasen, & Pierce, 2009 ). The transformation from victim to perpetrator is an adaptation that entails advantages for those who have begun to feel attracted to cruelty.…”

Children's exposure to community and war violence and mental health in four African countries

“…In Support of path b in Figure 1, and as reported in Table 1, studies have further found positive associations between exposure to violence in Africa with children's health problems in terms of PTSD symptoms, internalizing problems including symptoms of depression and anxiety, psychological distress, as well as externalizing problems including antisocial behaviors, aggressive behaviors, conduct problems and substance use (Bach & Louw, 2010; Betancourt, Borisova et al, 2010; Betancourt, Brennan et al, 2010; du Plessis, Kaminer, Hardy, & Benjamin, 2015; Fincham et al, 2009; Kaminer et al, 2013; Martin et al 2013; Shields 2009a, 2009b; Waller, Gardner, & Cluver, 2014). …”

“…School, family, and peer social support were found to decrease the effects of gang violence on psychological distress, while the positive association between hearing about violence and psychological distress was mitigated by higher levels of family organization (Shields et al, 2008). Finally, individual resources also showed a trend toward significance in modifying the effects of violence exposure, where children with a low unknown locus of control (i.e., not knowing why events happened) had lower distress than those with a higher unknown locus of control (Sheilds et al, 2009b). Gender also modified some of the effects of violence exposure on children's health (Betancourt, Borisova, de la Soudiere, & Williamson, 2011; Betancourt, McBain, Newnham, & Brennan, 2014).…”

“…In a sample from Cape Town, South Africa, 68.4% of young adolescents reported witnessing and being a victim of violence (Ward et al, 2007). Among children and adolescents also in Cape Town, 58.1% reported seeing someone attacked with a weapon in the neighborhood, while 92% indicated they had seen someone hit in the neighborhood (Shields et al, 2009b). Victimization in the neighborhood was also common with 65.6% of children reported being hit in the neighborhood, and 51.8% had been in a fight.…”

“…Other factors supported include perceived personal safety which partially mediated the effects of witnessing neighborhood violence on elevating psychological distress in South Africa (Shields et al, 2008). Additionally, other forms of psychopathology are involved in transmission pathways (Shields et al, 2009b). …”