Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women

Substance Abuse Treatment, Prevention, and Policy

Research

Carl Lombard¹  Shibe Mhlongo²  Rachel Jewkes³  Naeemah Abrahams⁴  Esnat Chirwa⁵  Bronwyn Myers⁶  Kim A. Nguyen⁷  Nasheeta Peer⁸  Andre P. Kengne⁸  Soraya Seedat⁹  Claudia Garcia-Moreno^1,10 

[1] Biostatistics Unit, South African Medical Research Council, 7505, Cape Town, South Africa;Gender and Health Research Unit, South African Medical Research Council, 7505, 0001, Cape Town and Pretoria, South Africa;Gender and Health Research Unit, South African Medical Research Council, 7505, 0001, Cape Town and Pretoria, South Africa;Office of the Executive Scientist, South African Medical Research Council, 7505, Cape Town, South Africa;Gender and Health Research Unit, South African Medical Research Council, 7505, 0001, Cape Town and Pretoria, South Africa;School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa;Gender and Health Research Unit, South African Medical Research Council, 7505, 0001, Cape Town and Pretoria, South Africa;School of Public Health, University of Witwatersrand, 2193, Johannesburg, South Africa;Mental Health, Alcohol, Substances, and Tobacco Research Unit, South African Medical Research Council, 7505, Cape Town, Substances, South Africa;Curtin enAble Institute, Faculty of Health Sciences, Curtin University, 6102, Perth, WA, Australia;Non-Communicable Diseases Research Unit, South African Medical Research Council, P.O. Box 19070, Cape Town, 7505 and Durban, 4091, Tygerberg, South Africa;Non-Communicable Diseases Research Unit, South African Medical Research Council, P.O. Box 19070, Cape Town, 7505 and Durban, 4091, Tygerberg, South Africa;Department of Medicine, Faculty of Health Sciences, University of Cape Town, 7925, Cape Town, South Africa;SAMRC Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland;

关键词: Gender-based violence;    Childhood maltreatment;    Intimate partner violence;    Rape;    Mediation analysis;    AUDIT-C;    Alcohol misuse;   

DOI  :  10.1186/s13011-023-00549-8

 received in 2023-04-13, accepted in 2023-06-15,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe association of traumatic experiences with problematic alcohol use has been described, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association between trauma exposure across the lifespan and alcohol use.MethodWe analysed cross-sectional data from a sample of rape-exposed and non-rape-exposed women, living in KwaZulu-Natal, with self-reported data on alcohol misuse (AUDIT-C cut-off ≥ 3) and exposure to childhood maltreatment (CM), intimate partner violence (IPV), non-partner sexual violence (NPSV), other traumatic events, and mental ill-health. Logistic regression and multiple mediation models were used to test the mediation effects of symptoms of depression and PTSS on the association between abuse/trauma and alcohol misuse.ResultsOf 1615 women, 31% (n = 498) reported alcohol misuse. Exposure to any CM (adjusted odds ratio (aOR): 1.59, 95% confidence interval (CI): 1.27–1.99), as well as to sexual, physical and emotional CM, were independently associated with alcohol misuse. Lifetime exposure to any IPV (aOR:2.01, 95%CI:1.59–2.54), as well as to physical, emotional and economic IPV, NPSV (aOR: 1.75, 95%CI: 1.32–2.33), and other trauma (aOR:2.08, 95%CI:1.62–2.66), was associated with alcohol misuse. Exposure to an increasing number of abuse types, and other traumatic events, was independently associated with alcohol misuse. PTSS partially mediated the associations of CM, IPV, NPSV and other trauma exposures with alcohol misuse (ps ≤ 0.04 for indirect effects), but depression symptoms did not.ConclusionsThese findings highlight the need for trauma-informed interventions to address alcohol misuse that are tailored to the needs of women who have experienced violence.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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