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

Humans Female Child Stress Disorders, Post-Traumatic / epidemiology Alcoholism / epidemiology Gender-Based Violence Cross-Sectional Studies South Africa / epidemiology Risk Factors
AUDIT-C Alcohol misuse Childhood maltreatment Gender-based violence Intimate partner violence Mediation analysis Rape

Journal

Substance abuse treatment, prevention, and policy
ISSN: 1747-597X
Titre abrégé: Subst Abuse Treat Prev Policy
Pays: England
ID NLM: 101258060

Informations de publication

Date de publication:
22 Jun 2023
Historique:
received: 13 04 2023
accepted: 15 06 2023
medline: 26 6 2023
pubmed: 23 6 2023
entrez: 22 6 2023
Statut: epublish

Résumé

The 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. We 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. Of 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. These findings highlight the need for trauma-informed interventions to address alcohol misuse that are tailored to the needs of women who have experienced violence.

Sections du résumé

BACKGROUND BACKGROUND
The 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.
METHOD METHODS
We 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.
RESULTS RESULTS
Of 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.
CONCLUSIONS CONCLUSIONS
These findings highlight the need for trauma-informed interventions to address alcohol misuse that are tailored to the needs of women who have experienced violence.

Identifiants

DOI: 10.1186/s13011-023-00549-8 PMID: 37349847 PMC: PMC10288665
pubmed: 37349847
doi: 10.1186/s13011-023-00549-8
pii: 10.1186/s13011-023-00549-8
pmc: PMC10288665
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

38

Subventions

Organisme : World Health Organization
ID : 001
Pays : International

Informations de copyright

© 2023. The Author(s).

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Auteurs

Kim A Nguyen (KA)

Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091, South Africa. kim.nguyen@mrc.ac.za.

Bronwyn Myers (B)

Mental Health, Alcohol, Substances, and Tobacco Research Unit, South African Medical Research Council, Cape Town, 7505, Substances, South Africa.
Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, 6102, Australia.

Naeemah Abrahams (N)

Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001, South Africa.
School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa.

Rachel Jewkes (R)

Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001, South Africa.
Office of the Executive Scientist, South African Medical Research Council, Cape Town, 7505, South Africa.

Shibe Mhlongo (S)

Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001, South Africa.

Soraya Seedat (S)

SAMRC Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Carl Lombard (C)

Biostatistics Unit, South African Medical Research Council, Cape Town, 7505, South Africa.

Claudia Garcia-Moreno (C)

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.

Esnat Chirwa (E)

Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001, South Africa.
School of Public Health, University of Witwatersrand, Johannesburg, 2193, South Africa.

Andre P Kengne (AP)

Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091, South Africa.
Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa.

Nasheeta Peer (N)

Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091, South Africa.
Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, South Africa.

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