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

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dc.contributor.authorNguyen, Kim A.
dc.contributor.authorMyers, Bronwyn
dc.contributor.authorAbrahams, Naeemah
dc.contributor.authorJewkes, Rachel
dc.contributor.authorMhlongo, Shibe
dc.contributor.authorSeedat, Soraya
dc.contributor.authorLombard, Carl
dc.contributor.authorGarcia-Moreno, Claudia
dc.contributor.authorChirwa, Esnat
dc.contributor.authorKengne, Andre P.
dc.contributor.authorPeer, Nasheeta
dc.date.accessioned2023-09-13T08:12:09Z
dc.date.available2023-09-13T08:12:09Z
dc.date.issued2023-06-22
dc.date.updated2023-06-26T09:30:00Z
dc.description.abstractAbstract 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 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 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 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.
dc.identifier.apacitationNguyen, Kim A., Myers, B., Abrahams, N., Jewkes, R., Mhlongo, S., Seedat, S., ... Peer, N. (2023). Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women. <i>Substance Abuse Treatment, Prevention, and Policy</i>, 18(1), 38. http://hdl.handle.net/11427/38576en_ZA
dc.identifier.chicagocitationNguyen, Kim A., Bronwyn Myers, Naeemah Abrahams, Rachel Jewkes, Shibe Mhlongo, Soraya Seedat, Carl Lombard, et al "Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women." <i>Substance Abuse Treatment, Prevention, and Policy</i> 18, 1. (2023): 38. http://hdl.handle.net/11427/38576en_ZA
dc.identifier.citationNguyen, Kim A., Myers, B., Abrahams, N., Jewkes, R., Mhlongo, S., Seedat, S., Lombard, C. & Garcia-Moreno, C. et al. 2023. Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women. <i>Substance Abuse Treatment, Prevention, and Policy.</i> 18(1):38. http://hdl.handle.net/11427/38576en_ZA
dc.identifier.risTY - Journal Article AU - Nguyen, Kim A. AU - Myers, Bronwyn AU - Abrahams, Naeemah AU - Jewkes, Rachel AU - Mhlongo, Shibe AU - Seedat, Soraya AU - Lombard, Carl AU - Garcia-Moreno, Claudia AU - Chirwa, Esnat AU - Kengne, Andre P. AU - Peer, Nasheeta AB - Abstract 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 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 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 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. DA - 2023-06-22 DB - OpenUCT DP - University of Cape Town KW - Gender-based violence KW - Childhood maltreatment KW - Intimate partner violence KW - Rape KW - Mediation analysis KW - AUDIT-C KW - Alcohol misuse LK - https://open.uct.ac.za PY - 2023 T1 - Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women TI - Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women UR - http://hdl.handle.net/11427/38576 ER -en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13011-023-00549-8
dc.identifier.urihttp://hdl.handle.net/11427/38576
dc.identifier.vancouvercitationNguyen Kim A, Myers B, Abrahams N, Jewkes R, Mhlongo S, Seedat S, et al. 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. 2023;18(1):38. http://hdl.handle.net/11427/38576.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central
dc.publisher.departmentMedicine
dc.publisher.facultyHealth Sciences
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceSubstance Abuse Treatment, Prevention, and Policy
dc.source.journalissue1
dc.source.journalvolume18
dc.source.pagination38
dc.source.urihttps://substanceabusepolicy.biomedcentral.com/
dc.subjectGender-based violence
dc.subjectChildhood maltreatment
dc.subjectIntimate partner violence
dc.subjectRape
dc.subjectMediation analysis
dc.subjectAUDIT-C
dc.subjectAlcohol misuse
dc.titleSymptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women
dc.typeJournal Article
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