Psychological legacies of intergenerational trauma under South African apartheid: Prenatal stress predicts greater vulnerability to the psychological impacts of future stress exposure during late adolescence and early adulthood in Soweto, South Africa

BACKGROUND

South Africa's rates of psychiatric morbidity are among the highest in sub-Saharan Africa and are foregrounded by the country's long history of political violence during apartheid. Growing evidence suggests that in utero stress exposure is a potent developmental risk factor for future mental illness risk, yet the extent to which the psychiatric effects of prenatal stress impact the next generation are unknown. We evaluate the intergenerational effects of prenatal stress experienced during apartheid on psychiatric morbidity among children at ages 17-18 and also assess the moderating effects of maternal age, social support, and past household adversity.

METHODS

Participants come from Birth-to-Twenty, a longitudinal birth cohort study in Soweto-Johannesburg, South Africa's largest peri-urban township which was the epicentre of violent repression and resistance during the final years of the apartheid regime. Pregnant women were prospectively enrolled in 1990 and completed questionnaires assessing social experiences, and their children's psychiatric morbidity were assessed at ages 17-18.

RESULTS

Full data were available from 304 mother-child pairs in 2007-8. Maternal prenatal stress in 1990 was not directly associated greater psychiatric morbidity during at ages 17-18. Maternal age and past household adversity moderated the intergenerational mental health effects of prenatal stress such that children born to younger mothers and late adolescent/young adult children experiencing greater household adversity exhibited worse psychiatric morbidity at ages 17-18. Social support did not buffer against the long-term psychiatric impacts of prenatal stress.

CONCLUSIONS

Greater prenatal stress from apartheid predicted adverse psychiatric outcomes among children born to younger mothers and adolescents/young adults who experienced greater concurrent stress. Our findings suggest that prenatal stress may affect adolescent mental health, have stress-sensitising effects, and represent possible intergenerational effects of trauma experienced under apartheid in this sample.

Trauma and self-harming behaviors in high school students: The mediating role of identity formation

INTRODUCTION

This study investigated the link between trauma and self-harming behaviors in South African high school students, and examined the mediating role of identity formation. Traumatic experiences have been commonly associated with self-harming behaviors in adolescents. However, research addressing this association in non-Western countries is limited.

METHODS

A total of 552 South African high school students aged 13-21 (60.4% female; M_age = 16 years) were included in the study. Students completed self-report questionnaires on traumatic experiences, identity formation, and self-harming behaviors (disturbed eating behaviors and suicidal thoughts and behaviors).

RESULTS

Structural equation modelling indicated that the association between traumatic experiences and self-harming behaviors was partially mediated by identity formation. Traumatic experiences were associated with more identity diffusion, bulimia, and suicidal thoughts and behaviors. Identity diffusion, in turn, was associated with more drive for thinness, bulimia, body dissatisfaction, and suicidal thoughts and behaviors. Identity consolidation was positively associated with drive for thinness and negatively with body dissatisfaction and suicidal thoughts and behaviors. No moderation effects by gender or age were found.

CONCLUSIONS

Traumatic experiences were associated with higher levels of identity diffusion, which, in turn, were associated with more self-harming behaviors in South African high school students. These findings suggest the importance of focusing on identity diffusion in prevention and intervention programs targeting self-harming behaviors.

Utilizing a General Strain Framework to Examine Behavioral Responses to Psychological Intimate Partner Violence: Are Responses Gendered?

We know from the violence literature that a distinct sex disparity exists in the perpetration of other-directed violence (ODV). Some scholars suggest that this disparity is explained in part by gendered reactions to stress, strain, or violence victimization, in which males and females engage in different coping mechanisms, with males more likely to engage in ODV than females. Using a college sample, we investigate the behavioral responses of male and female victims of psychological intimate partner abuse. We find that although there is a sex disparity in the use of ODV as a coping mechanism, there is also a distinct gender orientation disparity. Our results indicate that victims who ascribe to a masculine identity are more likely than those of a feminine identity to engage in ODV, regardless of biological sex. These findings shed light on the impact of gender orientation as both a risk and protective factor in the use of ODV.

A model for a positive youth development intervention

Modern-day life necessitates the application of interventions to facilitate the development of the youth in a more positive trajectory. Lacunae in the Positive Youth Development (PYD) paradigm include, inter alia, the lack of integration between theory and application and a lack of exposition of the processes underlying developmental change in the youth. The aim of this study was to develop a theoretical model to facilitate the development of youth in early adolescence. The proposed model builds on existing models, namely the Phenomenological Variant of Ecological Systems Theory and the Selection Optimization and Compensation (SOC) model. A review of the literature on the PYD paradigm and other areas of psychology with a similar strength-based focus, yielded theory which could be used to expand on the basic framework. The resulting Positive Youth Development Intervention model (PYDI) is described with reference to meta-theoretical assumptions, theoretical hypotheses, and constructs referring to phenomena and processes to be facilitated on an empirical level. This model can be operationalised to develop an intervention which can then be evaluated, thereby contributing to bridging theory and application in PYD.

Mediators of the relation between war experiences and suicidal ideation among former child soldiers in Northern Uganda: the WAYS study

BACKGROUND

Globally, suicide is a public health burden especially in the aftermath of war. Understanding the processes that define the path from previous war experiences (WE) to current suicidal ideation (SI) is crucial for defining opportunities for interventions. We assessed the extent to which different types of previous WE predict current SI and whether post-war hardships and depression mediate the relations between WE and SI among former child soldiers (FCS) in Northern Uganda.

METHODS

We performed cross-sectional analyses with a sample of 539 FCS (61% male) participating in an on-going longitudinal study. The influence of various types of previous WE on current SI and mediation by post-war hardships and depression were assessed by regression analyses.

RESULTS

The following types of war experiences: "witnessing violence", "direct personal harm", "deaths", "Involvement in hostilities", "sexual abuse" and "general war experiences" significantly predicted current SI in a univariable analyses whereas "direct personal harm", "involvement in hostilities", and "sexual abuse" independently predicted current SI in a multivariable analyses. General WE were linked to SI (β = 0.18 (95% CI 0.10 to 0.25)) through post-war hardships (accounting for 69% of the variance in their relationship) and through depression/anxiety (β = 0.17 (95% CI 0.12 to 0.22)) accounting for 65% of the variance in their relationship. The direct relationship between previous WE and current SI reduced but remained marginally significant (β = .08, CI: (.01, .17) for depression/anxiety but not for post-war hardships (β = .09, CI: (-.03, .20).

CONCLUSION

Types of WE should be examined when assessing risks for SI. Interventions to reduce SI should aim to alleviate post-war hardships and treat depression/anxiety.