Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda.
Adolescents
HIV
Uganda
adverse childhood experiences
mental health
sub-Saharan Africa
trauma
Journal
Journal of affective disorders reports
ISSN: 2666-9153
Titre abrégé: J Affect Disord Rep
Pays: Netherlands
ID NLM: 101773676
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
entrez:
29
11
2021
pubmed:
30
11
2021
medline:
30
11
2021
Statut:
ppublish
Résumé
Childhood trauma is associated with mental health problems among adolescents living with HIV (ALHIV) in sub-Saharan Africa, but little is known about potential moderating factors. We enrolled 224 ALHIV aged 13-17 years and collected information on childhood trauma, major depressive disorder, and suicidality. We used modified multivariable Poisson regression to estimate the association between the mental health outcome variables and childhood trauma, and to assess for effect modification by social support. Major depressive disorder had a statistically significant association with emotional abuse (adjusted relative risk [ARR] 2.57; 95% CI 1.31-5.04; P=0.006) and physical abuse (ARR 2.16; 95% CI 1.19-3.89; P=0.01). The estimated association between any abuse and major depressive disorder was statistically significant among those with a low level of social support (ARR 4.30; 95% CI 1.64-11.25; P=0.003) but not among those with a high level of social support (ARR 1.30; 95% CI 0.57-2.98; P=0.52). Suicidality also had a statistically significant association with emotional abuse (ARR 2.03; 95% CI 1.05-3.920; P=0.03) and physical abuse (ARR 3.17; 95% CI 1.60-6.25.; P=0.001), but no differences by social support were noted. Corporal punishment is used widely in schools and homes as a form of discipline in Uganda; this cultural practice could have biased reporting about physical abuse. Childhood trauma is associated with poor mental health among ALHIV, but its effects may be moderated by social support. More research is needed to develop social support interventions for ALHIV with adverse childhood experiences for improved mental health outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Childhood trauma is associated with mental health problems among adolescents living with HIV (ALHIV) in sub-Saharan Africa, but little is known about potential moderating factors.
METHODS
METHODS
We enrolled 224 ALHIV aged 13-17 years and collected information on childhood trauma, major depressive disorder, and suicidality. We used modified multivariable Poisson regression to estimate the association between the mental health outcome variables and childhood trauma, and to assess for effect modification by social support.
RESULTS
RESULTS
Major depressive disorder had a statistically significant association with emotional abuse (adjusted relative risk [ARR] 2.57; 95% CI 1.31-5.04; P=0.006) and physical abuse (ARR 2.16; 95% CI 1.19-3.89; P=0.01). The estimated association between any abuse and major depressive disorder was statistically significant among those with a low level of social support (ARR 4.30; 95% CI 1.64-11.25; P=0.003) but not among those with a high level of social support (ARR 1.30; 95% CI 0.57-2.98; P=0.52). Suicidality also had a statistically significant association with emotional abuse (ARR 2.03; 95% CI 1.05-3.920; P=0.03) and physical abuse (ARR 3.17; 95% CI 1.60-6.25.; P=0.001), but no differences by social support were noted.
LIMITATIONS
CONCLUSIONS
Corporal punishment is used widely in schools and homes as a form of discipline in Uganda; this cultural practice could have biased reporting about physical abuse.
CONCLUSIONS
CONCLUSIONS
Childhood trauma is associated with poor mental health among ALHIV, but its effects may be moderated by social support. More research is needed to develop social support interventions for ALHIV with adverse childhood experiences for improved mental health outcomes.
Identifiants
pubmed: 34841384
doi: 10.1016/j.jadr.2021.100094
pmc: PMC8623847
mid: NIHMS1758589
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : FIC NIH HHS
ID : D43 TW010128
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH113494
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH093310
Pays : United States
Déclaration de conflit d'intérêts
Disclosure statement The authors have no conflict of interest to declare.
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