Childhood Trauma and Mental Health in the Cape Town Adolescent Antiretroviral Cohort

Tatum Sevenoaks; Jean-Paul Fouche; Nicole Phillips; Sarah Heany; Landon Myer; Heather J Zar; Dan J Stein; Jacqueline Hoare

doi:10.1007/s40653-021-00362-0

Childhood Trauma and Mental Health in the Cape Town Adolescent Antiretroviral Cohort

J Child Adolesc Trauma. 2021 May 26;15(2):353-363. doi: 10.1007/s40653-021-00362-0. eCollection 2022 Jun.

Authors

Tatum Sevenoaks^{1

2}, Jean-Paul Fouche^{1

2}, Nicole Phillips^{1

2}, Sarah Heany^{1

2}, Landon Myer³, Heather J Zar^{4

5}, Dan J Stein^{1

2

6}, Jacqueline Hoare^{1

2}

Affiliations

¹ Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa.
² Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
³ Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
⁴ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
⁵ SA MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
⁶ SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

Abstract

This study aimed to assess the association of childhood trauma, stressful life events and HIV stigma with mental health in South African adolescents from the Cape Town Adolescent Antiretroviral Cohort (CTAAC). The Childhood Trauma Questionnaire, Life Events Questionnaire and the HIV Stigma Scale for South African Adolescents Living with HIV was used to assess childhood trauma, stressful life events and stigma in adolescents living with perinatally acquired HIV and healthy controls enrolled in the CTAAC. These measures were associated with mental health outcomes including the Beck-Youth Inventories, Child Behaviour Checklist, Columbian Impairment Scale, Childrens Motivation Scale, Conners Scale for Attention Deficit Hyperactivity Disorder using Pearson correlations and self-reported alcohol use, using Spearman-rank correlation. 63.7% of adolescents reported at least one childhood trauma on the CTQ. Significant associations were reported between CTQ measures and Beck-Youth Inventories. Emotional abuse was associated with anxiety, anger, depression and disruptive behaviour. Emotional neglect was associated with poor self-concept and disruptive behaviour. LEQ total score was significantly associated with Beck-Youth Inventories including anxiety, depression, anger and disruptive behaviour scales. HIV stigma was significantly associated with Beck-Youth Inventories including depression, anger and disruptive behaviour. Childhood trauma, stressful life events and HIV stigma in South African adolescents are associated with anxiety, depression, anger, disruptive-behaviour and poor self-concept. This study highlights the importance of enquiring about exposure to a variety of traumas, particularly those commonly experienced by South African adolescents. In addition, it is important to understand the impact of trauma exposure on each individuals mental health and functioning.

Keywords: Adolescent; Childhood trauma; Mental health; Perinatal HIV infection.

Grants and funding

R01 HD074051/HD/NICHD NIH HHS/United States