Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda.

Journal: Journal of affective disorders reports

Volume: 4

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry, Mbarara University Science and Technology, Mbarara, Uganda. Départment de Psychiatrie, Universitié de Genève, Switzerland. Department of Psychiatry, Makerere College of Health Sciences, Makerere, Uganda.

Abstract summary 

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.

Authors & Co-authors:  Ashaba Scholastic S Cooper-Vince Christine C Maling Samuel S Satinsky Emily N EN Baguma Charles C Akena Dickens D Nansera Denis D Bajunirwe Francis F Tsai Alexander C AC

Study Outcome 

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Statistics
Citations :  Abubakar A, Van de Vijver FJR, Hassan AS, Fischer R, Nyongesa MK, Kabunda B, Berkley JA, Stein A, & Newton CR (2017). Cumulative Psychosocial Risk is a Salient Predictor of Depressive Symptoms among Vertically HIV-Infected and HIV-Affected Adolescents at the Kenyan Coast. Annals of Global Health, 83(5–6), 743–752.
Authors :  9
Identifiers
Doi : 100094
SSN : 2666-9153
Study Population
Male,Female
Mesh Terms
Other Terms
Adolescents;HIV;Uganda;adverse childhood experiences;mental health;sub-Saharan Africa;trauma
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
Netherlands