Kaminer Debra, Grimsrud Anna, Myer Landon, Stein Dan J, Williams David R
Department of Psychology, University of Cape Town, South Africa.
Soc Sci Med. 2008 Nov;67(10):1589-95. doi: 10.1016/j.socscimed.2008.07.023. Epub 2008 Sep 5.
The South African population is exposed to multiple forms of violence. Using nationally representative data from 4351 South African adults, this study examined the relative risk for post-traumatic stress disorder (PTSD) associated with political, domestic, criminal, sexual and other (miscellaneous) forms of assault in the South African population. Violence exposure was assessed using the 'worst event' list from the WHO's Composite International Diagnostic Interview (CIDI) and a separate questionnaire assessing experiences of human rights abuses, and lifetime PTSD was assessed according to the APA's Diagnostic and Statistical Manual of Mental Disorders criteria using the CIDI. Findings indicated that over a third of the South African population has been exposed to some form of violence. The most common forms of violence experienced by men were criminal and miscellaneous assaults, while physical abuse by an intimate partner, childhood physical abuse and criminal assaults were most common for women. Among men, political detention and torture were the forms of violence most strongly associated with a lifetime diagnosis of PTSD, while rape had the strongest association with PTSD among women. At a population level, criminal assault and childhood abuse were associated with the greatest number of PTSD cases among men, while intimate partner violence was associated with the greatest number of PTSD cases among women. Recommendations for mental health service provision in South Africa and for future research on the relative risk for PTSD are offered.
南非人口面临多种形式的暴力。本研究利用来自4351名南非成年人的具有全国代表性的数据,调查了南非人口中与政治、家庭、刑事、性暴力及其他(杂项)形式的攻击相关的创伤后应激障碍(PTSD)的相对风险。使用世界卫生组织综合国际诊断访谈(CIDI)中的“最严重事件”清单以及一份评估人权侵犯经历的单独问卷来评估暴力暴露情况,并根据美国精神病学协会《精神疾病诊断与统计手册》标准,使用CIDI评估终生PTSD。研究结果表明,超过三分之一的南非人口曾遭受某种形式的暴力。男性经历的最常见暴力形式是刑事和杂项攻击,而亲密伴侣的身体虐待、童年期身体虐待和刑事攻击在女性中最为常见。在男性中,政治拘留和酷刑是与终生PTSD诊断关联最紧密的暴力形式,而强奸在女性中与PTSD的关联最为强烈。在总体人群层面,刑事攻击和童年期虐待在男性中与最多的PTSD病例相关,而亲密伴侣暴力在女性中与最多的PTSD病例相关。文中还给出了关于南非心理健康服务提供以及未来PTSD相对风险研究的建议。