South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Pretoria Private Bag x385, Pretoria 0001, South Africa.
School of Public Health, Faculty of Health Sciences, University of Witwatersrand, 60 York Road, Parktown, Johannesburg 2193, South Africa.
Int J Environ Res Public Health. 2022 Jun 28;19(13):7913. doi: 10.3390/ijerph19137913.
While ample evidence from high-income country settings indicates the prevalence and risk factors for multiple mental ill-health symptoms in student populations, evidence from low- and middle-income higher education settings remains limited. We determined the frequency, associations, and structural pathways between mental health outcomes and possible risk factors among a sample of 1292 predominantly Black African and female students ages 18-30 years, enrolled at nine purposefully selected public universities and Technical Vocational Education and Training (TVET) campuses. We measured and created a mental ill-health latent outcome consisting of depressive symptoms, post-traumatic stress disorder (PTSD), and suicidal thoughts. We also measured traumatic exposures including childhood trauma, recent intimate partner violence (IPV), non-partner rape, and other life traumatic events. We used structural equation modelling to analyse data. We found that 50% of the surveyed students binge drank, 43% reported depressive symptoms, 9% reported PTSD symptoms, and 21% had suicidal thoughts. Students' experiences of childhood trauma, food insecurity, other traumatic events, non-partner rape, and IPV impacted the mental ill-health latent. IPV experiences mediated the relationships between experiences of childhood trauma or other trauma and the mental ill-health latent, and the relationship between binge drinking and other life traumatic events. Non-partner rape mediated the relationship between food insecurity and the mental ill-health latent. Binge drinking directly impacted non-partner rape experience. The findings substantiate the need for campus-based mental health promotion, psychosocial services and treatments, and implementation of combined interventions that address the intersections of violence against women and mental health among students in South Africa.
虽然来自高收入国家环境的大量证据表明学生群体中存在多种心理健康问题的流行情况和风险因素，但来自中低收入高等教育环境的证据仍然有限。我们在一个由 1292 名主要为非洲裔黑人且年龄在 18 至 30 岁的学生组成的样本中，确定了心理健康结果与可能的风险因素之间的频率、关联和结构途径，这些学生就读于九所专门挑选的公立大学和技术职业教育与培训（TVET）校区。我们测量并创建了一个心理健康不良的潜在结果，该结果由抑郁症状、创伤后应激障碍（PTSD）和自杀念头组成。我们还测量了创伤暴露，包括儿童时期的创伤、最近的亲密伴侣暴力（IPV）、非伴侣强奸和其他生活创伤事件。我们使用结构方程模型来分析数据。我们发现，50%的被调查学生有狂饮行为，43%的学生报告有抑郁症状，9%的学生报告有 PTSD 症状，21%的学生有自杀念头。学生的童年创伤经历、食物不安全、其他创伤事件、非伴侣强奸和 IPV 经历影响了心理健康不良的潜在结果。IPV 经历在童年创伤或其他创伤经历与心理健康不良潜在结果之间以及与狂饮行为和其他生活创伤事件之间的关系中起中介作用。非伴侣强奸在食物不安全与心理健康不良潜在结果之间起中介作用。狂饮行为直接影响非伴侣强奸经历。这些发现证实了南非校园内需要进行心理健康促进、心理社会服务和治疗，以及实施针对暴力侵害妇女行为和学生心理健康交叉问题的综合干预措施。
