Galvin Michael D, Scheunemann Ann, Chiwaye Lesley, Luvuno Zoleka, Kim Andrew W, Moolla Aneesa
Health Economics and Epidemiology Research Office (HERO), University of the Witwatersrand, Johannesburg, South Africa.
S Afr J Psychiatr. 2025 May 20;31:2276. doi: 10.4102/sajpsychiatry.v31i0.2276. eCollection 2025.
South Africa bears a high burden of adverse childhood events (ACEs), which have been identified as a primary factor that can lead to negative mental health outcomes for adults. While studies within South Africa have examined the associations between ACEs, adult trauma and adult mental illness, there is less knowledge of how these preceding factors interact to affect mental distress together and which ACEs are most likely to lead to adverse mental health outcomes.
The main aim of this study was to explore the mediating effects of recent adult trauma on mental illness among patients at two psychiatric hospitals in Johannesburg, South Africa, using path analysis.
This study took place at two public psychiatric facilities in Johannesburg, South Africa.
Surveys were conducted with 309 adults living in Gauteng province. Mediational path analysis explored the association between ACEs, adult traumatic events, and depression, anxiety, and stress.
Adult traumatic events partially mediated the association between verbal abuse, emotional neglect, mental illness and substance use in the household as a child and adult mental illness. Adult traumatic events fully mediated the associations between experiencing domestic violence in childhood or child sexual abuse.
This study highlights the importance of disaggregating ACEs when exploring their effects while also reinforcing previous findings that ACEs increase the likelihood of experiencing adult trauma and adult mental illness.
Future studies should further pinpoint which ACEs are most impactful and target those for prevention in childhood and intervention in adulthood to mitigate their deleterious impacts.
南非儿童不良经历（ACEs）负担沉重，这些经历已被确定为可导致成年人心理健康出现负面结果的主要因素。虽然南非国内的研究探讨了儿童不良经历、成人创伤与成人精神疾病之间的关联，但对于这些前期因素如何共同相互作用影响心理困扰，以及哪些儿童不良经历最有可能导致不良心理健康结果，人们了解较少。
本研究的主要目的是运用路径分析，探究近期成人创伤对南非约翰内斯堡两家精神病医院患者精神疾病的中介作用。
本研究在南非约翰内斯堡的两家公立精神病机构开展。
对居住在豪登省的309名成年人进行了调查。中介路径分析探讨了儿童不良经历、成人创伤事件与抑郁、焦虑和压力之间的关联。
成人创伤事件部分中介了儿童时期家庭中的言语虐待、情感忽视、精神疾病和物质使用与成人精神疾病之间的关联。成人创伤事件完全中介了童年时期经历家庭暴力或儿童性虐待之间的关联。
本研究强调了在探究儿童不良经历的影响时对其进行分类的重要性，同时也强化了先前的研究结果，即儿童不良经历会增加经历成人创伤和成人精神疾病的可能性。
未来的研究应进一步明确哪些儿童不良经历影响最大，并针对这些经历进行儿童期预防和成年期干预，以减轻其有害影响。
