Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis

Background: 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 il...

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Main Authors: Michael D. Galvin, Ann Scheunemann, Lesley Chiwaye, Zoleka Luvuno, Andrew W. Kim, Aneesa Moolla
Format: Article
Language:English
Published: AOSIS 2025-05-01
Series:South African Journal of Psychiatry
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Online Access:https://sajp.org.za/index.php/sajp/article/view/2276
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author Michael D. Galvin
Ann Scheunemann
Lesley Chiwaye
Zoleka Luvuno
Andrew W. Kim
Aneesa Moolla
author_facet Michael D. Galvin
Ann Scheunemann
Lesley Chiwaye
Zoleka Luvuno
Andrew W. Kim
Aneesa Moolla
author_sort Michael D. Galvin
collection DOAJ
description Background: 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. Aim: 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. Setting: This study took place at two public psychiatric facilities in Johannesburg, South Africa. Methods: 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. Results: 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. Conclusion: 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. Contribution: 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.
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spelling doaj-art-624c9c6c0b044cf090f369fc6feb95ec2025-08-20T02:05:20ZengAOSISSouth African Journal of Psychiatry1608-96852078-67862025-05-01310e1e1010.4102/sajpsychiatry.v31i0.2276776Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysisMichael D. Galvin0Ann Scheunemann1Lesley Chiwaye2Zoleka Luvuno3Andrew W. Kim4Aneesa Moolla5Health Economics and Epidemiology Research Office (HE2RO), University of the Witwatersrand, JohannesburgHealth Economics and Epidemiology Research Office (HE2RO), University of the Witwatersrand, JohannesburgHealth Economics and Epidemiology Research Office (HE2RO), University of the Witwatersrand, JohannesburgHealth Economics and Epidemiology Research Office (HE2RO), University of the Witwatersrand, JohannesburgHealth Economics and Epidemiology Research Office (HE2RO), University of the Witwatersrand, JohannesburgHealth Economics and Epidemiology Research Office (HE2RO), University of the Witwatersrand, JohannesburgBackground: 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. Aim: 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. Setting: This study took place at two public psychiatric facilities in Johannesburg, South Africa. Methods: 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. Results: 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. Conclusion: 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. Contribution: 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.https://sajp.org.za/index.php/sajp/article/view/2276south africajohannesburgacestraumamental health
spellingShingle Michael D. Galvin
Ann Scheunemann
Lesley Chiwaye
Zoleka Luvuno
Andrew W. Kim
Aneesa Moolla
Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis
South African Journal of Psychiatry
south africa
johannesburg
aces
trauma
mental health
title Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis
title_full Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis
title_fullStr Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis
title_full_unstemmed Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis
title_short Trauma as a mediator of childhood adversity and mental illness in South Africa: A path analysis
title_sort trauma as a mediator of childhood adversity and mental illness in south africa a path analysis
topic south africa
johannesburg
aces
trauma
mental health
url https://sajp.org.za/index.php/sajp/article/view/2276
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