Child sexual abuse experiences mediate the relationship between poverty and posttraumatic stress disorder in a South African student sample.

Document Abstract / Summary Overview

Abstract There is a growing body of evidence from developing countries which suggests there is an association between poverty and risk of common mental disorders including posttraumatic stress disorder (PTSD; Patel & Kleinman, 2003). With respect to the mechanisms underlying this relationship, it is far from clear whether poverty exerts a direct influence on PTSD outcomes (i.e., over and above individual factors such as trauma exposure) as suggested by some researchers (Rockers, Kruk, Saydee, Varpilah, & Galea, 2010) or poverty is a risk factor for traumatic experiences (Townsend & Dawes, 2004), with such traumatic experiences in turn serving as determinants of PTSD. Attempting to obtain further clarity on this poverty-risk relationship, and with specific reference to child sexual abuse experiences (CSA), during 2010 I surveyed 323 South African undergraduate students (age: M = 20.14 years; gender: 71% female; ethnicity: 87% Black African). Poverty and CSA were assessed using the poverty and sexual abuse scales of the Developmental Trauma Inventory designed by Valjee and Collings (2010), who reported high test-retest reliability for the CSA (r = .98, p < .001) and poverty (r = .97, p < .001) subscales at 2 weeks, with construct validity being demonstrated by high correlations with other measures of CSA and with structural measures of poverty, respectively. PTSD was assessed using the Davidson Trauma Scale (Davidson, 2003). Davidson reported high test-retest reliability for the scale within a 1-week period (r = .86, p = .001), with construct validity being demonstrated by high correlations with other measures of PTSD. Zero-order correlations indicated that poverty scores were significantly correlated with both CSA (r = 0.20, p < .001) and PTSD scores (r = 0.12, p < .05), with CSA being significantly correlated with PTSD scores (r = 0.15, p < .01). A path analysis in which poverty was considered as an antecedent variable, CSA exposure as a potential mediating variable, and PTSD scores as an outcome variable, produced significant path coefficients for poverty and CSA (r = 0.22, p < .001) and for CSA and PTSD scores (r = 0.18, p < .01), but no significant coefficient for poverty and PTSD scores (r = 0.08, p = .118). Taken together, these findings are consistent with the view that poverty constitutes a risk factor for CSA (Townsend & Dawes, 2004), and suggest that CSA experiences may mediate the relationship between poverty and PTSD outcomes.