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. 2023 Dec;182(4):620-631.
doi: 10.1002/ajpa.24791. Epub 2023 Jun 7.

Childhood adversity during the post-apartheid transition and COVID-19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis

Andrew Wooyoung Kim  1   2 , Rihlat Said Mohamed  2 , Shane A Norris  2   3   4 , Sara Naicker  2   3 , Linda M Richter  2   3 , Christopher W Kuzawa  5   6
Affiliations

Childhood adversity during the post-apartheid transition and COVID-19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis

Andrew Wooyoung Kim et al. Am J Biol Anthropol. 2023 Dec.

Abstract

Objectives: The COVID-19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors-a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post-apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID-19) pandemic (ca. 2020-2021).

Materials and methods: Data came from 88 adults who participated in a follow-up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID-19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID-19 stress was calculated to evaluate the potential effect of stress sensitization.

Results: Fifty-six percent of adults exhibited moderate-to-severe PTSD symptoms. Greater childhood adversity and higher COVID-19 psychosocial stress independently predicted worse post-traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non-significantly worse PTSD symptoms from COVID-19 psychosocial stress.

Discussion: These results highlight the deleterious mental health effects of both childhood trauma and COVID-19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.

Keywords: COVID-19; South Africa; adulthood; childhood adversity; post-traumatic stress disorder; stress sensitization.

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Figures

Figure 1.
Figure 1.
Childhood adversity and adult PTSD severity by adult COVID psychosocial stress. Adults with greater childhood adversity and worse COVID-19 psychosocial stress exhibited non-significantly elevated PTSD symptom severity (b = 0.08, 95% CI [−0.03, 0.2], p = 0.146).
See this image and copyright information in PMC

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