Mental health outcomes and post-traumatic stress disorder associated with female genital mutilation

Abstract

The aim of this study was to examine mental health outcomes associated with FGM and identify possible predictors for the development of post-traumatic stress disorder (PTSD) in women affected by Female Genital Mutilation (FGM). A cross-sectional study was conducted among women who attended to Somalia Mogadishu Research and Training Hospital. Brief Resilience Scale, National Stressful Events Questionnaire for PTSD-Short Scale, Brief Symptom Inventory (BSI), Childhood Trauma Questionnaire-Short Form, Satisfaction with Life Scale, were used to collect data. Assessments of 180 women who underwent FGM revealed significant positive correlations between post-traumatic stress disorder (PTSD) symptoms and Brief Symptom Inventory (BSI) subscales (r = 0.32-0.52, p < 0.01). Key predictors of PTSD severity included trauma history, sexual dysfunction, unanticipated FGM procedures, and maternal or grandmother decision-making (β = 0.45, p < 0.001; β = 0.32, p < 0.01; β = 0.28, p < 0.05; β = 0.34, p < 0.01). Psychological resilience served as a protective factor against PTSD (β = - 0.22, p < 0.05). Childhood trauma, especially physical and sexual abuse, showed strong positive correlations with PTSD and other psychological symptoms (r = 0.32-0.52, p < 0.01). Key predictors of psychological distress included emotional neglect (β = - 0.28, p < 0.01), fear of violence (β = 0.22, p < 0.05), and low psychological resilience (β = - 0.22, p < 0.05). The study showed that women with FGM presents with substantially higher levels of PTSD. The primary decision-makers in the practice of FGM are predominantly mothers and grandmothers.

Keywords: Childhood trauma; Female genital mutilation; Mental health; Post traumatic stress disorder; Resilience; Somalia.

Fig. 1

Parallel mediation effect of resilience and CTQ-EN in the relationship between PTSD and obsessive–compulsive symptoms PTSD: National Stressful Events Survey for post-traumatic stress disorder, CTQ-EN: Childhood Trauma Questionnaire- Emotional Neglect, BRS: Brief Resilience Scale, BSI-O-C: BSI (Brief Symptom Inventory)- Obsession–Compulsion.

Fig. 2

Parallel mediation effect of resilience and CTQ-EN in the relationship between PTSD and depression. PTSD: National Stressful Events Survey for post-traumatic stress disorder, CTQ-EN: Childhood Trauma Questionnaire- Emotional Neglect, BRS: Brief Resilience Scale, BSI-DEP: BSI (Brief Symptom Inventory)- Depression.

Fig. 3

Parallel mediation effect of resilience and CTQ-EN in the relationship between PTSD and anxiety. PTSD: National Stressful Events Survey for post-traumatic stress disorder, CTQ-EN: Childhood Trauma Questionnaire- Emotional Neglect, BRS: Brief Resilience Scale, BSI-ANX: BSI (Brief Symptom Inventory)- Anxiety.