Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 20:31:2276.
doi: 10.4102/sajpsychiatry.v31i0.2276. eCollection 2025.

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

Michael D Galvin  1 , Ann Scheunemann  1 , Lesley Chiwaye  1 , Zoleka Luvuno  1 , Andrew W Kim  1 , Aneesa Moolla  1
Affiliations

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

Michael D Galvin et al. S Afr J Psychiatr. .

Abstract

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.

Keywords: ACEs; Johannesburg; South Africa; mental health; trauma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Path analysis of adult traumatic events as a mediator between adverse childhood events and adult mental illness.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Benjet C, Bromet E, Karam EG, et al. . The epidemiology of traumatic event exposure worldwide: Results from the World Mental Health Survey Consortium. Psychol Med. 2016;46(2):327–343. 10.1017/S0033291715001981 - DOI - PMC - PubMed
    1. Ng LC, Stevenson A, Kalapurakkel SS, et al. . National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis. PLoS Med. 2020;17(5):e1003090. 10.1371/journal.pmed.1003090 - DOI - PMC - PubMed
    1. Stoltenborgh M, Bakermans-Kranenburg MJ, Alink LR, Van IJzendoorn MH. The prevalence of child maltreatment across the globe: Review of a series of meta-analyses. Child Abuse Rev. 2015;24(1):37–50. 10.1002/car.2353 - DOI
    1. Smigelsky MA, Aten JD, Gerberich S, et al. . Trauma in sub-Saharan Africa: Review of cost, estimation methods, and interventions. Int J Emerg Ment Health. 2014;16(2):354–365. 10.4172/1522-4821.1000129 - DOI - PubMed
    1. Van Zyl L, Nel C, Du Toit M, Joubert G. Reported exposure to trauma among adult patients referred for psychological services at the Free State Psychiatric Complex, Bloemfontein. Health SA Gesondheid. 2017;22;235–240. 10.1016/j.hsag.2017.01.001 - DOI

LinkOut - more resources