@article{de1f74400ea04d4280a71f2ce1b47685,
title = "Association between witnessing traumatic events and psychopathology in the South African Stress and Health Study",
abstract = "Background: The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders. Methods: Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders. Results: Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders. Conclusion: Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected.",
keywords = "Africa, Anxiety disorders, Mood disorders, Trauma, Witnessing",
author = "Lukoye Atwoli and Jonathan Platt and Williams, {David R.} and Stein, {Dan J.} and Koenen, {Karestan C.}",
note = "Funding Information: Ethical approval was provided by the University of Michigan, Harvard Medical School, and Columbia University and by a single project assurance of compliance from the Medical University of South Africa that was approved by the National Institute of Mental Health. The study was therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent was obtained from all participants before conducting interviews. Funding Information: Ethical approval was provided by the University of Michigan, Harvard Medical School, and Columbia University and by a single project assurance of compliance from the Medical University of South Africa that was approved by the National Institute of Mental Health. Informed consent was obtained form all participants before conducting interviews. Funding Information: The South African Stress and Health (SASH) survey was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative which was supported by the National Institute of Mental Health (NIMH; R01 MH070884 and R01 MH093612), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, GlaxoSmithKline, and Bristol-Myers Squibb. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on data analysis. The South Africa Stress and Health Study (SASH) was supported by the US National Institute of Mental Health (R01-MH059575) and National Institute of Drug Abuse with supplemental funding from the South African Department of Health and the University of Michigan. None of the funders had any role in the design, analysis, interpretation of results, or preparation of this paper. A complete list of all within-country and cross-national WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/ . Dan Stein is supported by the Medical Research Council of South Africa. Jonathan Platt is supported by the National Institute of Mental Health (5-T32-MH-13043-43). Publisher Copyright: {\textcopyright} 2015, Springer-Verlag Berlin Heidelberg.",
year = "2015",
month = aug,
day = "31",
doi = "10.1007/s00127-015-1046-x",
language = "English",
volume = "50",
pages = "1235--1242",
journal = "Social Psychiatry and Psychiatric Epidemiology",
issn = "0933-7954",
publisher = "D. Steinkopff-Verlag",
number = "8",
}
