Childhood Trauma: Disorders and Risky Behavior

In middle-income countries, deteriorating mental health is considered to be one of the major causes of morbidity. Peltzer, Pengpid, and Tiembre (2013) suppose that many mental health issues stem from traumatizing events back in the childhood days. This assumption makes it compelling to study childhood traumas in association with subsequent disorders and risky behavior in adult life. In their study, Peltzer et al. (2013) focus on college-aged Ivory Coast youth. The researchers seek to pinpoint the relationship between poor mental health caused by childhood abuse among other factors and HIV risk behavior. The study is motivated by the prevalence of HIV in Ivory Coast that has been found to be the highest in West Africa. Populations that are considered to be high-risk are young people between the ages of 20 and 24. The hypothesis put forward by Peltzer et al. (2013) can be formulated as follows: “Young people with a history of childhood abuse have a higher likelihood of participating in HIV risk behaviors such as having sex with multiple partners and having unprotected sex.”

For their study, Peltzer et al. (2013) used cross-sectional survey design. The researchers put together an anonymous, self-administered questionnaire for data collection. The sampling procedure employed simple random sampling with the use of stratification. Namely, Peltzer et al. (2013) stratified and weighted the size and population of units of training and research at FélixHouphouët Boigny University. The calculated percentage as well as the sample rate were assigned to the 800 recruited students. Peltzer et al. (2013) made sure to follow the ethical guidelines: they obtained the permission to carry out the study from the President of Félix Houphouët Boigny University. The cover page of each questionnaire elaborated on the purpose of the study and provided the information about the researchers. Peltzer et al. (2013) only recruited participants who were mentally capable of sharing the information and received explicit consent to proceed with the data collection.

The study shows that poor mental health such as depressive and PTSD (post-traumatic stress disorder) symptoms, high childhood physical and sexial abuse as well as frequent HIV risk behavior were quite prevalent among the sample. The depression and PTSD rate among the recruited students from Ivory Coast were approximately the same as in other studied African populations. Peltzer et al. (2013) found an association between poor mental health (including substance abuse) and HIV risk behavior. However, the study did not confirm the relationship between experiencing physical and sexual abuse in the childhood and participating in HIV high-risk behavior. Peltzer et al. (2013) admit that their study has several serious limitations. First and foremost, the cross-sectional design of the study makes it difficult to apply causality to any of the factors. Secondly, the researchers state that even though the survey was anonymous, sexuality is still a sensitive topic. It could be that some of the participants were reluctant to share their experiences.

While Peltzer et al. (2013) did not confirm their primary hypothesis, other studies approaching a similar subject matter did. Paterniti et al. (2017) sought to explain why the course of depression was typically poorer in clinical settings as compared to general populations. The researchers focused on the predictors of such a phenomenon and took interest in childhood neglect as one of the major factors in particular. The study was motivated by the poorer outcomes of patients in clinical settings with regards to mental illness. As Paterniti et al. (2017) report, in general populations, the recovery rate from depression without any recurrent episodes was 47%. For those being treated in primary care, the rate was 30-35%, and for patients in clinical settings – less than 30%. The hypothesis for the study may be formulated as follows: “Childhood physical and emotional neglect predicts the course of depression in adult life.”

The sampling procedure used convenience sampling at the Assess-ment and Treatment Clinic (ATC) within the Royal Ottawa MentalHealth Centre’s (ROMHC) Mood Disorders Program. Between the years 2008 and 2012, Paternini et al. (2017) assessed 238 individuals who suffered from an ongoing major depressive episode. Half of the sample (N = 119) took part in a follow up study that took place from 2012 to 2014. During the followup, Paterniti et al. (2017) measured sociodemographic and clinical variables as well as logged the history of childhood abuse and neglect. The follow up study was needed for understanding the course of depression in the studied individuals. Paterniti et al. (2017) ensured full anonymity and confidentiality of the study and only recruited patients eligible for research.

The study has shown that the course of depression in patients in clinical settings was poorer than in those treated in primary care settings or general populations, which is consistent with existing literature. Out of all patients, 45% never recovered, and only 34% did not have any relapses during the next two-five years. Paterniti et al. (2017) discovered that childhood neglect was indeed a reliable predictor of a poorer prognosis. This finding implies that it is recommended to assess patients for the history of potential childhood mistreatment.

References

Paterniti, S., Sterner, I., Caldwell, C., & Bisserbe, J. C. (2017). Childhood neglect predicts the course of major depression in a tertiary care sample: A follow-up study. BMC Psychiatry17(1), 113.

Peltzer, K., Pengpid, S., & Tiembre, I. (2013). Mental health, childhood abuse and HIV sexual risk behaviour among university students in Ivory Coast. Annals of General Psychiatry12(1), 18.

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