Childhood Trauma and Post-traumatic Stress Disorder (PTSD) among Adolescent girls and young women aged between 18-28 years in Mpumalanga, South Africa: A Cross-sectional Study

Abstract

Background: Post traumatic stress disorder (PTSD), is a mental disorder which has been found to be associated with comorbid mental and physical disorders, as well as reduced quality of life. Children who have experienced traumatic events (TEs) before the age of 18 are at risk of physical disorders, mental disorders, and substance abuse later in life but more evidence is needed regarding their risk of PTSD. Main objective: To examine the association between PTSD and childhood TEs among adolescent girls and young women (AGYW) aged between 18 and 28 years in Agincourt, South Africa, in 2015-2017 utilising Complete Case Analysis (CCA). We also examined the effect of using Multiple Imputation (MI) or Inverse Probability Weighting (IPW) given the large proportion of missing values, on the estimated measure of association. Methods This study was a secondary analysis of cross-sectional data from a Randomised Controlled Trial (RCT). PTSD and childhood TEs data were collected between 2015 and 2017 from AGYW. Participants who had at least one childhood TE were included in the secondary analysis. Univariable and multivariable logistic regression models were used for the analyses. In addition to carrying out a CCA, MI, and IPW were utilised as methods for handling missing data. Results There were 1175 participants who met the inclusion criteria. The mean age of the study participants was 20.1 years with a standard deviation of 1.3 years. In the CCA multivariable model, PTSD was found to be associated with childhood TEs (aOR=1.69, 95% CI 1.01-2.47). This association remained after accounting for missing data in the MI multivariable model (aOR= 2.06, 95% CI 1.35-3.15), and the IPW multivariable model (aOR= 1.49, 95% CI 1.01-2.21). Conclusion We found that PTSD was associated with childhood TEs with the odds of experiencing PTSD increasing with increasing childhood TEs. The data were not MCAR, and CCA was biased as an analysis method. MI and IPW improved the analysis. Future analyses could use simulated data to examine which method performs better between MI and IPW.