Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries
Thesis (PhD)--Stellenbosch University, 2025.
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Stellenbosch : Stellenbosch University
2025
|
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613799046971392 |
|---|---|
| access_status_str | Open Access |
| author | Stevenson, Anne Holm |
| author2 | Seedat, Soraya |
| author_browse | Seedat, Soraya Stevenson, Anne Holm |
| author_facet | Seedat, Soraya Stevenson, Anne Holm |
| author_sort | Stevenson, Anne Holm |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2025. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/134388 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:41:52.972Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/134388 The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries Stevenson, Anne Holm Seedat, Soraya Koenen, Karestan C. Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry. Thesis (PhD)--Stellenbosch University, 2025. Stevenson, A. H. 2025. The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries. Unpublished doctoral thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/2c2aa846-27a7-448e-a800-fe3a832ec434 There is a well-established link between trauma exposure and serious mental health conditions (SMHCs), such as schizophrenia and bipolar disorder. One of the known risk factors for SMHCs is exposure to trauma, often defined as exposure to severe or life-threatening events. Research suggests that SMHCs may also increase individuals’ vulnerability to trauma exposure. SMHCs and posttraumatic stress disorder (PTSD) are often comorbid; with a reported 29% prevalence of PTSD among individuals with schizophrenia. Most research in this area has focused on high-income countries in Europe, North America, and Australasia. There has been less research on this link in low- and middle-income countries (LMICs), particularly in Africa. Of the studies in LMICs, most have used small samples and different tools, limiting their comparability across settings. Additionally, in both high-income settings and LMICs, much of the research to date has focused on childhood trauma as a risk factor for developing SMHCs. There is less known about lifetime trauma exposure as a risk factor for SMHCs or having a pre-existing SMHC as a risk factor for experiencing trauma. This dissertation aims to address these gaps through five sequential papers: i) “Serious mental health conditions and exposure to adulthood trauma in LMICs: A scoping review” provides a broad investigation and synthesis of the types of traumas that adults with SMHCs in LMICs report globally. ii) “National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis” determines the burden of trauma exposure, and specifically PTSD, in sub-Saharan Africa. iii) “Trauma exposure and psychometric properties of the Life Events Checklist among adults in South Africa” establishes the psychometric properties of a widely used trauma exposure measure, the Life Events Checklist, in a South African sample of 6 765 adults with and without psychotic disorders. iv) “The relationship between lifetime trauma exposure and psychosis in a multi-country case-control study in Africa” determines the distribution of trauma across a sample of 42 935 adults with and without psychotic disorders in Ethiopia, Kenya, South Africa, and Uganda by case-control status, by country, and by sex. v) “Relationships between trauma types and psychotic symptoms: A network analysis of patients with psychotic disorders in a large, multi-country study in East Africa” generates hypotheses about how trauma types and psychotic symptoms may be associated with each other in a sample of 16 628 adults with psychotic disorders in Ethiopia, Kenya, and Uganda. The results from these studies primarily align with previous research conducted in high-income countries and with some of the explanatory models of the interplay between trauma exposure and SMHCs. However, there are limitations with how trauma exposure has been captured in LMICs, reducing our understanding of potentially unique traumas, responses to trauma, and SMHCs in this population. In conclusion, when assessing the effect of trauma exposure on populations, specifically in populations with SMHCs in LMICs, it is critical to establish the impact of interpersonal violence, and armed conflict (and the overlap between these factors) and cultural concepts of trauma and idioms of distress. Doctoral 2025-11-19T06:05:51Z 2025-11-19T06:05:51Z 2025-03 Thesis https://scholar.sun.ac.za/handle/10019.1/134388 en Stellenbosch University 175 pages : ill. application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Stevenson, Anne Holm The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries |
| title | The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries |
| title_full | The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries |
| title_fullStr | The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries |
| title_full_unstemmed | The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries |
| title_short | The Relationship between Trauma Exposure and Serious Mental Health Conditions: A Focus on Africa and Low- and Middle-Income Countries |
| title_sort | relationship between trauma exposure and serious mental health conditions a focus on africa and low and middle income countries |
| url | https://scholar.sun.ac.za/handle/10019.1/134388 |
| work_keys_str_mv | AT stevensonanneholm therelationshipbetweentraumaexposureandseriousmentalhealthconditionsafocusonafricaandlowandmiddleincomecountries AT stevensonanneholm relationshipbetweentraumaexposureandseriousmentalhealthconditionsafocusonafricaandlowandmiddleincomecountries |