Browsing by Author "Fortuin, Chelsi Shante"
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- ItemDoes sexual violence alter social behvaiour via a maladaptive HPA-axis?(Stellenbosch : Stellenbosch University, 2023-03) Fortuin, Chelsi Shante; Qulu, Lihle; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Biomedical Sciences. Medical Physiology.ENGLISH ABSTRACT: Background and Aim: South Africa was identified as the rape capital of the world, recording one of the highest rates of sexual violence worldwide with 72.1 reported cases per 100 000 in the 2019/2020 year. The mental health and well-being of sexual assault survivors exhibit a dysregulated HPA-axis stress response, which may be a primary source of structural and functional alterations leading to PTSD symptoms, but they don’t always co-exist. Chronic stress and psychiatric diseases cause dysregulation of the HPA axis. A cortisol imbalance brought on by the dysregulation of the HPA-axis leads to a decrease in oxytocin secretion, which eliminates oxytocin's potential to attenuate HPA-axis activity. A lack of oxytocin has been linked to broken social and maternal bonds as well as losing relationship attachments as a result of trauma exposure such as sexual violence / rape. Oxytocin dysregulation has been associated in a large variety of dysregulated social behaviour and PTSD diagnosis. Additionally, when bound to cortisol, glucocorticoid receptor sensitivity modifies the stress response's equilibrium point, which in turn regulates the HPA axis's negative feedback loop. As a result, they have been linked to anticipating the effects of stress. Therefore, the aim of this study is to determine whether being subjected to sexual violence alters social behavior via a dysregulated HPA-axis. Methods: Data analysis was completed using PTSD, perceived stress and social support scores to investigate the effects of rape on mental health trajectory. Additionally, enzyme-linked immunosorbent assays were used, to explore the role of oxytocin and cortisol as indicators of PTSD in rape-exposed women. Both cortisol and oxytocin found within plasma samples were analysed over a one-year period at four time points (baseline [± twenty days], three months, six months and twelve months post rape) to assess whether these hormone levels, that are activated by sexual violence, were transient or long lasting, and whether these hormone levels may lead to the formation of PTSD. Mixed effect regression analysis were done to determine if cortisol and oxytocin concentrations predict PTSD outcomes. Results: PTSD symptoms significantly decreased overtime, p = 0.000. Similarly, perceived stress, p = 0.0023, and cortisol concentrations, p = 0.004, significantly decreased overtime. Whereas social support scores, p = 0.5851, and oxytocin concentrations, p = 0.995, had no significant changes. Additionally, cortisol concentrations, p = 0.1660, and social support, p = 0.827, were not able to predict PTSD outcome, however oxytocin concentrations, slope = 9.32, p = 0.002 and perceived stress scores, slope = -5.654, p = 0.033, could predict PTSD. Conclusion: These findings demonstrate a relationship between PTSD symptom severity and HPA-axis maladaptation, via augmented oxytocin responses in victims of rape. We conclude that these findings may have significant clinical ramifications for women who have been subjected to rape. Particularly, offering scientific based PTSD interventions to rape exposed victims may show promise in alleviating symptoms and "normalizing" HPA axis receptivity to stress related stimuli.