Depression and resilience in women with HIV and early life stress : does trauma play a mediating role? : a cross-sectional study
Date
2014-02
Authors
Spies, Georgina
Seedat, Soraya
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Abstract
Objectives: The present study sought to assess the relationship between depressive symptomatology and
resilience among women infected with HIV and to investigate whether trauma exposure (childhood trauma, other discrete lifetime traumatic events) or the presence of post-traumatic stress symptomatology mediated this relationship.
Design: Cross-sectional study.
Setting: Western Cape, South Africa.
Participants: A convenience sample of 95 women infected with HIV in peri-urban communities in the Western Cape, South Africa. All women had exposure to moderate-to-severe childhood trauma as determined by the Childhood Trauma Questionnaire.
Primary and secondary outcome measures: We examined the relationship between depressive symptomatology and resilience (the Connor-Davidson Resilience Scale) and investigated whether trauma
exposure or the presence of post-traumatic stress symptomatology mediated this relationship through the
Sobel test for mediation and PLS path analysis.
Results: There was a significant negative correlation between depressive symptomatology and resilience
(p=<0.01). PLS path analysis revealed a significant direct effect between depression and resilience. On the
Sobel test for mediation, distal (childhood trauma) and proximal traumatic events did not significantly mediate this association (p=> 0.05). However, post-traumatic stress symptomatology significantly mediated the relationship between depression and resilience in trauma-exposed women living with HIV.
Conclusions: In the present study, higher levels of resilience were associated with lower levels of selfreported
depression. Although causal inferences are not possible, this suggests that in this sample, resilience may act as protective factor against the development of clinical depression. The results also indicate that post-traumatic stress symptoms (PTSS), which are highly prevalent in HIV-infected and trauma exposed individuals and often comorbid with depression, may further explain and account for this relationship. Further investigation is required to determine whether early identification and treatment of PTSS in this population may ameliorate the onset and persistence of major depression.
Description
Publication of this article was funded by the Stellenbosch University Open Access Fund.
Spies, G. & Seedat, S. 2014. Depression and resilience in women with HIV and early life stress: does trauma play a mediating role?: A cross-sectional study. BMJ Open, 4:e004200, doi:10.1136/bmjopen-2013-004200.
The original publication is available at http://bmjopen.bmj.com/
Spies, G. & Seedat, S. 2014. Depression and resilience in women with HIV and early life stress: does trauma play a mediating role?: A cross-sectional study. BMJ Open, 4:e004200, doi:10.1136/bmjopen-2013-004200.
The original publication is available at http://bmjopen.bmj.com/
Keywords
HIV positive women -- Psychology, Depression in women, Resilience (Personality trait)
Citation
Spies, G. & Seedat, S. 2014. Depression and resilience in women with HIV and early life stress: does trauma play a mediating role?: A cross-sectional study. BMJ Open, 4:e004200, doi:10.1136/bmjopen-2013-004200.