Relationships Among HIV/AIDS Orphanhood, Stigma, and Symptoms of Anxiety and Depression in South African Youth: A Longitudinal Investigation Using a Path Analysis Framework

Cross-sectional research has demonstrated that HIV/AIDS orphanhood is associated with anxiety and depression and that HIV/AIDS-related stigma is a risk factor for these outcomes. This study used a longitudinal data set to determine whether relationships between HIV/AIDS orphanhood and anxiety/depression scores (measured at 4-year follow-up) operate indirectly via perceived stigma. Youths from poor communities around Cape Town were interviewed in 2005 (n = 1,025) and followed up in 2009 (n = 723). At baseline, HIV/AIDS-orphaned youth reported significantly higher stigma and depression scores than youth not orphaned by HIV/AIDS. At follow-up, HIV/AIDS-orphaned youth reported significantly higher stigma, anxiety, and depression scores. However, HIV/AIDS orphanhood was not directly associated with anxiety or depression. Instead, significant indirect effects (operating through perceived stigma) were obtained for both assessment periods. Results demonstrate that stigma persists across time and appears to mediate relationships between HIV/AIDS orphanhood and psychological distress. Interventions aiming to reduce stigma may help promote the mental health of HIV/AIDS-orphaned youth

Bullying Victimisation, Internalising Symptoms, and Conduct Problems in South African Children and Adolescents: A Longitudinal Investigation

Bullying victimisation has been prospectively linked with mental health problems among children and adolescents in longitudinal studies in the developed world. However, research from the developing world, where adolescents face multiple risks to social and emotional development, has been limited by cross-sectional designs. This is the first longitudinal study of the psychological impacts of bullying victimisation in South Africa. The primary aim was to examine prospective relationships between bullying victimisation and internalising and externalising symptoms in South African youth. Secondary aims were to examine gender and age-related differences in experiences of bullying victimisation. Children and adolescents (10–17 years, 57 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up 1 year later (97 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces and door-to-door sampling included all households with a resident child/adolescent. Exposure to multiple experiences of bullying victimisation at baseline predicted internalising symptoms and conduct problems 1 year later. Additionally, baseline mental health scores predicted later bullying victimisation, demonstrating bi-directionality of relationships between bullying victimisation and mental health outcomes in this sample. Expected gender differences in physical, verbal, and relational bullying victimisation were evident and predicted declines in bullying victimisation over time were observed. In the developed world, school-based anti-bullying programmes have been shown to be effective in reducing bullying and victimisation. Anti-bullying programmes should be implemented and rigorously evaluated in South Africa, as this may promote improved mental health among South African children and adolescents