Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations
Abstract Background Anecdotal evidence suggests the frequently traumatic nature of female genital mutilation (FGM). At present, systematic research on the psychological sequelae of this tradition has remained limited. The study provides preliminary, high-quality psychodiagnostic data on potential ps...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12888-018-1757-0 |
| _version_ | 1818305060518494208 |
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| author | Anke Köbach Martina Ruf-Leuschner Thomas Elbert |
| author_facet | Anke Köbach Martina Ruf-Leuschner Thomas Elbert |
| author_sort | Anke Köbach |
| collection | DOAJ |
| description | Abstract Background Anecdotal evidence suggests the frequently traumatic nature of female genital mutilation (FGM). At present, systematic research on the psychological sequelae of this tradition has remained limited. The study provides preliminary, high-quality psychodiagnostic data on potential psychopathological consequences of FGM, with a focus on posttraumatic stress disorder (PTSD), shutdown dissociation and other stress-related variables. Methods We investigated a convenience sample of N = 167 women, supported by the women’s affairs headquarters in Jijiga (capital of the Ethiopian Somali Region) and a local Ethiopian non-governmental organization. Our main outcome measures were PTSD (PSS-I) and shutdown dissociation (ShuD). We also assessed depression and anxiety (HSCL-25), major depression, substance abuse and dependence, suicidality and psychotic disorders (M.I.N.I.; sub-scales A., B., K., and L.). In addition, we collected hair samples to assess hair cortisol concentrations (HCC) as a neuroendocrinological measure. Results The majority of women endured FGM (FGM I: 36%, FGM II/III: 52%) and, regardless of the level of the physical invasiveness, almost all women reported having felt intense fear and/or helplessness. FGM II/III, the more invasive form, was associated with a greater vulnerability to PTSD symptoms (p < .001) and shutdown dissociation (p < .001). Symptoms of depression (p < .05) and anxiety (p < .01) were also elevated. Random forest regression with conditional inference trees revealed evidence of an alteration of the cortisol levels in relation to the age when FGM was experienced (< 1 year) and the invasiveness of the procedure. Conclusion More extensive forms of FGM are associated with more severe psychopathological symptoms – particularly with an increased vulnerability to PTSD. Higher hair cortisol levels in women who experienced FGM before their first year of age or had more severe forms of FGM indicate long-term neuroendocrinological consequences of FGM and trauma in general on the stress system. |
| first_indexed | 2024-12-13T06:20:35Z |
| format | Article |
| id | doaj.art-41f4af97542e4e35835674a385441d5b |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-13T06:20:35Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-41f4af97542e4e35835674a385441d5b2022-12-21T23:56:51ZengBMCBMC Psychiatry1471-244X2018-06-0118111210.1186/s12888-018-1757-0Psychopathological sequelae of female genital mutilation and their neuroendocrinological associationsAnke Köbach0Martina Ruf-Leuschner1Thomas Elbert2Department of Clinical and Neuropsychology, University KonstanzDepartment of Clinical and Neuropsychology, University KonstanzDepartment of Clinical and Neuropsychology, University KonstanzAbstract Background Anecdotal evidence suggests the frequently traumatic nature of female genital mutilation (FGM). At present, systematic research on the psychological sequelae of this tradition has remained limited. The study provides preliminary, high-quality psychodiagnostic data on potential psychopathological consequences of FGM, with a focus on posttraumatic stress disorder (PTSD), shutdown dissociation and other stress-related variables. Methods We investigated a convenience sample of N = 167 women, supported by the women’s affairs headquarters in Jijiga (capital of the Ethiopian Somali Region) and a local Ethiopian non-governmental organization. Our main outcome measures were PTSD (PSS-I) and shutdown dissociation (ShuD). We also assessed depression and anxiety (HSCL-25), major depression, substance abuse and dependence, suicidality and psychotic disorders (M.I.N.I.; sub-scales A., B., K., and L.). In addition, we collected hair samples to assess hair cortisol concentrations (HCC) as a neuroendocrinological measure. Results The majority of women endured FGM (FGM I: 36%, FGM II/III: 52%) and, regardless of the level of the physical invasiveness, almost all women reported having felt intense fear and/or helplessness. FGM II/III, the more invasive form, was associated with a greater vulnerability to PTSD symptoms (p < .001) and shutdown dissociation (p < .001). Symptoms of depression (p < .05) and anxiety (p < .01) were also elevated. Random forest regression with conditional inference trees revealed evidence of an alteration of the cortisol levels in relation to the age when FGM was experienced (< 1 year) and the invasiveness of the procedure. Conclusion More extensive forms of FGM are associated with more severe psychopathological symptoms – particularly with an increased vulnerability to PTSD. Higher hair cortisol levels in women who experienced FGM before their first year of age or had more severe forms of FGM indicate long-term neuroendocrinological consequences of FGM and trauma in general on the stress system.http://link.springer.com/article/10.1186/s12888-018-1757-0Female genital mutilationFGMFemale genital cuttingPosttraumatic stress disorder (PTSD)DissociationDepression |
| spellingShingle | Anke Köbach Martina Ruf-Leuschner Thomas Elbert Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations BMC Psychiatry Female genital mutilation FGM Female genital cutting Posttraumatic stress disorder (PTSD) Dissociation Depression |
| title | Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations |
| title_full | Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations |
| title_fullStr | Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations |
| title_full_unstemmed | Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations |
| title_short | Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations |
| title_sort | psychopathological sequelae of female genital mutilation and their neuroendocrinological associations |
| topic | Female genital mutilation FGM Female genital cutting Posttraumatic stress disorder (PTSD) Dissociation Depression |
| url | http://link.springer.com/article/10.1186/s12888-018-1757-0 |
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