Posttraumatic stress disorder symptoms in adolescents: risk factors versus resilience moderation

Background: Exposure to community violence and trauma, stress, and childhood abuse and neglect have been identified as risk factors for the development of posttraumatic stress disorder (PTSD) symptoms among adolescents. Although evidence suggests that resilience may moderate the relationship between some of these risk factors and PTSD symptoms, no studies to date have examined these risk factors collectively. Aims: Our first aim was to examine the relationship between exposure to community violence, childhood abuse and neglect, perceived stress, and PTSD symptoms. Our second aim was to examine the extent to which resilience moderated the relationship between risk factors and PTSD symptoms. Method: A convenience sample of 787 participants was drawn from 5 public secondary schools in the Cape Town metropole of South Africa. The participants were invited to complete a battery of questionnaires on a single occasion. Results: Of the participants, 48.3% were Black, 58.6% were female, and 31.6% were in grade 8. After controlling for covariates, we found that exposure to community violence, perceived stress, and childhood abuse and neglect together accounted for 33.4% of the variance in PTSD symptoms (F_8,778 = 71.06, P < .001). Nevertheless, resilience moderated the relationship between childhood abuse and symptoms of PTSD (β = .09, t₇₈₆ = 2.88, P < .001), where the independent effect of childhood abuse and neglect on PTSD symptoms was significantly reduced with increasing resilience. Resilience did not, however, interact with exposure to community violence or perceived levels of stress to influence PTSD symptoms. Conclusion: High levels of exposure to community violence, perceived stress, and childhood abuse and neglect may contribute to the development of PTSD symptoms in South African adolescents. However, high levels of resilience may buffer the negative effects of childhood abuse and neglect.