Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations

Koebach, Anke; Ruf-Leuschner, Martina; Elbert, Thomas

Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations

Dateien

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Datum

2018

Open Access-Veröffentlichung

Open Access Gold

Sammlungen

Psychologie

Publikationstyp

Zeitschriftenartikel

Publikationsstatus

Published

Erschienen in

BMC Psychiatry. 2018, 18, 187. eISSN 1471-244X. Available under: doi: 10.1186/s12888-018-1757-0

Zusammenfassung

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.

Fachgebiet (DDC)

150 Psychologie

Schlagwörter

Female genital mutilation, FGM, Female genital cutting, Posttraumatic stress disorder (PTSD), Dissociation, Depression, Hair cortisol

Zitieren

ISO 690

KOEBACH, Anke, Martina RUF-LEUSCHNER, Thomas ELBERT, 2018. Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations. In: BMC Psychiatry. 2018, 18, 187. eISSN 1471-244X. Available under: doi: 10.1186/s12888-018-1757-0

BibTex

@article{Koebach2018-06-13Psych-43011,
  year={2018},
  doi={10.1186/s12888-018-1757-0},
  title={Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations},
  volume={18},
  journal={BMC Psychiatry},
  author={Koebach, Anke and Ruf-Leuschner, Martina and Elbert, Thomas},
  note={Article Number: 187}
}

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    <dcterms:abstract xml:lang="eng">Background&lt;br /&gt;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.&lt;br /&gt;&lt;br /&gt;Methods&lt;br /&gt;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.&lt;br /&gt;&lt;br /&gt;Results&lt;br /&gt;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 &lt; .001) and shutdown dissociation (p &lt; .001). Symptoms of depression (p &lt; .05) and anxiety (p &lt; .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 (&lt; 1 year) and the invasiveness of the procedure.&lt;br /&gt;&lt;br /&gt;Conclusion&lt;br /&gt;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.</dcterms:abstract>
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