Sex differences in the experience of COVID-19 post-traumatic stress symptoms by adults in South Africa

Abstract

Background The COVID-19 pandemic has created multiple mental health challenges. Many residents in South Africa face pre-existing elevated levels of stress and the pandemic may have had varying impacts on sub-populations. The aims of this study were to determine: 1) the factors associated with post-traumatic stress symptoms (PTSS) and 2) sex differences in the factors associated with PTSS in adults residing in South Africa during the COVID-19 pandemic. Methods Study participants aged 18 years and above, were recruited for this cross-sectional study through an online survey implemented from June 29, 2020 to December 31, 2020. The outcome variable was PTSS; explanatory variables were sex at birth, COVID-19 status, social isolation and access to emotional support. Confounders considered were age, education level completed and current work status. Logistic regressions were used to determine the association between the outcome and explanatory variables after adjusting for confounders. Outcomes There were 489 respondents. Among all respondents, those who were older (AOR: 0.97; 95% CI: 0.95 – 0.99) and had access to emotional support from family and relatives (AOR: 0.27; 95% CI: 0.14 – 0.53) had significantly lower odds of PTSS. Respondents who felt socially isolated had higher odds of PTSS (AOR: 1.17; 95% CI: 1.08 – 1.27). Females had higher PTSS scores and higher odds of PTSS compared to males (AOR: 2.18; 95% CI: 1.41-3.39). Females (AOR: 0.27; 95% CI: 0.08 – 0.95) and males (AOR: 0.26; 95% CI: 0.11, 0.59) who had access to emotional support had significantly lower odds of PTSS than those who had no support. Females (AOR: 1.15; 95% CI: 1.04 -1.27) and males (AOR: 1.19; 95% CI: 0.11, 0.59) who felt socially isolated had higher odds of PTSS compared to those who did not feel socially isolated. Interpretation Compared to males, females had higher scores and higher odds of reporting PTSS during the COVID-19 pandemic. Access to emotional support ameliorated the odds of having PTSS for both sexes, while feeling socially isolated worsened the odds for both sexes.

Incidence, Risk Factors, and Consequences of Post-Traumatic Stress Disorder Symptoms in Survivors of COVID-19-Related ARDS

“…Furthermore, female gender was shown to be a risk factor for the onset of symptoms related to PTSD. This finding is in line with numerous post-COVID-19 studies [ 54 , 55 , 56 ] and confirms the reduced ability of the female gender to deal with traumatic events, due to psychosocial and biological explanations (e.g., oxytocin related) [ 57 ]. In the multivariate analysis, the female gender-role was not confirmed as a risk factor for the development of symptoms related to PTSD; this is in contrast with previous literature concerning stressor events, but it could be the sign of a different trajectory in the development of PTSD symptoms, not related to gender, but to a general greater sensitivity to mental health problems even in traditionally excluded parts of the population (i.e., the older men) due to cultural taboos that do not consider it acceptable to talk about problems in managing traumatic events.…”

An Online Survey on the Relationship Between Positive Coping and Post-Traumatic Stress Symptoms (PTSS) of Medical Students in China During the COVID-19 Pandemic: The Mediating Role of Social Support

“…A previous study has shown that there is a gender difference in the incidence of PTSS during the COVID-19 pandemic. The prevalence of PTSS in females is higher than that in males [36]. Interestingly, the prevalence rate of PTSD in healthcare professionals was also different by gender during the COVID-19 pandemic.…”