Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice

ABSTRACT

Background and Objectives: The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC).

Methods: Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD).

Results: Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t = −2.49, p = .013), anxiety (t = −3.08, p = .002), and PTSD (t = −2.94, p = .003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma.

Conclusions: Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.

KEYWORDS:

• Social support
• stigma
• mental health
• refugees
• displaced populations

Acknowledgements

We thank the women who participated in the original research, and whose lives were severely impacted by violent conflict. Many thanks to Dr. Stephanie Rivaux who helped guide the development of the analysis and paper, and Dr. Laurie Cook Heffron who reviewed an early draft.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The current analysis was made possible by dissertation fellowships provided to Dr. Wachter by the Hogg Foundation for Mental Health (Harry E. and Bernice M. Moore Fellowship for Doctoral Research) and the Institute of Domestic Violence & Sexual Assault at the University of Texas at Austin. Dr. Murray was supported in part by an NIMH T32 Training Grant for Global Mental Health (T32MH103210). The original study was funded the U.S. Agency for International Development Victims of Torture Fund and the World Bank.