Effects of Childhood Trauma on Mental Health Experiences of Ghanaian Adolescents: Moderating Effect of Resilience Coping

Background and Purpose:
Adolescents in Ghana are experience high levels of trauma, which has been linked to adverse mental health outcomes such as anxiety, depression, and suicide ideation. Despite the growing recognition of these issues, there is limited research exploring the relationships between trauma, resilience, and mental health outcomes in this population. This study aimed to examine the prevalence of trauma, anxiety, depression, and suicide ideation among Ghanaian adolescents and assess whether resilience moderates the relationships between trauma and mental health outcomes. We hypothesized that trauma would be positively associated with anxiety, depression, and suicide ideation, and that resilience would buffer these effects.

Methods:
This cross-sectional study involved 1,736 adolescents aged 13–19 years from Junior High Schools in Ghana. Data were collected using validated self-report measures, including the Child Trauma Scale (CTS) to assess trauma exposure, Generalized Anxiety Disorder-7 (GAD-7) for anxiety, the Patient Health Questionnaire-9 (PHQ-9) for depression, and a single-item measure for suicide ideation. Resilience was measured using the Brief Resilient Coping Scale (BRCS). Trauma was dichotomized as present if participants scored 1 or higher on the CTS. Logistic regression models were used to examine associations between trauma and mental health outcomes (anxiety, depression, and suicide ideation), controlling for resilience and its interaction with trauma. Descriptive statistics and chi-square tests were conducted to assess prevalence rates and associations.

Results:
Trauma exposure was highly prevalent, with 93.09% of participants reporting trauma. Anxiety was reported by 76.73%, depression by 77.48%, and suicide ideation by 13.36% of the sample. Chi-square analyses showed significant associations between trauma and anxiety (χ² = 11.39, p = 0.001) and between trauma and suicide ideation (χ² = 6.80, p = 0.009), but not between trauma and depression (χ² = 2.49, p = 0.114). Logistic regression revealed that trauma significantly predicted anxiety (OR = 1.84, p = 0.003) and suicide ideation (OR = 2.86, p = 0.015), but not depression (OR = 1.31, p = 0.206). Resilience and its interaction with trauma were not significant predictors of any mental health outcomes. Marginal effects analysis showed that trauma increased the predicted probability of anxiety and suicide ideation regardless of resilience levels.

Conclusions and Implications:
The findings highlight the pervasive impact of trauma on mental health, particularly anxiety and suicide ideation, among Ghanaian adolescents. Resilience did not moderate the effects of trauma, suggesting that other protective factors or contextual influences may be more relevant in this population. These results underscore the need for trauma-informed mental health interventions tailored to adolescents in Ghana. Programs should focus on addressing trauma exposure and its psychological effects while exploring additional strategies to enhance resilience and other protective factors. Future research should investigate longitudinal relationships and cultural factors influencing the trauma-resilience-mental health nexus to inform more effective interventions and policies.