Perpetration of gross human rights violations in South Africa: Association with psychiatric disorders

Abstract

Background: A nationally representative study of psychiatric disorders in South Africa provides an opportunity to study the association between perpetration of human rights violations (HRV) during apartheid, and presence of psychiatric disorder. Prior work has suggested an association between perpetration and posttraumatic stress disorder, but this remains a controversial area.
Methods: Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and twelve-month prevalence of DSM-IV disorders were assessed with Version 3.0 of the WHO Composite International Diagnostic Interview (CIDI 3.0). Sociodemographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed.
Results: HRV perpetrators were more likely to be male, black, and more educated, while perpetrators of DV were more likely to be female, older, married, less educated, and with lower income. HRV perpetration was associated with lifetime and 12 month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders.
Conclusion: Sociodemographic profiles of perpetrators of HRV and DV in South Africa differ considerably. While the causal relationship between perpetration and psychiatric disorders further deserves further study, it is possible that some HR and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention.