Living in the Aftermath: Narratives on the impact of exposure to community and school violence in childhood on mental health and adjustment outcomes in later life.

OBJECTIVES: To understand the impact of and subsequent reactions to exposure to extreme violence in young adults in South Africa exposed during school years. In particular, to get an in-depth understanding of its immediate consequences and factors that ameliorate or exacerbate it. DESIGN: An exploratory qualitative research design was used, using purposive sampling. METHODS: Semi-structured interviews with 21 young South African adults aged 19-31 were conducted online. Transcripts were analysed using thematic analysis. RESULTS: Violence exposure was found to result in trauma reactions with themes of a continued sense of being unsafe, feeling damaged and defective because of having these reactions, and mistrust towards others. In terms of coping reactions, a theme of avoidance and/or reacting with aggressive behaviour was identified, which likely exacerbated the challenges they experienced. By contrast, a more positive theme was identified in some, focused on having a sense of community and connectedness, which was experienced as ameliorating these challenges. CONCLUSIONS: Exposure to community and school violence in childhood has a lasting impact on mental health and adjustment in later life. The impact is likely worsened by mistrust of others, a continued sense of feeling unsafe and counterproductive coping mechanisms, while connectedness and community seem to lessen the impact. Further research can refine these findings to build an understanding of these mechanisms to inform secondary prevention and treatment interventions in low- and middle-income countries.