While the specific biological mechanisms that underlie the long-term psychiatric effects of prenatal stress are unknown, growing evidence from the literature on the fetal origins of psychopathology suggests that prenatal stress exposure alters the development, function, sensitivity of human stress physiological systems across the life course, which in turn may elevate one’s risk for a psychopathological presentation. Additionally, the intergenerational signatures of maternal prenatal stress exposure have been reported in offspring during adulthood in large cohort studies and across various contexts such as Australia, the Philippines, and the United States ( Betts et al. 2018), and internalizing disorders like anxiety and depression among adolescents ( O’Donnell et al.
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2010), conduct disorders ( MacKinnon et al. For instance, large population-based studies in the United Kingdom show that greater levels of maternal prenatal stress are associated with an increased future risk for externalizing disorders in their children, such as attention deficit hyperactivity disorder ( Rice et al. Recent findings also suggest that these stress-linked alterations in stress physiology may also affect the developing offspring through various pathways of genetic and non-genetic inheritance. 1999 Gluckman & Hanson 2004 Kuzawa 2008 Taylor et al. Growing evidence from the fetal origins of health and disease framework shows that past stress and trauma exposures, particularly those that occur during early development, can durably alter the development and function of various stress regulatory mechanisms in humans, including the immune system, cardiovascular system, neurobiological function, and neuroendocrine pathways (Barker et al. In addition to these ongoing societal effects of poverty, structural violence and inequality, there is growing evidence, from South African studies and other populations, that the stressors of the past could have lingering biological effects that continue to influence socio-emotional behavior and mental health across the lifecourse. 2016 Burns 2015), all of which are known risk factors for psychiatric disorders ( Allen et al. 2018), discrimination (Kuzawa & Sweet 2009), and racialized class inequality ( Adjaye-Gbewonyo et al. Despite the legislative end of Apartheid policies and the birth of a new democratic in 1994, South African society continues to be plagued by the persistent societal institutions of Apartheid, including chronic poverty ( Gibbs et al.
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This period was characterized by systematic disenfranchisement of non-White communities through various modes of social, economic, and political oppression (Beinhart 2001). The current state of public mental health in South Africa is foregrounded by a long and recent history of institutionalized White supremacist policies implemented during the Apartheid regime (c. Despite these elevated rates of psychiatric morbidity, access to mental health treatment is poor: only 27% of patients living with severe mental illness are expected to receive treatment ( Herman et al.
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In 2016, the estimated 12-month prevalence for any psychiatric disorder was 16.2%, or approximately 9.1 million individuals (GBDCN 2017). South Africa’s rates of mental, neurological, and substance use disorders are among the highest in sub-Saharan Africa.