TABLE 3.
Associations Between Mental Health Outcomes and Exposures to Trauma Before and During Trafficking Among Trafficked and Sexually Exploited Girls and Women (n = 204): Posttrafficking Care Sites in 7 European Countries, 2004–2005
| Participants With High Levels of Mental Health Symptoms |
|||||||
| Depression |
Anxiety |
PTSD |
|||||
| Total, No. (%) | % | OR (95% CI) | % | OR (95% CI) | % | OR (95% CI) | |
| Trafficking-related violence | |||||||
| Sexual violence | |||||||
| No | 15 (7.4) | 33.3 | 1.0 | 26.7 | 1.0 | 46.7 | 1.0 |
| Yes | 187 (92.6) | 57.5 | 2.7 (0.9, 8.3) | 50.5 | 2.8 (0.9, 9.2) | 80.7 | 4.8* (1.6, 14.4) |
| Total | 202 (100) | ||||||
| Physical violence (hit or kicked) | |||||||
| No | 45 (22.3) | 45.5 | 1.0 | 34.1 | 1.0 | 70.5 | 1.0 |
| Yes | 157 (77.7) | 58.6 | 1.7 (0.9, 3.3) | 52.9 | 2.2 (1.1, 4.4)* | 80.3 | 1.7 (0.8, 3.6) |
| Total | 202 (100) | ||||||
| Physical violence (weapon used; threatened with weapon) | |||||||
| No | 137 (69.2) | 55.9 | 1.0 | 47.1 | 1.0 | 77.9 | 1.0 |
| Yes | 61 (30.8) | 55.7 | 1.0 (0.5, 1.9) | 52.5 | 1.3 (0.7, 2.3) | 78.7 | 1.1 (0.5, 2.2) |
| Total | 198 (100) | ||||||
| Threats against participant | |||||||
| No | 16 (8.0) | 60.0 | 1.0 | 33.3 | 1.0 | 60.0 | 1.0 |
| Yes | 185 (92.0) | 55.7 | 0.8 (0.3, 2.4) | 50.3 | 2.0 (0.7, 6.1) | 79.5 | 2.5 (0.8, 7.6) |
| Total | 201 (100) | ||||||
| Threats against participant's family or loved ones | |||||||
| No | 124 (62.3) | 59.4 | 1.0 | 50.4 | 1.0 | 76.4 | 1.0 |
| Yes | 75 (37.7) | 49.3 | 0.7 (0.4, 1.2) | 45.3 | 0.8 (0.4, 1.4) | 81.3 | 1.3 (0.6, 2.6) |
| Total | 199 (100) | ||||||
| Restricted freedom | |||||||
| None | 39 (19.7) | 48.7 | 1.0 | 38.5 | 1.0 | 76.9 | 1.0 |
| Always | 159 (80.3) | 58.9 | 1.5 (0.7, 3.1) | 52.5 | 1.8 (0.9, 3.6) | 79.1 | 1.1 (0.5, 2.6) |
| Total | 198 (100) | ||||||
| Serious injury | |||||||
| No | 83 (41.3) | 45.8 | 1.0 | 37.4 | 1.0 | 68.7 | 1.0 |
| Yes | 118 (58.7) | 63.3 | 2.1* (1.2, 3.7) | 57.3 | 2.3* (1.3, 4.1) | 85.5 | 2.7* (1.3, 5.4) |
| Total | 201 (100) | ||||||
| Duration in and out of trafficking | |||||||
| Time in trafficking | |||||||
| < 6 mo | 107 (56.9) | 53.3 | 1.0 | 45.7 | 1.0 | 77.1 | 1.0 |
| ≥ 6 mo | 81 (43.1) | 63.0 | 1.5 (0.8, 2.7) | 56.8 | 1.5 (0.8, 2.7) | 80.3 | 1.2 (0.6, 2.4) |
| Total | 188 (100) | ||||||
| Time out of trafficking | |||||||
| < 3 mo | 125 (61.6) | 61.3 | 1.0 | 54.8 | 1.0 | 80.7 | 1.0 |
| ≥ 3 mo | 78 (38.4) | 47.4 | 0.6 (0.3, 1.0) | 39.5 | 0.5 (0.3, 1.0) | 75.0 | 0.7 (0.4, 1.5) |
| Total | 203 (100) | ||||||
| Pretrafficking-related violence | |||||||
| Physical violence before trafficking | |||||||
| No | 96 (48.0) | 58.3 | 1.0 | 50.0 | 1.0 | 76.0 | 1.0 |
| Yes | 104 (52.0) | 54.4 | 0.8 (0.5, 1.5) | 48.5 | 0.9 (0.5, 1.6) | 80.6 | 1.2 (0.6, 2.5) |
| Total | 200 (100) | ||||||
| Sexual violence before trafficking | |||||||
| No | 132 (67.0) | 58.3 | 1.0 | 52.3 | 1.0 | 80.3 | 1.0 |
| Yes | 65 (33.0) | 53.9 | 0.8 (0.5, 1.5) | 43.1 | 0.7 (0.4, 1.3) | 77.0 | 0.8 (0.4, 1.7) |
| Total | 197 (100) | ||||||
Note. PTSD = posttraumatic stress disorder; OR = odds ratio; CI = confidence interval. Participants were determined to have high levels of mental health symptoms on the basis of their responses to the Brief Symptom Inventory (BSI) subscales for depression and anxiety and to the Harvard Trauma Questionnaire (HTQ) for PTSD. Cutpoints for determining high levels of each symptom were as follows: depression BSI score ≥ 1.87; anxiety BSI score ≥ 1.71; PTSD HTQ score ≥ 2.0. The 7 posttrafficking care sites were located in Belgium, Bulgaria, the Czech Republic, Italy, Moldova, Ukraine, and the United Kingdom.
*P < .05.