Lupus & antiphospholipid syndrome
Childhood trauma and systemic lupus erythematosus activity in Tunisian patients: exploring the mediating role of post-traumatic stress disorder
Authors' conclusion
PTSD appears to play a key mediating role
Study context
- Population
- Adult Tunisian patients with Systemic Lupus Erythematosus (SLE), Internal Medicine Department of Mahdia University Hospital, September 2024–February 202588.7% women
- Participants
- 106 patients
- Exposure
- Childhood adverse childhood experiences (ACEs) and probable post-traumatic stress disorder (PTSD) vs none, in relation to SLE activity
- Outcome
- Mediating role of PTSD in the path from ACEs to SLE activity (SLEDAI and BILAG)
Methodological detailsmediation analysis (Sobel test), single-centre
- Mediation analysis (Sobel test)
- Single-centre
Main finding
As reported in the abstract
PTSD mediation of childhood community violence → SLE activity
PTSD partially mediated the association; proportion of total effect on Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)
27.7%
Proportion of total effect on BILAG mediated by PTSD
41.5%
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Community violence exposure and disease activity (SLEDAI and BILAG)Community violence exposure vs No exposure · significantly higher disease activity | P < 0.001 |
| Probable PTSD and disease activityProbable PTSD vs No probable PTSD · higher disease activity | SLEDAI: p < 0.001 |
| Probable PTSD and disease activityProbable PTSD vs No probable PTSD · higher disease activity | BILAG: p = 0.044 |
Prevalence of ACEs and probable PTSD
- At least one ACE
- All participants
- Intra-familial adversities
- 96.2%
- Extra-familial ACEs
- 67%
- Community violence
- 43.4%
- Probable PTSD
- 57.5%
Original publication
Childhood trauma and systemic lupus erythematosus activity in Tunisian patients: exploring the mediating role of post-traumatic stress disorder. Lupus Sci Med. Published 24 September 2026. doi:10.
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