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Blair DL, Kingsbury M, Eccles H, Akther A, Siddiqi S, Condran G, Obeegadoo I, Murray J, Geoffroy MC, Menezes AMB, Sikora L, Colman I. Adverse childhood experiences and suicidality in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Glob Health 2025; 10:e018129. [PMID: 40316412 PMCID: PMC12049941 DOI: 10.1136/bmjgh-2024-018129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Accepted: 04/04/2025] [Indexed: 05/04/2025] Open
Abstract
INTRODUCTION Suicide is an important public health problem with a complex aetiology; this includes adverse childhood experiences (ACEs). Common to suicide and ACEs research is a lack of evidence from low-income and middle-income countries (LMICs). This review aims to evaluate associations between ACEs and suicidality in LMICs. METHODS In this systematic review and meta-analysis, a search for articles investigating associations between any ACEs and suicidal outcomes in LMICs was conducted using Medline, Embase, PsycINFO, CINAHL and Web of Science on 2 December 2022; updated on 14 January 2025. Cross-sectional or cohort study research articles investigating ACEs prior to age 18 and using population-based, probabilistic or total population, sampling were eligible for inclusion. Suicidal outcomes across the spectrum were eligible for inclusion. Identified records underwent two-step screening by two independent reviewers; data extraction and risk of bias assessment using Joanna Briggs Institute Critical Appraisal tools were also completed in duplicate. Random-effects models were used to calculate pooled ORs. Articles that could not be meta-analysed were narratively synthesised. Reporting of this review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. RESULTS Ultimately, 118 articles were included; all were of low or moderate risk of bias and none reported on suicide mortality. Six ACEs were significantly associated with increased odds of suicidal outcomes: (1) bullying-victimisation, (2) emotional, verbal or psychological abuse victim, (3) parental separation, divorce or death, (4) physical abuse or violence victim, (5) physical attack victim and (6) sexual abuse victim. Significant ORs ranged from 1.19 to 2.61. Positive associations were found across subgroup and sensitivity analyses. Narrative review found statistically significant positive and non-significant associations between ACEs and suicidal outcomes. CONCLUSIONS ACEs are associated with suicidal outcomes in LMICs, highlighting the need for early intervention strategies and multisector public health approaches to reducing ACEs and their potential impacts.
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Affiliation(s)
- Dawn-Li Blair
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Mila Kingsbury
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Heidi Eccles
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Asia Akther
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Sara Siddiqi
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Georgia Condran
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ishika Obeegadoo
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marie-Claude Geoffroy
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Lindsey Sikora
- Health Sciences Library, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
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Luo Z, Chen Y, Epstein RA. Risk factors for child abuse and neglect: Systematic review and meta-analysis. Public Health 2025; 241:89-98. [PMID: 39961167 DOI: 10.1016/j.puhe.2025.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 12/17/2024] [Accepted: 01/22/2025] [Indexed: 03/17/2025]
Abstract
OBJECTIVES Child maltreatment is a major public health issue associated with adverse outcomes and societal costs, yet its risk factors lack contemporary quantitative synthesis. This review aims to identify and quantify individual, familial, community, and societal risk factors associated with different types of child maltreatment and explore patterns across maltreatment types. STUDY DESIGN Systematic review and meta-analysis. METHODS This study followed PRISMA guidelines and reviewed literature on child maltreatment from 2013 to 2023. Eligible studies focused on physical, sexual, emotional abuse, neglect, and multi-type maltreatment in children under 18. Databases used included PubMed, PsycINFO, and Web of Science. Data was extracted and analyzed using meta-analysis with fixed and random effects models. Risk of bias was assessed using the ROBINS-I tool, and sensitivity and subgroup analyses were performed. Certainty of evidence was evaluated using the GRADE approach. RESULTS Of 5554 identified studies, 42 met inclusion criteria. Significant results include: male children showed higher odds of physical abuse (OR:1.49). Employed families, higher family education, older parental age, and higher family income had lower odds of maltreatment (OR from 0.51 for income to 0.99 for parental age). Larger family size, parental mental health, maltreatment history, and substance use had higher odds of maltreatment (OR from 1.07 for family size to 5.21 for mental health). Urban areas had lower odds of physical abuse (OR: 0.88). CONCLUSIONS Findings underscore the importance of addressing identified risk factors at multiple levels, with implications for practice, policy, and future research to refine prevention strategies and promote child well-being.
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Affiliation(s)
- Zhidi Luo
- Department of Psychiatry and Behavioral Sciences, Mental Health Services and Policy Program, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Yeyige Chen
- Department of Psychiatry and Behavioral Sciences, Mental Health Services and Policy Program, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Richard A Epstein
- Department of Psychiatry and Behavioral Sciences, Mental Health Services and Policy Program, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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Ezenwosu IL, Uzochukwu BSC. Prevalence, risk factors and interventions to prevent violence against adolescents and youths in Sub-Saharan Africa: a scoping review. Reprod Health 2025; 22:23. [PMID: 39953560 PMCID: PMC11827455 DOI: 10.1186/s12978-024-01926-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Accepted: 12/02/2024] [Indexed: 02/17/2025] Open
Abstract
BACKGROUND Violence is a pervasive human rights issue with public health consequences affecting adolescents and young people. This review aimed to describe the scope of existing research on the prevalence of violence and risk factors as well as intervention programmes targeted at adolescents and youths in Sub-Saharan Africa. METHOD An eleven-year search from 2014 to 2024 was conducted for peer-reviewed research articles, irrespective of their quality, on the prevalence of violence and risk factors as well as interventions on the types of violence against adolescents and youths in all SSA countries using PubMed, Google Scholar, Google search, African Index Medicus and direct searches of reference list of pertinent journal articles. Publications in English or translated to English were included. The methodological framework was described by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was used to describe the review. RESULT Hundred and three studies were identified across 33 out of the 46 Sub-Saharan African countries with the majority of articles emanating from Ethiopia. The prevalence studies consisted of 71 articles, sexual coercion was reported in 52 articles with a moderate number of studies focusing on physical or corporal punishment (21) and emotional violence (27). Also, the male gender was grossly understudied in the various forms of violence. The primary interventions on violence were categorized using the socio-ecological framework and the least implemented intervention based on peer-reviewed articles was at the policy level. The effectiveness of the interventions was reported in some studies while others noted no significant reduction in violence. CONCLUSION The findings show there is a modest volume of peer-reviewed articles on prevalence of violence mostly in the dimension of sexual violence. Also, the interventions that addressed the policy level are limited and scale-up of focus on the level is imperative in SSA.
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Affiliation(s)
- Ifeyinwa L Ezenwosu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
| | - Benjamin S C Uzochukwu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
- Department of Community Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
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Chipalo E. Adverse Childhood Experiences and Mental Distress Among Adolescents and Youth in Zimbabwe. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:4329-4355. [PMID: 38444122 DOI: 10.1177/08862605241234660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Adverse childhood experiences (ACEs) are a global public health crisis associated with physical and poor mental health outcomes. The current study examined the prevalence and association between individual and cumulative ACEs with mental distress among adolescents and youth in Zimbabwe. Data from the 2017 Violence Against Children and Youth Survey were utilized (13-25 years old, n = 8,715). Bivariate analysis was conducted using chi-square tests to obtain the prevalence estimates. Two sets of logistic regression models were conducted to determine significant associations between independent variables (i.e., experiencing childhood physical, emotional, and sexual violence; witnessing intimate partner violence (IPV) and community violence; orphan status; and cumulative ACE exposure) and the dependent variable (i.e., mental distress in the past 30 days as measured by Kelser 6). 28.4% of the adolescents and youth reported experiencing mental distress in the past 30 days. Regarding ACEs, cumulative ACE exposure (34.7%; adjusted odds ratio [AOR] = 2.13) and individual ACEs (i.e., experiencing childhood physical violence [39.3%; AOR = 1.41], emotional violence [55.8%; AOR = 2.67], sexual violence [50.8%; AOR = 2.00], witnessing community violence [47.3%; AOR = 1.52], witnessing IPV [43.1%; AOR = 1.47], and being orphaned during childhood [33.6%; AOR = 1.24]) were significantly associated with higher prevalence rates and odds of experiencing mental distress in the past 30 days among adolescents and youth in Zimbabwe. These findings show that ACEs are highly prevalent and increases the risk of mental distress for vulnerable adolescents and youth in Zimbabwe. Effective interventions to reduce violence exposure in families, schools, and communities are essential to mitigate the negative consequences of ACEs and mental distress of adolescents and youth in Zimbabwe. Strengthening child protection policies and involving social workers, psychologists, and mental health workers are also crucial for safeguarding vulnerable children who might be impacted by ACEs in Zimbabwe. Implications for future research are further discussed.
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BenYishay A, Sayers R, Wells J. Prevalence of school related violence in seven countries: A cross-sectional survey. PLoS One 2024; 19:e0301833. [PMID: 38748656 PMCID: PMC11095737 DOI: 10.1371/journal.pone.0301833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 03/21/2024] [Indexed: 05/19/2024] Open
Abstract
Violence against children in schools harms the affected children, limits their learning and educational attainment, and extends its harms to families and the broader communities. However, to date, comparable cross-country data on violence against children in schools has not been available. We utilize the Violence Against Children and Youth Surveys (VACS) to estimate school-related violence against children in seven countries (Honduras, Kenya, Malawi, Nigeria, Tanzania, Uganda, and Zambia). Leveraging the unique comparability of the surveys, we are able to estimate both physical and sexual violence experienced in childhood and adolescence among youth aged 13-24. Where possible, we also disaggregate by gender and perpetrator type. Overall, within our sample seven countries, we find that 12.11-44.63% of females and 14.28-53.85% of males experienced at least one form of violence. Males experience higher levels of school-related violence and a significant portion of this is due to experiencing physical violence perpetrated by male classmates.
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Affiliation(s)
- Ariel BenYishay
- Department of Economics, William & Mary, Williamsburg, Virginia, United States of America
- AidData, William & Mary, Williamsburg, Virginia, United States of America
| | - Rachel Sayers
- AidData, William & Mary, Williamsburg, Virginia, United States of America
| | - Jessica Wells
- AidData, William & Mary, Williamsburg, Virginia, United States of America
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Vahedi L, Seff I, Meinhart M, Roa AH, Villaveces A, Stark L. The association between youth violence and mental health outcomes in Colombia: A cross sectional analysis. CHILD ABUSE & NEGLECT 2024; 150:106336. [PMID: 37442669 PMCID: PMC10896151 DOI: 10.1016/j.chiabu.2023.106336] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Violence against children and youth poses public health risks regarding mental health symptoms and substance use. Less studied is the relationship between violence and mental health/substance abuse in the Latin American context. This study explored sex-stratified relationships between violence and mental health/substance use among Colombian youth. METHODS We analyzed the 2018 Colombian Violence Against Children and Youth Survey, which collected cross-sectional data from Colombian youth (13-24 years) (n = 2705). Exposure variables were (i) binary sexual, emotional, and physical victimization and (ii) poly-victimization. The outcomes were binary suicidal thoughts, self-harm, past-month psychological distress, binge drinking, smoking, and drug use. Sex-stratified, logistic regressions were adjusted for age, primary school, parental presence, relationship status, and witnessing community violence. RESULTS For females, (i) emotional violence (compared to being unexposed) was associated with greater odds of suicidal thoughts, self-harm, and psychological distress and (ii) sexual violence was associated with suicidal thoughts and self-harm. For males, (i) emotional violence (compared to being unexposed) was associated with greater odds of suicidal thoughts and psychological distress, but not self-harm and (ii) sexual violence exposure was associated with suicidal thoughts and self-harm. Physical violence was generally not associated with internalized mental health outcomes for females/males, when emotional and sexual violence were held constant. Poly-victimization was consistently and positively associated with internalized mental health symptoms among females, and to a lesser degree for males. Substance use outcomes for males or females were not associated with violence. CONCLUSIONS Findings highlight the internalized mental health burden of emotional and sexual violence.
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Affiliation(s)
- Luissa Vahedi
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Ilana Seff
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Andrés Villaveces
- Division of Violence Prevention, NCIPC, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lindsay Stark
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA.
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 PMCID: PMC11238702 DOI: 10.1016/j.chiabu.2024.106701] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Chemhaka GB, Moyo S, Simelane MS, Odimegwu C. Women's socioeconomic status and attitudes toward intimate partner violence in Eswatini: A multilevel analysis. PLoS One 2023; 18:e0294160. [PMID: 37956118 PMCID: PMC10642784 DOI: 10.1371/journal.pone.0294160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Attitudes supportive of spousal violence retards developmental efforts worldwide, and in particular in patriarchal African settings. It is important to curb this behavior by designing preventative evidence-based policies. This study examines the acceptance of intimate partner violence among women residing in Eswatini and determines whether attitudes supportive of intimate partner violence are associated with women's low socioeconomic status both at the individual- and community-level. METHODS Cross-sectional secondary data from two Eswatini Multiple Indicator Cluster Surveys (MICS) conducted in 2010 and 2014 with representative samples of 4,686 and 4,761 women, respectively were analyzed using descriptive statistics and multilevel (random effect) logistic regressions. RESULTS Overall, the prevalence of acceptance of intimate partner violence declined significantly between 2010 and 2014 in Eswatini (29.0% vs. 19.8%, p<0.001). In both surveys, socioeconomic factors associated with women's supportive attitudes toward intimate partner violence were educational level, marital structure, and community socioeconomic disadvantage. Overall, primary or lower educational attainment, single/unmarried relationships, and women living in a community with a high socioeconomic disadvantage were key factors associated with supportive attitudes toward intimate partner violence. CONCLUSIONS Secondary or higher education for individual women and a high proportion of women in the community with low socioeconomic disadvantage are important socioeconomic predictors of reducing women's supportive attitudes toward intimate partner violence. Therefore, further gains in non-supportive attitudes toward acceptance of intimate partner violence could be achieved through efforts and intervention in the education of individual women and improving women's socioeconomic status in the community.
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Affiliation(s)
- Garikayi B. Chemhaka
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Manzini, Eswatini
| | - Stanzia Moyo
- Department of Demography Settlement and Development, Faculty of Social and Behavioural Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Maswati S. Simelane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Manzini, Eswatini
| | - Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Social Sciences and Public Health, University of the Witwatersrand, Braamfontein, Johannesburg, South Africa
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Nyandwi A, Munyanshongore C, Nyirazinyoye L, Ndola P, Perren-Klingler G. Correlates of emotional violence against children in Rwanda: Findings from a cross-sectional national survey. PLoS One 2023; 18:e0286788. [PMID: 37310951 PMCID: PMC10263359 DOI: 10.1371/journal.pone.0286788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 05/06/2023] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION National data on children affected by violence are critical in preventing violence against children. Rwanda conducted its first cross-sectional national survey on violence against children in 2015. This study used data from the Rwanda Survey to describe the profile of children affected by emotional violence (EV) and to assess factors associated with it in Rwanda. METHODS A sample of 1,110 children (618 boys and 492 girls) aged 13-17 from the Rwanda Survey was analysed. Weighted descriptive statistics were applied to describe the prevalence of EV and the profile of children affected by it. In addition, factors associated with EV were investigated using logistic regression. RESULTS Male children were more likely to experience EV than female children. Nine percent (8.87%, 95% CI [6.95-11.25]) of male children versus five percent (5.17%, 95% CI [3.79-7.03]) of female children reported having experienced EV in their lifetime. Seven percent (6.77%, 95% CI [5.15-8.84]) of male children versus four percent of female children (3.97%, 95% CI [2.83-5.54]) reported having experienced EV in the last twelve months before the survey. Fathers and mothers were the top two perpetrators of EV against children. Seventeen percent of male children (17.09%, 95% CI [11.06-25.47]) and 12 percent of female children (11.89%, 95% CI [6.97,19.55]) reported EV by their fathers. Mothers were responsible for nineteen percent (19.25%, 95% CI [12.94-27.65]) of EV reported by male children and eleven percent (10.78%, 95% CI [5.77-19.25]) of EV reported by female children. Female children (OR = 0.48, 95% CI [0.31-0.76]) and children with some trust in people from their communities (OR = 0.47, 95% CI [0.23-0.93]) were less likely to report EV. Factors associated with risk for EV were not attending school (OR = 1.80, 95% CI [1.10-2.92]), living with father only (OR = 2.96, 95% CI [1.21-7.85]), not feeling close to biological parents (OR = 7.18, 95% CI [2.12-24.37]), living in a larger household (OR = 1.81, 95% CI [1.03-3.19]), not having a friend (OR = 2.08, 95% CI [1.02-4.11]), and not feeling safe in the community (OR = 2.56, 95% CI [1.03-6.38]). CONCLUSION EV against children was pervasive in Rwanda, with parents topping the list of its perpetrators. Children from unsupportive socioeconomic family environments, i.e., children without a close relationship with biological parents, children not attending school, children living with their fathers only, children from larger households of five people and more, children without a friend, and children who reported not feeling safe in their communities, were identified as groups of children vulnerable to emotional violence in Rwanda. A family-centred approach, focusing on positive parenting and protecting vulnerable children, is needed to reduce emotional violence against children and the risk factors associated with it in Rwanda.
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Affiliation(s)
| | | | | | - Prata Ndola
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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Nace A, Maternowska C, Fernandez B, Cravero K. The Violence Against Children Surveys (VACS): Using VACS data to drive programmes and policies. Glob Public Health 2022; 17:2807-2825. [PMID: 34905473 DOI: 10.1080/17441692.2021.2010116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Violence Against Children Surveys (VACS) are nationally representative surveys of males and females aged 13-24 years, designed to measure the burden of sexual, physical, and emotional violence experienced in childhood, adolescence and early adulthood. As of 2020, 22 countries implemented or are implementing a VACS. Since the first article using VACS data was published in 2009, several peer-reviewed articles have been published on the VACS. However, no publications have analysed the breadth of the work and how the data are represented in the literature. We conducted a review of the peer-reviewed research which used VACS data or mentioned the VACS. Between 2009 and July 2020, 50 peer-reviewed articles with data from 11 countries were published. Two studies (2/50; 4.0%) focused on boys, while 14 studies (14/50; 28.0%) focused on violence against girls. Fourteen articles focused on sexual violence (14/50; 28.0%), compared to three on emotional violence (3/50; 6.0%), and two on physical violence (2/50; 4.0%). Lastly, 52% of the articles (26 of the 50) were first authored by someone at the U.S. Centers for Disease Control and Prevention. We identified the need to support local authors, and additional research on violence against boys, and physical and emotional violence.
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Affiliation(s)
- Amanda Nace
- University Research Co., Chevy Chase, MD, USA
| | | | | | - Kathleen Cravero
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
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Lee N, Massetti GM, Perry EW, Self-Brown S. Adverse Childhood Experiences and Associated Mental Distress and Suicide Risk: Results From the Zambia Violence Against Children Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21244-NP21265. [PMID: 34906001 PMCID: PMC9192820 DOI: 10.1177/08862605211056726] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose: Adverse childhood experiences (ACEs) are a global public health concern. Little research exists on the prevalence and health consequences of ACEs in Zambia. The current study examined associations between individual and cumulative ACEs, mental distress, and suicide risk among Zambian youth. Methods: Data from Zambia Violence Against Children and Youth Survey were used (18-24 years old, n=1034). Bivariate and adjusted logistic models were performed with independent variables (i.e., experienced physical violence (PV), sexual violence (SV), and emotional violence (EV); witnessed intimate partner violence (IPV) and community violence (CV); orphan status; cumulative ACE exposure) and dependent variables (i.e., mental distress and suicide risk). Adjusted models controlled for demographic and social characteristics. Results: 76.8% of Zambian youth experienced one or more ACEs, and more than 30% witnessed CV (38.4%) or IPV (30.2%), or experienced PV (35.1%), prior to age 18. 27.5% were orphans, and less than 20% experienced EV (17.3%) or SV (15.4%) in childhood. 42.4% experienced mental distress in the past 30 days, and 12.5% reported lifetime suicidal thoughts or suicide attempts. PV, EV, cumulative ACE exposure, older age, being single, and stronger friendships were significantly related to experiencing mental distress. Cumulative ACEs exposure was associated with significantly higher suicide risk. Conclusions: Preventing ACEs can reduce mental distress and suicide risk among Zambian youth. Youth with cumulative ACE exposure can be prioritized for mental health intervention. More research is warranted to investigate the broad-based prevention of ACEs, especially PV and EV, and protective factors that can promote resilience among youth who have experienced ACEs.
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Affiliation(s)
- NaeHyung Lee
- Copial Business Strategists, Chamblee, GA, USA
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Greta M. Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth W. Perry
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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12
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Bahmani T, Naseri NS, Fariborzi E. Relation of parenting child abuse based on attachment styles, parenting styles, and parental addictions. CURRENT PSYCHOLOGY 2022; 42:1-15. [PMID: 35002186 PMCID: PMC8723913 DOI: 10.1007/s12144-021-02667-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to complete the cycle of recognizing these relationships. In this regard, the effect of parenting styles, attachment styles, and the mediating variable of addiction was investigated on child abuse (CA). Multi-stage random sampling and sample size were selected based on the sample size estimation software (510 people) and according to the 20% probability of a drop in the number of subjects, 530 people (265 boys and 265 girls) and 1060 parents were selected. The available method was selected from a sample of 530 people who were selected based on the Addiction Severity Index (ASI) and answered Baumrind's Parenting Styles Questionnaire (PSQ), Childhood Trauma Questionnaire (CTQ), and Adult Attachment Scale (AAS). Data were assessed by analysis of variance, mediator analysis, and path analysis. The results showed that differences in parenting styles cause differences in their attachment styles. The results supported only the relationship between the two components of parental affection and control with the attachment avoidance index, and no relationship was observed between these components and the anxiety index. Perceived emotional abuse, mediates the relationship between parental parenting components and the child attachment avoidance index. Finally, it was achieved to a model that shows how the two factors of affection and control simultaneously affect the avoidance index, mediated by parental addiction.
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Affiliation(s)
- Tahmine Bahmani
- Department of Educational Science, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Nazia Sadat Naseri
- Department of Educational Science, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - E. Fariborzi
- Department of Educational Science, Mashhad Branch, Islamic Azad University, Mashhad, Iran
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Bahrami N, Tork-Torabi M, Sotoudeh R, Namnabati M. Perceived Child Abuse and Neglect in Hospitalized Children with Special Health Care Needs in Iran. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:526-530. [PMID: 34900652 PMCID: PMC8607892 DOI: 10.4103/ijnmr.ijnmr_296_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/11/2020] [Accepted: 05/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Child Abuse and Neglect (CAN) is an important public health concern. Nurses play a key role in caring for the children and keeping them safe from abuse and neglect. The aim of this study was to determine the rate of perceived CAN in Hospitalized Children with Special Health Care Needs (CSHCN) as well as the relationship between the rate and some effective factors. MATERIALS AND METHODS This is a descriptive cross-sectional study on 199 CSHCN aged 6-18 years old, admitted to the pediatric wards in an educational hospital, in Isfahan, Iran, in 2018. Children were selected through convenience sampling method and assessed for CAN through a child abuse questionnaire. The Pearson correlation coefficient and Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. The p values smaller than 0.05 were regarded as significant. RESULTS According to the findings, 173 children (86.93%) had perceived CAN, the average total score of which was 9.36 contributing commonly to malnutrition 3.01 (2.36) followed by psycho-emotional abuse 2.71 (1.76), neglect 1.62 (1.23), and physical 1.52 (1.08) and sexual 0.54 (0.31) abuse based on mean (SD). Statistical analysis indicated a significant effect of child's age, economic situation of the family, mother's education and occupation, and parents' illness on the total score of perceived CAN (p < 0.05). CONCLUSIONS Malnutrition was found to be the most common type of perceived CAN. Therefore, parents and the health system are advised to prioritize nutritional needs when planning their nutrition.
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Affiliation(s)
- Niloofar Bahrami
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Tork-Torabi
- Emam Hosseine Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Sotoudeh
- Isfahan Disaster and Emergency Medical Management Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Namnabati
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Mahboobeh Namnabati, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan - 73461-81746, Iran. E-mail:
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Theron L, van Breda A. Multisystemic enablers of sub-Saharan child and youth resilience to maltreatment. CHILD ABUSE & NEGLECT 2021; 119:105083. [PMID: 33931239 DOI: 10.1016/j.chiabu.2021.105083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/04/2021] [Accepted: 04/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The resilience of sub-Saharan children and youth to abuse and neglect is under-researched. In particular, the multisystemic and contextually sensitive nature of their resilience is under-appreciated. PURPOSE In response we conceptualized a discussion paper. Its intention is to make a case for a contextually relevant, multisystemic understanding of the resilience of sub-Saharan children and youth with exposure to maltreatment. METHOD This discussion paper draws on a critical analysis of pertinent peer-reviewed publications. It also draws on our lifelong residence in sub-Saharan Africa and related insight into this region's situational and cultural dynamics. RESULTS We advance three assertions regarding the multisystemic nature of sub-Saharan young people's resilience to abuse and neglect : (i) family↔communities are pivotal to sub-Saharan child and youth resilience to maltreatment; (ii) institutional supports matter too, particularly when multiple systems interact to provide networks of institutional support; and (iii) the resilience-enabling potential of built and natural environments is yet to be fully harnessed. CONCLUSION Interacting social and ecological system factors and processes matter for the resilience of sub-Saharan children and youth who experience abuse and neglect. Appreciation for their complexity and contextual fit are crucial to practice and policy efforts to advance the protection and wellbeing of sub-Saharan young people.
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Affiliation(s)
- Linda Theron
- Department of Educational Psychology, University of Pretoria, South Africa.
| | - Adrian van Breda
- University of Johannesburg, Department of Social Work, PO Box 524, Auckland Park, 2006, South Africa
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Cerna-Turoff I, Fang Z, Meierkord A, Wu Z, Yanguela J, Bangirana CA, Meinck F. Factors Associated With Violence Against Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Regression of Nationally Representative Data. TRAUMA, VIOLENCE & ABUSE 2021; 22:219-232. [PMID: 33461441 PMCID: PMC7961628 DOI: 10.1177/1524838020985532] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND This systematic review and meta-regression sought to identify the relative importance of factors associated with physical, emotional, and sexual violence against children in low- and middle-income countries. Understanding of factors associated with violence is important for targeted programming and prevention on the population level. METHODS We searched 17 electronic databases from 1989 to 2018 and reports from child violence surveys. Nationally representative studies that described evidence on potential factors associated with violence against children under 18 years old were included. The search was restricted to the English language. Factors were synthesized quantitatively using robust variance estimation, with 95% confidence intervals, for each violence type. RESULTS We identified 8,346 unduplicated studies, and 103 publications met our eligibility criteria. The data distribution was uneven across region, country income status, factors, and violence types. Of the 94 eligible studies quantitatively synthesized, no specific factors were significant for physical violence. Lower household socioeconomic status, being a girl, and primary education of mothers and adults in the household were associated with emotional violence, and being a girl was associated with sexual violence. CONCLUSION A broad spectrum of factors merit consideration for physical violence policy and prevention among the general population of children in low- and middle-income countries. Conversely, a tailored approach may be warranted for preventing emotional and sexual violence. Information is unequally distributed across countries, factors, and violence types. Greater emphasis should be placed on collecting representative data on the general population and vulnerable subgroups to achieve national reductions in violence against children.
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Affiliation(s)
- Ilan Cerna-Turoff
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zuyi Fang
- Department of Social Policy and Intervention, University of Oxford, United Kingdom
| | - Anne Meierkord
- Faculty of Medicine, University of Southampton, United Kingdom
| | - Zezhen Wu
- Department of Applied Psychology, New York University, USA
| | - Juan Yanguela
- Department of Social Policy and Intervention, University of Oxford, United Kingdom
| | - Clare Ahabwe Bangirana
- AfriChild Centre, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, United Kingdom
- Faculty of Health Sciences, North-West University, Vanderbijlpark, South Africa
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Zhang S, Lin X, Yang T, Zhang S, Pan Y, Lu J, Liu J. Prevalence of childhood trauma among adults with affective disorder using the Childhood Trauma Questionnaire: A meta-analysis. J Affect Disord 2020; 276:546-554. [PMID: 32871685 DOI: 10.1016/j.jad.2020.07.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 06/05/2020] [Accepted: 07/02/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Childhood trauma is associated with major depressive disorder (MDD) and bipolar disorder (BD) in adults. However, no meta-analysis was performed on the prevalence of different types of childhood trauma in adults with affective disorders, using the Childhood Trauma Questionnaire (CTQ). METHODS Four databases were used to search articles regarding the prevalence of childhood emotional abuse (CEA), childhood physical abuse (CPA), childhood sexual abuse (CSA), childhood physical neglect (CPN), and childhood emotional neglect (CEN) in patients with MDD and BD using the CTQ. RESULTS A total of 17 and 11 articles were found analyzing patients with MDD and BD, respectively. A pooled prevalence rate of 33.0% and 30.0% for CEA, 17.0% and 18.0% for CPA, 19.0% and 22.0% for CSA, 37.0% and 31.0% for CEN, and 31% and 30.0% for CPN was found in patients with MDD and BD respectively. A difference in 95% confidence interval in the CSA rate between men and women was found in patients with MDD in the gender subgroup and in the rate of some types of childhood trauma in the continent subgroup in both patient types. LIMITATIONS A limited number of articles were included in some continents, thus, the heterogeneity in the meta-analysis was generally high. CONCLUSION The prevalence of CEA, CEN, and CPN in patients with affective disorders was relatively high, whereas that of CPA and CSA was relatively low. These childhood traumas might be affected by continent and gender.
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Affiliation(s)
- Simei Zhang
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center; Shenzhen University, Mental Health School, Shenzhen 518020, China
| | - Xiujin Lin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080
| | - Tingyu Yang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Shengjie Zhang
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530000, China
| | - Yuli Pan
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530000, China
| | - Jianping Lu
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center; Shenzhen University, Mental Health School, Shenzhen 518020, China.
| | - Jianbo Liu
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center; Shenzhen University, Mental Health School, Shenzhen 518020, China.
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Annor FB, Gilbert LK, Davila EP, Massetti GM, Kress H, Onotu D, Ogbanufe O. Emotional violence in childhood and health conditions, risk-taking behaviors, and violence perpetration among young adults in Nigeria. CHILD ABUSE & NEGLECT 2020; 106:104510. [PMID: 32447142 PMCID: PMC8299818 DOI: 10.1016/j.chiabu.2020.104510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/12/2020] [Accepted: 04/18/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Globally, over 1 billion children are victims of violence against children annually. Studies examining the health consequences of childhood violence have mostly focused on childhood physical violence (PV) and sexual violence (SV). Recent evidence suggests that childhood emotional violence (EV) may also be deleterious to the health and wellbeing of victims. OBJECTIVE This study examines the independent association between EV and some health conditions, risk taking behaviors, and violence perpetration among Nigerian young adults ages 18-24 years. PARTICIPANTS AND SETTING Data from 2014 Nigeria Violence Against Children Survey (n = 4,203), a nationally representative cross-sectional survey of individuals ages 13-24 were used. METHODS Childhood EV was defined as EV victimization before age 18 perpetrated by a parent, adult caregiver or other adult relative. Logistic regression analyses assessed the association between EV in childhood and mental distress in the past 30 days, ever self-harm behaviors and history of sexually transmitted infections; risk behaviors such as having multiple sex partners in the past 12 months; and ever violence perpetration. RESULTS After controlling for study covariates, EV in childhood was associated with mental distress in both males and females, and self-harm behaviors in females; excessive alcohol use and infrequent condom use in males, and multiple sexual partners in females; and PV perpetration in males and SV perpetration in females. CONCLUSION EV in childhood is associated with some health conditions, risk taking behaviors, and violence perpetration. Implementing programs that address all forms of violence in childhood, including EV may benefit children.
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Affiliation(s)
- Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Leah K Gilbert
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Evelyn P Davila
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Howard Kress
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Dennis Onotu
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Obinna Ogbanufe
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
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