Emotional violence in childhood and health conditions, risk-taking behaviors, and violence perpetration among young adults in Nigeria

The association between emotional abuse in childhood and healthcare utilization in adulthood among sami and non-sami: the SAMINOR 2 questionnaire survey

BACKGROUND

Emotional abuse in childhood is the most common type of childhood abuse worldwide and is associated with a variety of somatic and mental health issues. However, globally and in indigenous contexts, research on the associations between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood is sparse.

AIM

The main aim of this study was to investigate the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization in adulthood in Sami and non-Sami populations, and to examine whether this association differs between the two ethnic groups.

METHOD

This study used cross-sectional data from the SAMINOR 2 Questionnaire Survey - a population-based study on health and living conditions in areas with Sami and non-Sami populations in Middle and Northern Norway. In total, 11 600 individuals participated in SAMINOR 2. Logistic regression was used to present the association between emotional abuse in childhood and somatic and mental specialist healthcare utilization.

RESULTS

Emotional abuse in childhood was significantly associated with somatic specialist healthcare utilization in adulthood (fully adjusted odds ratio [OR] 1.31, 95% confidence interval [CI] 1.15-1.49), with no differences observed between ethnic groups. Emotional abuse in childhood was also associated with mental specialist healthcare utilization (fully adjusted OR 3.99, 95% CI 3.09-5.14), however this association was weaker among Sami (crude OR 2.38, 95% CI 1.37-4.13) compared with non-Sami (crude OR 5.40, 95% Cl 4.07-7.15) participants.

CONCLUSIONS

Emotional abuse in childhood is associated with somatic and mental specialist healthcare utilization in adulthood, with a stronger association to mental healthcare utilization. The association between emotional abuse in childhood and mental specialist healthcare utilization was weaker among Sami than non-Sami participants. Future studies should investigate the reason for this ethnic difference. Our results highlight the need to strengthen efforts to prevent childhood abuse and develop strategies to reduce its societal and personal burden.

Adverse Childhood Experiences and Associations with Mental Health, Substance Use, and Violence Perpetration among Young Adults in sub-Saharan Africa

Background

Adverse childhood experiences (ACEs) can have debilitating effects on child well-being, with consequences persisting into adulthood. Most ACE studies have been conducted in high-income countries and show a graded relationship between multiple ACE exposures and adverse health outcomes. Less is known about the types and burden of ACEs in sub-Saharan Africa (SSA).

Objective

To estimate the pooled prevalence of six individual and cumulative ACE exposures (physical, sexual, and emotional violence; orphanhood; witnessing interparental and community violence) and assess their association with mental health outcomes, substance use, and violence perpetration among young adults in SSA.

Participants and setting

Aggregate data from the Violence Against Children and Youth Survey (VACS) in Cote d'Ivoire 2018, Kenya 2019, Lesotho 2018, Mozambique 2019, and Namibia 2019 included a sample of 11,498 young adults aged 18-24 years.

Methods

Cumulative ACEs were defined by an integer count of the total number of individual ACEs (0 to 6). Weighted prevalence and adjusted odds ratios were estimated.

Result

ACEs prevalence ranged from 7.8% (emotional violence) to 55.0% (witnessing community violence). Strong graded relationships between cumulative ACE exposure and all study outcomes for both males and females were observed. Among females, witnessing interparental violence was the only individual ACE risk factor significantly associated with increased odds of substance use; among males, emotional violence was significantly associated with all outcomes.

Conclusion

ACEs are associated with adverse mental health, substance use, and violence perpetration in SSA. Gender-specific and culturally sensitive intervention strategies are needed to effectively mitigate ACEs in this population.

The Violence Against Children Surveys (VACS): Using VACS data to drive programmes and policies

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.

Adverse Childhood Experiences and Associated Mental Distress and Suicide Risk: Results From the Zambia Violence Against Children Survey

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.

Experiences of participation in a population-based survey on violence: Emotional discomfort, disclosure concerns, and the perceived value of participation among adolescents and young adults

The accurate measurement of violence depends on high-quality data collected using methods that ensure participant confidentiality, privacy, and safety. To assess survey participants' emotional distress, discomfort, and self-perceived value of participating in the Honduras (2017), El Salvador (2017), Cote d'Ivoire (2018), and Lesotho (2018) Violence Against Children and Youth Surveys, which include sensitive topics such as sexual, physical, and emotional violence, we investigated individual self-reported distress and perceived value of participation by age, sex, and other demographic factors. We also examined the associations between past experiences of violence and both self-reported distress and perceived value of survey participation. Few individuals reported distress or concerns about disclosure. Across countries, 82.9% (Cote d'Ivoire) to 96.1% (Honduras) of participants indicated they were not afraid that someone might overhear their answers, 82.5% (Cote d'Ivoire) to 98.0% (El Salvador) said participation was not upsetting or stressful, and 93.3% (Cote d'Ivoire) to 98.6% (Honduras) said participation was worthwhile. The value of these interviews may exceed the negative feelings that some questions potentially elicit and can contribute to improved responses to victims.

Associations between adverse childhood experiences and contraceptive use among young adults in Honduras

OBJECTIVE

Research on adverse childhood experiences (ACEs) and use of modern contraception is limited in Honduras. The government has made substantial gains in promoting modern contraception. Young adults experience high rates of violence. The aim of this study was to assess the relationship between ACEs and contraceptive behaviors among young women and men.

METHODS

We used data from 810 women and 753 men aged 18-24 years from the 2017 Honduras Violence against Children Survey, a cross-sectional, nationally representative household survey of childhood adversity. We assessed associations between ACEs and three contraceptive use outcomes: use versus nonuse of modern contraceptives; use of methods requiring medium/high or low programmatic support among current contraceptive users; and frequent versus infrequent condom use.

FINDINGS

Exposure to physical or emotional abuse and witnessing violence in the home was not significantly associated with the three contraceptive use outcomes for men or women. Sexual abuse and parental separation reduced odds of contraceptive use among women (Odds Ratio (OR) < 0.60) but not among men. In contrast, orphan status increased odds of modern contraception use among men (OR 1.93) and frequent condom use among women (OR 2.22).

CONCLUSION

The inconsistent direction and magnitude of associations between ACEs and modern contraceptive use among young men and women suggests divergent relationships between ACEs and sexual and reproductive health behaviors. Results may highlight the strength of norms around contraceptive use and/or widespread access to community-based family planning programs and comprehensive sexuality education, irrespective of exposure to ACEs in Honduras.