Mental health and gender-based violence: An exploration of depression, PTSD, and anxiety among adolescents in Kenyan informal settlements participating in an empowerment intervention

Prevalence and factors associated with the perpetration and victimization of teen dating violence: A systematic review and meta-analysis protocol

Dating violence is a global health problem that affects adolescents physically, psychologically and sexually. During adolescence, there is a high prevalence and negative consequences in both perpetration and victimization, which can vary according to culture, but maintain common characteristics in traditional societies. Factors associated with the perpetration and victimization of gender-based violence among adolescents include gender inequality, discrimination, substance use, parental neglect, peer influence and exposure to family violence. Despite modern criticisms of gender expectations, traditional views that legitimize violence persist. In this sense, the collection of global data on the prevalence and factors associated with dating violence among adolescents could favour comparative studies between Western and Eastern cultures and is fundamental for informing public policies in a globalized world. It is hoped that the results will contribute to expanding scientific knowledge in the area, as well as helping managers and the academic community to target resources, identify risk groups and promote gender equality from adolescence onwards. In this sense, this study aims to globally assess the prevalence and factors associated with the perpetration and victimization of dating violence among adolescents. It is hoped that the results will expand scientific knowledge in this area.

Key mental health differences in conflict-related sexual violence and how sex, severity, and early intervention impact on improvement: a retrospective observational study

BACKGROUND

Conflict-related sexual violence (CRSV) is a significant health and human rights issue in humanitarian contexts, but there is a need of further research on differences between sexes in terms of severity of symptoms and improvement. Consequently, we explored the differences in severity and outcomes among male and female survivors of CRSV who received mental health and psychosocial support (MHPSS) in an armed conflict setting.

METHODS

We retrospectively analysed medical records from 3442 CRSV survivors in a MHPSS programme in Borno State, Nigeria, between 2018 and 2019. Patient characteristics, severity (measured with Clinical Global Impression of Severity Scale [CGI-S scale]), and improvement (measured with Clinical Global Impression of improvement [CGI-I] scale) were assessed by an attending counsellor. We assessed predictors for severity and improvement using a multivariable logistic regression analysis and time to improvement by sex using Kaplan Meier (K-M) curves and Cox regression.

RESULTS

We included 3442 patients who had at least one CRSV event in this study (2955 [85.9%] female, 486 [14.1%] male, one unknown). The most prevalent categories of symptoms were depression (49.9%; n = 1716), post-traumatic (25.6%; n = 879), and anxiety (20.3%; n = 697) symptoms. Most patients had mild (59.0%; n = 1869/3170) or moderate (36.4%; n = 1153/3170) symptoms at baseline, with 4.7% having severe symptoms (n = 148/3170). The logistic regression analysis (n = 1106), showed male patients had a 59% higher odds of severe symptoms at baseline than female patients (aOR 1.59; 95% CI 1.04-2.45). Among males, those older than 55 years had three times higher odds of presenting severe symptoms than younger patients (aOR 3.65; 95% CI 1.43-9.34). Women aged 36-55 years were more likely to present improvement than younger female patients (aOR 1.32; 95% CI 1.11-1.58). For both sexes, prompt attention after a CRSV event (≤ 3 days) positively predicted improvement (aOR 13.9; 95% CI 1.48-130 males, aOR 2.11; 95% CI 1.22-3.64 females) compared to late attention. Time to improvement did not differ between sexes, with an average of at least three consultations needed to achieve improvement.

CONCLUSIONS

Our study suggests that psychological attention of survivors within the first 72 h should be a priority. MHPSS programmes addressing CRSV should be inclusive to all patients, and gender-neutral approaches to ensure access, safety, confidentiality, and non-discrimination for all survivors should be developed.

Sexual Assault Among Young Adolescents in Informal Settlements in Nairobi, Kenya: Findings from the IMPower and SOS Cluster-Randomized Controlled Trial

Sexual assault is a global threat to adolescent health, but empowerment self-defense (ESD) interventions have shown promise for prevention. This study evaluated the joint implementation of a girls' ESD program and a concurrent boys' program, implemented via a cluster-randomized controlled trial in informal settlements of Nairobi, Kenya, from January 2016 to October 2018. Schools were randomized to the 12-h intervention or 2-h standard of care. Students were randomly sampled to complete surveys at baseline and again at 24 months post-intervention. A total of 3263 girls, ages 10-14, who completed both baseline and follow-up surveys were analyzed; weights were adjusted for dropout. At follow-up, 5.9% (n = 194/3263) of girls reported having been raped in the prior 12 months. Odds of reporting rape were not significantly different in the intervention versus SOC group (OR: 1.21; 95% CI (0.40, 5.21), p = 0.63). Secondary outcomes, social self-efficacy (OR: 1.08; 95% CI (0.95, 1.22), p = 0.22), emotional self-efficacy (OR 1.07; 95% CI (0.89, 1.29), p = 0.49), and academic self-efficacy (OR: 0.90; 95% CI (0.82, 1.00), p = 0.06) were not significantly different. Exploratory analyses of boys' victimization and perpetration are reported. This study improved on previous ESD studies in this setting with longitudinal follow-up of individuals and independent data collection. This study did not show an effect of the intervention on self-reported rape; findings should be interpreted cautiously due to limitations. Sexual assault rates are high in this young population, underscoring a dire need to implement and rigorously test sexual assault prevention interventions in this setting. The trial was registered with Clinical Trials.gov # NCT02771132. Version 3.1 registered on May 2017, first participant enrolled January 2017.

Intergenerational effects of child maltreatment on adolescents' anxiety and depression in Ethiopia: the important mediating and moderating roles of current psychological distress

BACKGROUND

Child abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents' maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC.

METHODS

A total of 231 adolescents (age: 13-21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors.

RESULTS

The frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents' psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents' anxiety and depression (95% CI [- 0.770, - 0.012]).

CONCLUSIONS

We found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents' anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa.

A Scoping Review of Anti-Bullying Interventions: Reducing Traumatic Effect of Bullying Among Adolescents

Bullying is a violent activity that causes significant harm to both victims and perpetrators. Anxiety, despair, low self-esteem, and suicidal ideation are signs of bullying's traumatic effect. The social environment's support proved critical in lessening the devastating experience of bullying on adolescents. The purpose of this study is to conduct a scoping Review of Anti-Bullying Interventions with the aim of reporting techniques to reduce traumatic effect of bullying among adolescents. A design scoping review was done in this investigation. The publications were discovered using the PRISMA Extension for Scoping Review method. Three databases were used to find this article: PubMed, CINAHL, and Scopus. The inclusion criteria for this study were that the sample included adolescent victims of bullying, that it was full text, that it was written in English, that it included anti-bullying therapies, that it used randomized control trials or quasi-experimental designs, and that it was published during the last ten years (2014-2023). The authors found 16 articles were obtained that explored Anti-bullying therapies to minimize symptoms of trauma in adolescent bullies. All of the studies found that the intervention significantly reduced the effects of bullying on victims (p<0.05). The sample sizes ranged from 31 to 5539 teenage respondents. This study discovered three types of anti-bullying interventions: social support, social skills, and school-based programs. Activities such as education, counseling, and training are used to prevent bullying behavior in schools. Adolescent intervention takes into account the participants' physical and psychological situations and focuses on completing the stages of adolescent development. Interventions to reduce the impact of trauma on bullying victims need to involve health providers, parents, and adolescents. This aims to form a mutually supportive system in overcoming the problem of bullying.