Unveiling the Nexus: Vulnerability to Psychological Distress and Childhood Violence among Adolescents in Zimbabwe

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DOI: 10.21522/TIJAR.2014.11.01.Art009

Authors : Edson Chipalo, Ikenna Obasi Odii

Abstract:

Exposure to multiple forms of violence increases the risk of developing psychiatric illnesses such as depression, PTSD, and other mental health problems. Despite this, studies investigating the relationship between psychological distress and childhood violence exposure are limited. This study aimed to estimate the prevalence of childhood violence across psychological distress and examined the association between vulnerability to psychological distress and experiencing childhood violence among Zimbabwean adolescents. Utilizing data from the 2017 Zimbabwe Violence Against Children Survey (ZVACS), a representative household survey of adolescents aged 13 to 19 (n=5344), we employed chisquare tests to determine the prevalence estimates across independent and dependent variables. Additionally, four sets of logistic regression models (both unadjusted and adjusted) were performed to predict significant associations between independent and dependent variables. Prevalence results indicated that among adolescents experiencing moderate-to-severe psychological distress, 35.3% had experienced childhood physical violence, 27.2% emotional violence, 15% sexual violence, and 51.2% had been exposed to multiple forms of violence. Similarly, regression results indicated that adolescents with moderate-to-severe psychological distress had higher odds of experiencing childhood physical violence (aOR=2.13), emotional violence (aOR=3.69), sexual violence (aOR=1.93), and multiple forms of violence (aOR=2.59) compared to their counterparts without psychological distress in the past 30 days. These findings underscore the need for interventions that prioritize education and increased access to mental health treatment programs. Moreover, addressing evolving cultural norms and enforcing existing legislation to curb violence are crucial steps to mitigate the risk of further victimization in Zimbabwe.

Keywords: Psychological distress, emotional violence, sexual violence, physical violence, childhood, adolescence, Zimbabwe.

References:

[1] Organization, W.H., The World Health Report 2001: Mental health: new understanding, new hope. 2001.

[2] Dahlberg, L.L. and J.A. Mercy, The history of violence as a public health issue. 2009.

[3] Association, A.P., Publication manual of the american psychological association, (2020). American Psychological Association, 2019: p. 428.

[4] Hoefer, R., The dangers of social justice advocacy. Social Work, 2019. 64(1): p. 87-90.

[5] Drapeau, A., A. Marchand, and D. Beaulieu-Prevost, Epidemiology of psychological distress. Mental illnesses-understanding, prediction, and control, 2012. 69(2): p. 105-106.

[6] Organization, W.H., Violence against women prevalence estimates, 2018: Global, regional, and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. Executive summary. 2021: World Health Organization.

[7] United Nations Children's Fund. Violence against children. 2023 December 10, 2023]; Available from: https://data.unicef.org/topic/child-protection/violence/.

[8] Farrington, D.P., and R. Loeber, Epidemiology of Juvenile Violence. Child and Adolescent Psychiatric Clinics of North America, 2000. 9(4): p. 733-748.

[9] United Nations Children's Fund. Violence against children. 2020 December 10, 2023]; Available from: https://www.unicef.org/protection/violence-against-children.

[10] Lin, W.H., J.K. Cochran, and T. Mieczkowski, Direct and vicarious violent victimization and juvenile delinquency: An application of general strain theory. Sociological inquiry, 2011. 81(2): p. 195-222.

[11] Anyanwu, M.U. and I. Tamwesigire, A cross-sectional study of prevalence and predictors of risky sexual behavior among school-going adolescents in Mbarara municipality, Uganda. African Health Sciences, 2023. 23(3): p. 109-116.

[12] Siziya, S. and M.L. Mazaba, Prevalence, and correlates for psychosocial distress among in-school adolescents in Zambia. Frontiers in public health, 2015. 3: p. 180.

[13] Handrick, C., et al., Risk factors and health consequences of physical and emotional violence against children in Zimbabwe: a nationally representative survey. BMJ Global Health, 2018. 3(3): p. e000533.

[14] Finkelhor, D., Childhood victimization: Violence, crime, and abuse in the lives of young people. 2008: oxford university Press.

[15] Greenfield, E.A. and N.F. Marks, identifying experiences of physical and psychological violence in childhood that jeopardize mental health in adulthood. Child Abuse & Neglect, 2010. 34(3): p. 161-171.

[16] Biçakçi, M.Y., S. Er, and N. Aral, An overview of child neglect and abuse: Types, causes, impact, and prevention. Studies on Ethno-medicine, 2016. 10(2): p. 221-228.

[17] Mills, R., et al., Child maltreatment and adolescent mental health problems in a large birth cohort. Child abuse & neglect, 2013. 37(5): p. 292-302.

[18] Gilbert, R., et al., Burden and consequences of child maltreatment in high-income countries. The lancet, 2009. 373(9657): p. 68-81.

[19] Meinck, F., et al., Measuring and monitoring national prevalence of child maltreatment: a practical handbook. Measuring and monitoring national prevalence of child maltreatment: a practical handbook, 2016.

[20] Victor, B.G., et al., Domestic violence, parental substance misuse and the decision to substantiate child maltreatment. Child abuse & neglect, 2018. 79: p. 31-41.

[21] Zheng, X., et al., Violence against children and human capital in South Africa. Journal of family violence, 2019. 34: p. 139-151.

[22] Hsiao, C., et al., Violence against children in South Africa: the cost of inaction to society and the economy. BMJ global health, 2018. 3(1): p. e000573.

[23] Sherr, L., et al., Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi. International Health, 2015. 8(1): p. 36-43.

[24] Eckenrode, J., et al., Mobility as a mediator of the effects of child maltreatment on academic performance. Child development, 1995. 66(4): p. 1130-1142.

[25] Perez, C.M. and C.S. Widom, Childhood victimization and long-term intellectual and academic outcomes. Child abuse & neglect, 1994. 18(8): p. 617-633.

[26] Fry, D., et al., The relationships between violence in childhood and educational outcomes: A global systematic review and meta-analysis. Child abuse & neglect, 2018. 75: p. 6-28.

[27] Fang, X. and P.S. Corso, Gender differences in the connections between violence experienced as a child and perpetration of intimate partner violence in young adulthood. Journal of Family Violence, 2008. 23: p. 303-313.

[28] Corso, P.S., et al., Health-related quality of life among adults who experienced maltreatment during childhood. American journal of public health, 2008. 98(6): p. 1094-1100.

[29] Chan, K.L., R. Lo, and P. Ip, From exposure to family violence during childhood to depression in adulthood: a path analysis on the mediating effects of intimate partner violence. Journal of interpersonal violence, 2021. 36(9-10): p. 4431-4450.

[30] Yan, E., and T. Karatzias, Childhood abuse and current intimate partner violence: A population study in Hong Kong. Journal of interpersonal violence, 2020. 35(1-2): p. 233-251.

[31] Fang, X., et al., The burden of child maltreatment in China: a systematic review. Bulletin of the World Health Organization, 2015. 93: p. 176-185C.

[32] Downey, J.C., et al., Adverse childhood experiences affect health risk behaviors and chronic health of Iowans. Journal of Family Violence, 2017. 32: p. 557-564.

[33] Herrenkohl, T.I., et al., Child maltreatment, youth violence, intimate partner violence, and elder mistreatment: A review and theoretical analysis of research on violence across the life course. Trauma, violence, & abuse, 2022. 23(1): p. 314-328.

[34] Tanaka, M., et al., The linkages among childhood maltreatment, adolescent mental health, and self-compassion in child welfare adolescents. Child Abuse & Neglect, 2011. 35(10): p. 887-898.

[35] Vettese, L.C., et al., Does Self-Compassion Mitigate the Association Between Childhood Maltreatment and Later Emotion Regulation Difficulties? A Preliminary Investigation. International Journal of Mental Health and Addiction, 2011. 9(5): p. 480-491.

[36] Rumble, L., et al., Childhood sexual violence in Zimbabwe: Evidence for the epidemic against girls. Child Abuse & Neglect, 2015. 46: p. 60-66.

[37] Muridzo, N.G., An exploration of the phenomenon of child sexual abuse in Zimbabwe. 2018.

[38] Bensley, L.S., J. Van Eenwyk, and K.W. Simmons, Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking. American journal of preventive medicine, 2000. 18(2): p. 151-158.

[39] Reading, R., Exposure to physical and sexual violence and adverse health behaviours in African children: results from the Global School‐based Student Health Survey. 2009, Wiley Online Library.

[40] Norman, R.E., et al., The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS medicine, 2012. 9(11): p. e1001349.

[41] Lindert, J., et al., Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis. International journal of public health, 2014. 59: p. 359-372.

[42] Lee, M., et al., Mediators and moderators of the effects of early exposure to intimate partner violence on children’s mental health. Development and psychopathology, 2023: p. 1-13.

[43] Zimbabwe Ministry of Health and Childcare, Young Adult Survey of Zimbabwe: A Violence Against Children Survey, 2017. 2019, Elizabeth Glaser Pediatric AIDS Foundation: Harare, Zimbabwe.

[44] Anderson, T.M., et al., The 10-item Kessler psychological distress scale (K10) as a screening instrument in older individuals. The American journal of geriatric psychiatry, 2013. 21(7): p. 596-606.

[45] Juan, C., et al., Associations between mental distress, poly-victimisation, and gender attitudes among adolescent girls in Cambodia and Haiti: an analysis of Violence Against Children surveys. Journal of Child & Adolescent Mental Health, 2019. 31(3): p. 201-213.

[46] Prochaska, J.J., et al., Validity study of the K6 scale as a measure of moderate mental distress based on mental health treatment need and utilization. International journal of methods in psychiatric research, 2012. 21(2): p. 88-97.


[47] Thai, T.T., et al., The effect of adverse childhood experiences on depression, psychological distress, and suicidal thought in Vietnamese adolescents: Findings from multiple cross-sectional studies. Asian journal of psychiatry, 2020. 53: p. 102134.

[48] Zimbabwe Ministry of Health and Childcare, oung Adult Survey of Zimbabwe: A Violence Against Children Survey, 2017. 2019.

[49] Kemal, S., A. Nwabuo, and J. Hoffmann, Mental health and violence in children and adolescents. Pediatric Clinics, 2023. 70(6): p. 1201-1215.

[50] Ribeiro, W.S., et al., Exposure to violence and mental health problems in low and middle-income countries: a literature review. Brazilian Journal of Psychiatry, 2009. 31: p. S49-S57.

[51] Hom, K.A. and S.J. Woods, Trauma and its aftermath for commercially sexually exploited women as told by front-line service providers. Issues in mental health nursing, 2013. 34(2): p. 75-81.

[52] McKay, M., M. Davis, and P. Fanning, Thoughts, and feelings: Taking control of your moods and your life. 2021: New Harbinger Publications.

[53] Brassard, M.R., S.N. Hart, and D. Glaser, Psychological maltreatment: An international challenge to children's safety and well-being. Child Abuse & Neglect, 2020. 110: p. 104611.

Frieh, E.C., Stigma, trauma, and sexuality: the experiences of women hospitalised with serious mental illness. Sociology of Health & Illness, 2020. 42(3): p. 526-543.