Age at first exposure to violence and later mental health outcomes: A sex-disaggregated, multi-country analysis in sub-Saharan Africa

• Published in: Child abuse & neglect 2022-03, Vol.125, p.105509-105509, Article 105509
• Main Authors: Seff, Ilana, Rodriguez, Deidi Olaya, Meinhart, Melissa, Colarelli, Jonathan, Vahedi, Luissa, Stark, Lindsay
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent health; Adult; Age; Age differences; Alcohol use; Anxiety; Child; Child Advocacy; Children; Drinking; Drug abuse; Drug Use; Early childhood violence; Exposure to Violence; Female; Gender differences; Health status; Humans; Kenya; Malawi; Male; Males; Men; Mental Health; Nigeria; Physical Abuse - psychology; Prevalence; Sadness; Sex differences; Smoking; Sub-Saharan Africa; Substance abuse; Suicidal ideation; Suicide; Tanzania; Uganda; Violence; Violence - psychology; Well being; Young Adult
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2022.105509

A growing body of research has begun examining the relationship between a child's age at first exposure to violence and outcomes of mental wellbeing, though no studies have assessed these relationships in the sub-Saharan African (SSA) region. Given known gender and sex differences in violence exposure and mental health symptomology, this study conducts a multi-country, gender-stratified analysis of the relationship between age at first incident of physical violence and outcomes of wellbeing in SSA. This study uses data from the Violence Against Children Surveys on 13–24-year-old males and females in five SSA countries (Kenya (2010), Malawi (2013), Nigeria (2014), Tanzania (2009), and Uganda (2015)). The predictor of interest is a categorical variable indicating whether a respondent's first exposure to physical violence took place from 0 to 5, 6–11, 12 and older, or never. Outcomes of interest include: sadness, anxiety, suicide ideation, smoking, drug use, and alcohol use. Employing both country-specific and pooled data, gender-stratified, multiple logistic regressions are used to estimate the effect of age at first exposure to physical violence on the six outcomes of interest. Findings show significant variation across countries in age at first exposure to physical violence. For females, findings reveal no association between age at first exposure and outcomes of wellbeing; all periods were equally associated with poor outcomes. For males, results show increased likelihood of anxiety, suicide ideation, and alcohol use when the first violence exposure occurred from 0 to 5 years. This study advances the literature on gender and sex differences in mental health symptomology, suggesting that boys and girls may exhibit different symptomology in response to comparable exposures to violence.