Violence Against Children, Self-Harm, and Suicidal Behaviors: A Pooled and Country-Specific Analysis of Eight Low- and Middle-Income Countries

Abigail Puno; Jinseo Kim; Amiya Bhatia; Joshua Jeong; Rockli Kim

doi:10.1016/j.jadohealth.2024.02.034

Violence Against Children, Self-Harm, and Suicidal Behaviors: A Pooled and Country-Specific Analysis of Eight Low- and Middle-Income Countries

J Adolesc Health. 2024 May 10:S1054-139X(24)00151-4. doi: 10.1016/j.jadohealth.2024.02.034. Online ahead of print.

Authors

Abigail Puno¹, Jinseo Kim², Amiya Bhatia³, Joshua Jeong⁴, Rockli Kim⁵

Affiliations

¹ Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Division of Biological Sciences, University of the Philippines Visayas, Iloilo, Philippines.
² Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea.
³ Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom.
⁴ Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
⁵ Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea. Electronic address: rocklikim@korea.ac.kr.

PMID: 38739049
DOI: 10.1016/j.jadohealth.2024.02.034

Abstract

Purpose: This study assessed associations between experiences of physical or sexual violence in childhood and self-harm, suicidal ideation, and suicide attempts among young people in low- and middle-income countries (LMICs) and whether these associations varied by sex and perpetrator identity.

Methods: We used nationally representative data from the Violence Against Children and Youth Surveys in eight LMICs (2017-2019). The analytic sample included 33,381 young men and women (ages 13-24 years). Multivariable logistic regressions with country-fixed effects were used to estimate the associations between childhood physical and sexual violence and the three outcomes. Stratified analyses were performed by country, participant's sex, and type of perpetrator (parent/caregiver, other adults, peers, and intimate partner).

Results: About 40% of the participants reported physical childhood violence, and 10% experienced childhood sexual violence. Childhood violence was associated with increased odds of self-harm (physical violence: adjusted odds ratio [aOR]: 2.2, 95% confidence interval [CI]: 2.0-2.4; sexual violence: aOR: 2.7, 95%, CI: 2.3-3.0), suicidal ideation (physical: aOR: 3.0, 95% CI: 2.7-3.3; sexual: aOR: 4.0, 95%, CI: 3.6-4.5), and suicide attempts (physical: aOR: 3.6, 95% CI: 3.2-4.1; sexual: aOR: 4.9, 95%, CI: 4.3-5.7). Consistent findings were observed in country-specific analyses. The odds of all outcomes were highest among those who experienced childhood physical violence by intimate partners and childhood sexual violence by parents or caregivers. Young women who experienced childhood sexual violence had higher odds for all outcomes than young men.

Discussion: Violence prevention and mental health programs for young people in LMICs should consider the types of violence experienced, the perpetrator, and the sex of the survivor.

Keywords: LMIC; Perpetrator; Self-harm; Suicidal behaviors; Violence against children.