Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda

Abstract Background Many studies have documented an association between violence victimisation and poor mental health. However, few studies use longitudinal data from low- and middle-income countries with attention to how associations differ by experiencing specific types of violence or alongside di...

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Main Authors: Rebecca Akunzirwe, Daniel J. Carter, Lauren Hanna, Anja Zinke-Allmang, Aggrey Akim, Simone Datzberger, Jenny Parkes, Louise Knight, Lydia Atuhaire, Janet Nakuti, Angel Mirembe, Elizabeth Allen, Dipak Naker, Karen Devries, Amiya Bhatia
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-20950-7
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author Rebecca Akunzirwe
Daniel J. Carter
Lauren Hanna
Anja Zinke-Allmang
Aggrey Akim
Simone Datzberger
Jenny Parkes
Louise Knight
Lydia Atuhaire
Janet Nakuti
Angel Mirembe
Elizabeth Allen
Dipak Naker
Karen Devries
Amiya Bhatia
author_facet Rebecca Akunzirwe
Daniel J. Carter
Lauren Hanna
Anja Zinke-Allmang
Aggrey Akim
Simone Datzberger
Jenny Parkes
Louise Knight
Lydia Atuhaire
Janet Nakuti
Angel Mirembe
Elizabeth Allen
Dipak Naker
Karen Devries
Amiya Bhatia
author_sort Rebecca Akunzirwe
collection DOAJ
description Abstract Background Many studies have documented an association between violence victimisation and poor mental health. However, few studies use longitudinal data from low- and middle-income countries with attention to how associations differ by experiencing specific types of violence or alongside different contexts of peer and family support. In this study, we quantify the association between experiences of violence in early adolescence and depression and suicide attempts in late adolescence and explore whether this association is modified by family and peer connectedness. Methods Data came from the Contexts of Violence Against Children (CoVAC) cohort study in Luwero District, Uganda, involving 2773 participants aged 11–14 years at Wave 1 (2014) and 15–18 years at Wave 2 (2018). Physical, sexual, and emotional violence were measured at Wave 1. Mental health outcomes, depression symptoms in the past two weeks, and lifetime suicide attempts were measured at Wave (2) We used logistic regression models, stratified by sex, to estimate adjusted odds ratios with an interaction term to test for effect modification by peer and family connectedness at Wave 1. Findings At Wave 1, the prevalence of any violence from any perpetrator was 90% (physical violence: 87%, physical violence excluding caning: 68%, sexual violence: 6.3%, emotional violence: 56.8%). At Wave 2, 13.3% of participants had scores indicative of depression and 4.3% reported ever attempting suicide. Physical violence excluding caning, emotional violence, and sexual violence during early adolescence increased the odds of depression and attempting suicide in late adolescence for both boys and girls. Experiencing any violence (including caning) in early adolescence was not associated with depression in late adolescence, including in sex-stratified models. Childhood experience of any violence was associated with a suicide attempt violence in early adolescence (aOR: 2.60; 95%CI: 1.08, 6.27). High peer support mitigated the effect of any violence and physical violence on depression. Conclusions Findings highlight the importance of efforts to prevent violence and improve access to response and support services for violence and mental health for young people. Findings also underscore the important role friends and peer networks can play in mitigating the effects of violence as young people grow up.
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spelling doaj-art-d68a74d37bcc4dfca063ac1ec143b73a2024-12-22T12:52:31ZengBMCBMC Public Health1471-24582024-12-0124111510.1186/s12889-024-20950-7Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, UgandaRebecca Akunzirwe0Daniel J. Carter1Lauren Hanna2Anja Zinke-Allmang3Aggrey Akim4Simone Datzberger5Jenny Parkes6Louise Knight7Lydia Atuhaire8Janet Nakuti9Angel Mirembe10Elizabeth Allen11Dipak Naker12Karen Devries13Amiya Bhatia14Raising VoicesDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineRaising VoicesInstitute of Education, University College LondonInstitute of Education, University College LondonDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineRaising VoicesRaising VoicesRaising VoicesDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineRaising VoicesDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Social Policy and Intervention, University of OxfordAbstract Background Many studies have documented an association between violence victimisation and poor mental health. However, few studies use longitudinal data from low- and middle-income countries with attention to how associations differ by experiencing specific types of violence or alongside different contexts of peer and family support. In this study, we quantify the association between experiences of violence in early adolescence and depression and suicide attempts in late adolescence and explore whether this association is modified by family and peer connectedness. Methods Data came from the Contexts of Violence Against Children (CoVAC) cohort study in Luwero District, Uganda, involving 2773 participants aged 11–14 years at Wave 1 (2014) and 15–18 years at Wave 2 (2018). Physical, sexual, and emotional violence were measured at Wave 1. Mental health outcomes, depression symptoms in the past two weeks, and lifetime suicide attempts were measured at Wave (2) We used logistic regression models, stratified by sex, to estimate adjusted odds ratios with an interaction term to test for effect modification by peer and family connectedness at Wave 1. Findings At Wave 1, the prevalence of any violence from any perpetrator was 90% (physical violence: 87%, physical violence excluding caning: 68%, sexual violence: 6.3%, emotional violence: 56.8%). At Wave 2, 13.3% of participants had scores indicative of depression and 4.3% reported ever attempting suicide. Physical violence excluding caning, emotional violence, and sexual violence during early adolescence increased the odds of depression and attempting suicide in late adolescence for both boys and girls. Experiencing any violence (including caning) in early adolescence was not associated with depression in late adolescence, including in sex-stratified models. Childhood experience of any violence was associated with a suicide attempt violence in early adolescence (aOR: 2.60; 95%CI: 1.08, 6.27). High peer support mitigated the effect of any violence and physical violence on depression. Conclusions Findings highlight the importance of efforts to prevent violence and improve access to response and support services for violence and mental health for young people. Findings also underscore the important role friends and peer networks can play in mitigating the effects of violence as young people grow up.https://doi.org/10.1186/s12889-024-20950-7Violence against childrenChild healthAdolescent healthSuicideMental healthLMICs
spellingShingle Rebecca Akunzirwe
Daniel J. Carter
Lauren Hanna
Anja Zinke-Allmang
Aggrey Akim
Simone Datzberger
Jenny Parkes
Louise Knight
Lydia Atuhaire
Janet Nakuti
Angel Mirembe
Elizabeth Allen
Dipak Naker
Karen Devries
Amiya Bhatia
Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
BMC Public Health
Violence against children
Child health
Adolescent health
Suicide
Mental health
LMICs
title Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
title_full Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
title_fullStr Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
title_full_unstemmed Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
title_short Associations between violence in childhood, depression and suicide attempts in adolescence: evidence from a cohort study in Luwero district, Uganda
title_sort associations between violence in childhood depression and suicide attempts in adolescence evidence from a cohort study in luwero district uganda
topic Violence against children
Child health
Adolescent health
Suicide
Mental health
LMICs
url https://doi.org/10.1186/s12889-024-20950-7
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