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

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 Information
  1. Rebecca Akunzirwe: Raising Voices, Kampala, Uganda. akunzirwe@gmail.com.
  2. Daniel J Carter: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  3. Lauren Hanna: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  4. Anja Zinke-Allmang: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  5. Aggrey Akim: Raising Voices, Kampala, Uganda.
  6. Simone Datzberger: Institute of Education, University College London, London, UK.
  7. Jenny Parkes: Institute of Education, University College London, London, UK.
  8. Louise Knight: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  9. Lydia Atuhaire: Raising Voices, Kampala, Uganda.
  10. Janet Nakuti: Raising Voices, Kampala, Uganda.
  11. Angel Mirembe: Raising Voices, Kampala, Uganda.
  12. Elizabeth Allen: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  13. Dipak Naker: Raising Voices, Kampala, Uganda.
  14. Karen Devries: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  15. Amiya Bhatia: Department of Social Policy and Intervention, University of Oxford, Oxford, UK.

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.

Keywords

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Grants

  1. MR/R002827/1/Medical Research Council

MeSH Term

Humans
Adolescent
Male
Female
Suicide, Attempted
Uganda
Child
Depression
Cohort Studies
Peer Group
Child Abuse
Longitudinal Studies
Prevalence
Violence

Word Cloud

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