Skip to main content Accessibility help

The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo

  • L. Stark (a1), K. Asghar (a1), S. Meyer (a1), G. Yu (a2), T. Bakemore (a3), C. Poulton (a4) and K. Falb (a5)...



Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls’ hope in these settings. We assessed attitudes toward traditional gender norms as an effect modifier of the relationship between violence exposure and future orientation in displaced girls.


Secondary analysis, using multivariable regression of cross-sectional data from girls ages 10–14 in South Kivu, Democratic Republic of the Congo. Key variables of interest were attitudes toward intimate partner violence (IPV), Children's Hope Scale (CHS) score, and exposure to physical, emotional, and sexual violence within the last 12 months. Additional covariates included age, educational status, and territory.


The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for physical violence (β = −0.09, p = 0.040) and unwanted sexual touching (β = −0.20, p = 0.003) among girls age 10–14, when adjusting for other covariates. The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for forced sex (β = −0.22, p = 0.016) among girls age 13–14, when adjusting for covariates. Findings for emotional violence, any form of sexual violence, and coerced sex trended toward lower CHS scores for girls who reported higher acceptance of IPV, but did not reach significance.


Findings support the utility of gender norms-transformative programming in increasing resilience of girls who have experienced sexual violence in humanitarian contexts.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo
      Available formats


This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Address for correspondence: Dr L. Stark, DrPH, Associate Professor, Department of Population and Family Health, Columbia University, 60 Haven Avenue B-4, New York NY 10032, USA. (Email:


Hide All
Attanayake, V, McKay, R, Joffres, M, Singh, S, Burkle, F Jr., Mills, E (2009). Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. Medicine, Conflict, and Survival 25, 419.
Ayyash, H, Sanchez-Ruiz, M-J, Barbari, ML (2016). Resiliency predicts academic performance of Lebanese adolescents over demographic variables and hope. Learning and Individual Differences 48, 916.
Bass, JK, Annan, J, McIvor Murray, S, Kaysen, D, Griffiths, S, Cetinoglu, T, Wachter, K, Murray, LK, Bolton, PA (2013). Controlled trial of psychotherapy for Congolese survivors of sexual violence. New England Journal of Medicine 368, 21822191.
Bell, M (2006). Child alert: Democratic Republic of Congo (
Broderick, PC, Korteland, C (2002). Coping style and depression in early adolescence: relationships to gender, gender role, and implicit beliefs. Sex Roles 46, 201213.
Chrisler, JC, Ferguson, S (2006). Violence against women as a public health issue. Annals of the New York Academy of Sciences 1087, 235249.
Demographic and Health Survey (2007). Congo Democratic Republic: Standard DHS, 2007, August 2008.
Diekman, AB, Goodfriend, W (2006). Rolling with the changes: a role congruity perspective on gender norms. Psychology of Women Quarterly 30, 369383.
Eagly, AH, Diekman, AB (2005). What is the problem? Prejudice as an attitude in-context. In On the nature of prejudice: Fifty years after Allport (ed. Dovidio, J. F., Glick, P. and Rudman, L. A.), pp. 1925. Blackwell: Malden, MA.
Eagly, AH, Koenig, AM (2008). Gender prejudice: on the risks of occupying incongruent roles. In Beyond Common Sense: Psychological Science in the Courtroom (ed. Borgida, E. and Fiske, S. T.), pp. 6382. Blackwell: Malden, MA.
Eggerman, M, Panter-Brick, C (2010). Suffering, hope, and entrapment: resilience and cultural values in Afghanistan. Social Science and Medicine 71, 7183.
Falb, K, Tanner, S, Ward, L, Erskine, D, Noble, E, Assazenew, A, Bakomere, T, Graybill, E, Lowry, C, Mallinga, P, Neiman, A, Poulton, C, Robinette, K, Sommer, M, Stark, L (2016). Creating opportunities through mentorship, parental involvement, and safe spaces (COMPASS) program: multi-country study protocol to protect girls from violence in humanitarian settings. BMC Public Health 16, 110.
Finkelhor, D, Hotaling, G, Lewis, IA, Smith, C (1990). Sexual abuse in a national survey of adult men and women: prevalence, characteristics and risk factors. Child Abuse and Neglect 14, 1928.
Geiger, KA, Kwon, P (2010). Rumination and depressive symptoms: evidence for the moderating role of hope. Personality and Individual Differences 49, 391395.
Gilman, R, Dooley, J, Florell, D (2006). Relative levels of hope and their relationship with academic and psychological indicators among adolescents. Journal of Social and Clinical Psychology 25, 166178.
Gupta, J, Falb, KL, Lehmann, H, Kpebo, D, Xuan, Z, Hossain, M, Zimmerman, C, Watts, C, Annan, J (2013). Gender norms and economic empowerment intervention to reduce intimate partner violence against women in rural Cote d'Ivoire: a randomized controlled pilot study. BMC International Health and Human Rights 13, 46.
Gushue, GV, Scanlan, KLR, Pantzer, KM, Clarke, CP (2006). The relationship of career decision-making self-efficacy, vocational identity, and career exploration behavior in African-American high school students. Journal of Career Development 33, 1928.
Heise, L (2011). What Works to Prevent Partner Violence: An Evidence Overview. STRIVE Research Consortium. London School of Hygiene and Tropical Medicine, London UK.
Hindin, MJ, Fatusi, AO (2009). Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions. International Perspectives on Sexual and Reproductive Health 35, 5862.
Hobfoll, SE, Watson, P, Bell, CC, Bryant, RA, Brymer, MJ, Friedman, MJ, Friedman, M, Gersons, BP, de Jong, JT, Layne, CM, Maguen, S, Neria, Y, Norwood, AE, Pynoos, RS, Reissman, D, Ruzek, JI, Shalev, AY, Solomon, Z, Steinberg, AM, Ursano, RJ (2007). Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry 70, 283315.
Jaycox, LH, Stein, BD, Kataoka, SH, Wong, M, Fink, A, Escudero, P, Zaragoza, C (2002). Violence exposure, posttraumatic stress disorder, and depressive symptoms among recent immigrant schoolchildren. Journal of the American Academy of Child and Adolescent Psychiatry 41, 11041110.
Jordans, MJD, Komproe, IH, Tol, WA, Kohrt, BA, Luitel, NP, Macy, RD, de Jong, TVM (2010). Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial. Journal of Child Psychology and Psychiatry 51, 818826.
Jordans, MJD, Pigott, H, Tol, WA (2016). Interventions for children affected by armed conflict: a systematic review of mental health and psychosocial support in low- and middle-income countries. Current Psychiatry Reports 18(9). Published online January 14, 2016. doi: 10.1007/s11920-015-0648-z.
Jovanović, V (2013). Evaluation of the children's hope scale in Serbian adolescents: dimensionality, measurement invariance across gender, convergent and incremental validity. Child Indicators Research 6, 797811.
Kasler, J, Dahan, J, Elias, MJ (2008). The relationship between sense of hope, family support and post-traumatic stress disorder among children: the case of young victims of rocket attacks in Israel. Vulnerable Children and Youth Studies 3, 182191.
Kazdin, AE, French, NH, Unis, AS, Esveldt-Dawson, E, Sherick, RB (1983). Hopelessness, depression, and suicidal intent among psychiatrically disturbed inpatient children. Journal of Consulting and Clinical Psychology 51, 504510.
Lichter, EL, McCloskey, LA (2004). The effects of childhood exposure to martial violence on adolescent gender-role beliefs and dating violence. Psychology of Women Quarterly 28, 344357.
Mels, C, Derluyn, I, Broekaert, E, Rosseel, Y (2010). The psychological impact of forced displacement and related risk factors on Eastern Congolese adolescents affected by war. Journal of Child Psychology and Psychiatry 51, 10961104.
Miller, KE, Jordans, MJD (2016). Miller determinants of children's mental health in war-torn settings: translating research into action. Current Psychiatry Reports 18(58). Published online before print April 18, 2016. doi: 10.1007/s11920-016-0692-3.
Mollica, RF, Poole, C, Son, L, Murray, CC, Tor, S (1997). Effects of war trauma on Cambodian refugee adolescents’ functional health and mental health status. Journal of the American Academy of Child and Adolescent Psychology 36, 10981106.
Morley, CA, Kohrt, BA (2013). Impact of peer support on PTSD, hope, and functional impairment: a mixed-methods study of child soldiers in Nepal. Journal of Aggression, Maltreatment and Trauma 22, 714734.
Patel, V, Flisher, AJ, Hetrick, S, McGorry, P (2007). Mental health of young people: a global public health challenge. Lancet 369, 13021313.
Peterman, A, Palermo, T, Bredenkamp, C (2011). Estimates and determinants of sexual violence against women in the Democratic Republic of Congo. American Journal of Public Health 101, 10601067.
Reed, RV, Fazel, M, Jones, L, Panter-Brick, C, Stein, A (2012). Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet 379, 250265.
Reza, A, Brieding, MJ, Gulaid, J, Mercy, JA, Clanton, C, Mthethwa, Z, Bamrah, S, Dahlberg, L, Anderson, M (2009). Sexual violence and its health consequences for female children in Swaziland: a cluster survey study. Lancet 373, 19661972.
Savahl, S, Isaacs, S, Adams, S, Zeta Carels, C, September, R (2013). An exploration into the impact of exposure to community violence and hope on children's perceptions of well-being: a South African Perspective. Child Indicators Research 6, 579592.
Snyder, CR, Hoza, B, Pelham, WE, Rapoff, M, Ware, L, Danovsky, M, Highberger, L, Ribinstein, H, Stahl, KJ (1997). The development and validation of the Children's Hope Scale. Journal of Pediatric Psychology 22, 399421.
Stark, L, Rubenstein, B, Mansourian, H, Spencer, C, Noble, E, Chisolm-Straker, M (2016). Estimating child separation in emergencies: results from North Kivu. Child Abuse and Neglect 52, 3846.
Thimm, JC, Holte, A, Brennen, T, Wang, CEA (2013). Hope and expectancies for future events in depression. Frontiers in Psychology 4, 470.
Tol, WA, Komproe, IH, Jordans, MJD, Ndayisha, A, Ntamutumba, P, Sipsma, H, Smallegange, ES, Macy, RD, de Jong, J (2014). School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial. BMC Medicine 12, 56.
Tol, WA, Komproe, IH, Susanty, D, Jordans, MJD, Macy, RD, De Jong, J (2008). School-based mental health intervention for children affected by political violence in Indonesia: a cluster randomized trial. JAMA 300, 655662.
Tol, WA, Patel, V, Tomlinson, M, Baingana, F, Galappatti, A, Panter-Brick, C, Silove, D, Sondorp, E, Wessells, M, van Ommeren, M (2011). Research priorities for mental health and psychosocial support in humanitarian settings. PLoS Med 8, e1001096.
Tol, WA, Song, S, Jordans, MJD (2013). Annual research review: resilience and mental health in children and adolescents living in areas of armed conflict – a systematic review of findings in low- and middle-income countries. Journal of Child Psychology and Psychiatry 54, 445460.
Tolin, DF, Foa, EB (2006). Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychological Bulletin 132, 959992.
Turner, HA, Finkelhor, D, Ormrod, R (2006). The effect of lifetime victimization on the mental health of children and adolescents. Social Science and Medicine 62, 1327.
UNOCHA (2008). Population Movements in Eastern Democratic Republic of the Congo, July 2008.
Valle, MF, Huebner, ES, Suldo, SM (2004). Further evaluation of the Children's Hope Scale. Journal of Psychoeducational Assessment 22, 320337.
Van der Kolk, BA (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books: New York.
van de Vijver, FJR (2007). Cultural and gender differences in gender-role beliefs, sharing household task and child-care responsibilities, and well-being among immigrants and majority members in The Netherlands. Sex Roles 57, 813824.
Yarcheski, A, Mahon, NE (2016). Meta-analyses of predictors of hope in adolescents. Western Journal of Nursing Research 38, 345368. Published online before print November 23, 2014. doi: 10.1177/0193945914559545.
Zhang, J, Zhao, G, Li, X, Hong, Y, Fang, X, Barnett, D, Lin, X, Zhao, J, Zhang, L (2009). Positive future orientation as a mediator between traumatic events and mental health among children affected by HIV/AIDS in rural China. AIDS Care 21, 15081516.
Zolotor, AJ, Runyan, DK, Dunne, MP, Jain, D, Peturs, HR, Ramirez, C, Volkova, E, Deb, S, Lidchi, V, Muhammad, T, Isaeva, O (2009). ISPCAN child abuse screening tool children's version (ICAST-C): instrument development and multi-national pilot testing. Child Abuse and Neglect 33, 833841.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed