Skip to main content Accessibility help
×
Home

Latent class analysis of violence against adolescents and psychosocial outcomes in refugee settings in Uganda and Rwanda

  • S. R. Meyer (a1), G. Yu (a1) (a2), S. Hermosilla (a3) and L. Stark (a1)

Abstract

Background

Little is known about violence against children in refugee camps and settlements, and the evidence-base concerning mental health outcomes of youth in refugee settings in low and middle-income countries is similarly small. Evidence is needed to understand patterns of violence against children in refugee camps, and associations with adverse mental health outcomes.

Methods

Surveys were conducted with adolescent refugees (aged 13–17) in two refugee contexts – Kiziba Camp, Rwanda (n = 129) (refugees from Democratic Republic of Congo) and Adjumani and Kiryandongo refugee settlements, Uganda (n = 471) (refugees from South Sudan). Latent Class Analysis was utilized to identify classes of violence exposure (including exposure to witnessing household violence, verbal abuse, physical violence and sexual violence). Logistic regressions explored the association between latent class of violence exposure and symptoms of depression and anxiety.

Results

In Rwanda, a two-class solution was identified, with Class 1 (n = 33) representing high levels of exposure to violence and Class 2 (n = 96) representing low levels of exposure. In Uganda, a three-class solution was identified: Class 1 (high violence; n = 53), Class 2 (low violence, n = 100) and Class 3 (no violence, n = 317). Logistic regression analyses indicated that latent violence class was associated with increased odds of high anxiety symptoms in Rwanda (AOR 3.56, 95% CI 1.16–0.95), and high v. no violence class was associated with depression (AOR 3.97, 95% CI 1.07–7.61) and anxiety symptoms (AOR 2.04, 95% CI 1.05–3.96) in Uganda.

Conclusions

The present results support the existing evidence-base concerning the association between violence and adverse mental health outcomes, while identifying differences in patterns and associations between refugee youth in two different contexts.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org 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 @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ 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.

      Latent class analysis of violence against adolescents and psychosocial outcomes in refugee settings in Uganda and Rwanda
      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.

      Latent class analysis of violence against adolescents and psychosocial outcomes in refugee settings in Uganda and Rwanda
      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.

      Latent class analysis of violence against adolescents and psychosocial outcomes in refugee settings in Uganda and Rwanda
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Address for correspondence: S. R. Meyer, Columbia University Mailman School of Public Health, Population and Family Health, New York, NY, USA. (Email: sm3992@cumc.columbia.edu)

References

Hide All
Adaku, A, Okello, J, Lowry, B, Kane, JC, Alderman, S, Musisi, S, ToL, WA (2016). Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment. Conflict and Health 10, 18.
Anda, RF, Felitti, VJ, Bremner, JD, Walker, JD, Whitfield, C, Perry, BD, Dube, SR, Giles, WH (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience 256, 174186.
Angold, A, Costello, EJ (1987). Mood and Feelings Questionnaire(MFQ), Child Self Report – Short Version. Duke University: Durham, NC.
Bair-Merritt, MH, Blackstone, M, Feudtner, C (2006). Physical health outcomes of childhood exposure to intimate partner violence: a systematic review. Pediatrics 117, e278e290.
Betancourt, TS, Borisova, I, Williams, TP, Meyers-Ohki, SE, Rubin-Smith, JE, Annan, J, Kohrt, BA (2013). Psychosocial adjustment and mental health in former child soldiers–systematic review of the literature and recommendations for future research. Journal of Child Psychology and Psychiatry 54, 1736.
Birmaher, B, Brent, DA, Chiappetta, L, Bridge, J, Monga, S, Baugher, M (1999). Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): a replication study. Journal of the American Academy of Child and Adolescent Psychiatry 38, 12301236.
Blum, RW, Astone, NM, Decker, MR, Mouli, VC (2014). A conceptual framework for early adolescence: a platform for research. International Journal of Adolescent Medicine and Health 26, 321331.
Cardoso, LF, Gupta, J, Shuman, S, Cole, H, Kpebo, D, Falb, KL (2016). What factors contribute to intimate partner violence against women in Urban, conflict-affected settings? Qualitative findings from Abidjan, Cote d'Ivoire. Journal of Urban Health 93, 364378.
Cherewick, M, Kohli, A, Remy, MM, Murhula, CM, Kurhorhwa, AK, Mirindi, AB, Bufole, NM, Banywesize, JH, Ntakwinja, GM, Kindja, GM, Glass, N (2015). Coping among trauma-affected youth: a qualitative study. Conflict and Health 9, 35.
Choi, HJ, Weston, R, Temple, JR (2016). A Three-Step Latent Class Analysis to Identify How Different Patterns of Teen Dating Violence and Psychosocial Factors Influence Mental Health. J Youth Adolesc 46, 854866.
Clarke, K, Patalay, P, Allen, E, Knight, L, Naker, D, Devries, K (2016). Patterns and predictors of violence against children in Uganda: a latent class analysis. BMJ Open 6, e010443.
Coker, EM (2004). ‘Traveling pains’: embodied metaphors of suffering among Southern Sudanese refugees in Cairo. Culture, Medicine, and Psychiatry 28, 1539.
Davies, L, Ford-Gilboe, M, Willson, A, Varcoe, C, Wuest, J, Campbell, J, Scott-Storey, K (2015). Patterns of cumulative abuse among female survivors of intimate partner violence: links to women's health and socioeconomic status. Violence Against Women 21, 3048.
Davis, KC, Masters, NT, Casey, E, Kajumulo, KF, Norris, J, George, WH (2015). How childhood maltreatment profiles of male victims predict adult perpetration and psychosocial functioning. Journal of Interpersonal Violence. Article first published online: November 20, 2015 DOI: https://doi-org.ezproxy.cul.columbia.edu/10.1177/0886260515613345
Falb, KL, Asghar, K, Laird, B, Tanner, S, Graybill, E, Mallinga, P, Stark, L (2017). Caregiver parenting and gender attitudes: associations with violence against adolescent girls in South Kivu, Democratic Republic of Congo. Child Abuse & Neglect 69, 278284.
Fazel, M, Reed, RV, Panter-Brick, C, Stein, A (2012). Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet 379, 266282.
Felitti, VJ, Anda, RF, Nordenberg, D, Williamson, DF, Spitz, AM, Edwards, V, Koss, MP, Marks, JS (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine 14, 245258.
Feseha, G, Abebe, GM, Gerbaba, M (2012). Intimate partner physical violence among women in Shimelba refugee camp, northern Ethiopia. BMC Public Health 12, 125.
Goodman, JH (2004). Coping with trauma and hardship among unaccompanied refugee youths from Sudan. Qualitative Health Research 14, 11771196.
Hillis, S, Mercy, J, Amobi, A, Kress, H (2016). Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics 137, e20154079.
Hossain, M, Zimmerman, C, Kiss, L, Kone, D, Bakayoko-Topolska, M, Manan, DK, Lehmann, H, Watts, C (2014). Men's and women's experiences of violence and traumatic events in rural Cote d'Ivoire before, during and after a period of armed conflict. BMJ Open 4, e003644.
Ismayilova, L, Gaveras, E, Blum, A, To-Camier, A, Nanema, R (2016). Maltreatment and mental health outcomes among ultra-poor children in Burkina faso: a latent class analysis. PLoS ONE 11, e0164790.
ISPCAN (2015). ISPCAN Child Abuse Screening Tools (ICAST) – Child Version. ISPCAN: Aurora, CO.
Kane, JC, Ventevogel, P, Spiegel, P, Bass, JK, Van Ommeren, M, Tol, WA (2014). Mental, neurological, and substance use problems among refugees in primary health care: analysis of the Health Information System in 90 refugee camps. BMC Medicine 12, 228.
Kohrt, BA, Jordans, MJD, Tol, WA, Speckman, RA, Maharjan, SM, Worthman, CM, komproe, IH (2008). Comparison of mental health between former child soldiers and children never conscripted by armed groups in Nepal. Journal of the American Medical Association 300, 691702.
Loescher, G (2011). The global crisis of protracted displacement. World Politics Review. http://www.worldpoliticsreview.com/articles/7804/the-global-crisis-of-protracted-displacement
Lundgren, R, Amin, A (2015). Addressing intimate partner violence and sexual violence among adolescents: emerging evidence of effectiveness. Journal of Adolescent Health 56, S42S50.
Mcchesney, GC, Adamson, G, Shevlin, M (2015). A latent class analysis of trauma based on a nationally representative sample of US adolescents. Social Psychiatry and Psychiatric Epidemiology 50, 12071217.
Mersky, JP, Topitzes, J, Reynolds, AJ (2013). Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: a cohort study of an urban, minority sample in the US. Child Abuse & Neglect 37, 917925.
Muthen, L. K., & Muthen, B. O. (1998). Mplus users guide (3rd ed.). Los Angeles, CA: Muthen & Muthen.
Neuner, F, Schauer, M, Karunakara, U, Klaschik, C, Robert, C, Elbert, T (2004). Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry 4, 34.
Nooner, KB, Litrownik, AJ, Thompson, R, Margolis, B, English, DJ, Knight, ED, Everson, MD, Roesch, S (2010). Youth self-report of physical and sexual abuse: a latent class analysis. Child Abuse Negl 34, 146–54.
Norman, RE, Byambaa, M, De, R, Butchart, A, Scott, J, Vos, T (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Medicine 9, e1001349.
Panter-Brick, C, Goodman, A, Tol, W, Eggerman, M (2011). Mental health and childhood adversities: a longitudinal study in Kabul, Afghanistan. Journal of the American Academy of Child and Adolescent Psychiatry 50, 349363.
Plan International (2016). A time of transition: Plan International's work with and for adolescents in humanitarian settings Plan International.
Reed, RV, Fazel, M, Jones, L, Panter-Brick, C, Stein, A (2011). Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet 379, 250265.
Rubenstein, BL, Stark, L (2017). The impact of humanitarian emergencies on the prevalence of violence against children: an evidence-based ecological framework. Psychology Health and Medicine, 22(sup1): 5866.
Sipsma, HL, Falb, KL, Willie, T, Bradley, EH, Bienkowski, L, Meerdink, N, Gupta, J (2015). Violence against Congolese refugee women in Rwanda and mental health: a cross-sectional study using latent class analysis. BMJ Open 5, e006299.
Spiegel, PB, Checchi, F, Colombo, S, Paik, E (2010). Health-care needs of people affected by conflict: future trends and changing frameworks. Lancet 375, 341345.
Stark, L, Ager, A (2011). A systematic review of prevalence studies of gender-based violence in complex emergencies. Trauma Violence Abuse 12, 127134.
Stark, L, Asghar, K, Yu, G, Bora, C, Baysa, AA, Falb, KL (2017). Prevalence and associated risk factors of violence against conflict-affected female adolescents: a multi-country, cross-sectional study. Journal of Global Health 7, 010416.
Stark, L, Decormier Plosky, W, Horn, R, Canavera, M (2015). ‘He always thinks he is nothing’: the psychosocial impact of discrimination on adolescent refugees in urban Uganda. Social Science & Medicine 146, 173181.
Sumner, SA, Mercy, JA, Buluma, R, Mwangi, MW, Marcelin, LH, Kheam, T, Lea, V, Brookmeyer, K, Kress, H, Hillis, SD (2016). Childhood sexual violence against boys: a study in 3 countries. Pediatrics 137, pii: e20153386. doi: 10.1542/peds.2015-3386. Epub 2016 Apr 18.
The Ministry of Gender, Children, Disability and Social Welfare, Republic of Malawi (2013). Violence Against Children and Young Women in Malawi: Findings from a National Survey, 2013. Malawi.
Tol, WA, Komproe, IH, Jordans, MJ, Vallipuram, A, Sipsma, H, Sivayokan, S, Macy, RD, Jt De, J (2012). Outcomes and moderators of a preventive school-based mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial. World Psychiatry 11, 114122.
Verelst, A, De Schryver, M, Broekaert, E, Derluyn, I (2014 a). Mental health of victims of sexual violence in eastern Congo: associations with daily stressors, stigma, and labeling. BMC Womens Health 14, 106.
Verelst, A, De Schryver, M, De Haene, L, Broekaert, E, Derluyn, I (2014 b). The mediating role of stigmatization in the mental health of adolescent victims of sexual violence in Eastern Congo. Child Abuse & Neglect 38, 11391146.
WHO (2016). INSPIRE: Seven Strategies for Ending Violence Against Women. World Health Organization: Geneva.
Witt, A, Munzer, A, Ganser, HG, Fegert, JM, Goldbeck, L, Plener, PL (2016). Experience by children and adolescents of more than one type of maltreatment: association of different classes of maltreatment profiles with clinical outcome variables. Child Abuse & Neglect 57, 111.
Yu, G, Wall, MM, Chiasson, MA, Hirshfield, S (2015). Complex drug use patterns and associated HIV transmission risk behaviors in an Internet sample of U.S. men who have sex with men. Archives of Sexual Behavior 44, 421428.

Keywords

Type Description Title
WORD
Supplementary materials

Meyer et al supplementary material
Meyer et al supplementary material 1

 Word (53 KB)
53 KB

Latent class analysis of violence against adolescents and psychosocial outcomes in refugee settings in Uganda and Rwanda

  • S. R. Meyer (a1), G. Yu (a1) (a2), S. Hermosilla (a3) and L. Stark (a1)

Metrics

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