Polyvictimization and its Influence on Adolescent Health and Well-Being in Ethiopia: Patterns, Risk Factors, and Resilience
Open AccessBackground: Interpersonal violence is a pervasive experience affecting one billion children and adolescents annually, resulting in adverse health and well-being outcomes. Evidence suggests that polyvictimization, the experience of multiple forms of violence, is associated with more harmful consequences for adolescents than experiencing individual types of violence, although data from low-and middle-income countries (LMICs) are limited. Consequentially, few studies have identified the patterns of polyvictimization, and associated individual, interpersonal, household, and community level risk factors in LMICs. Methods: The first study in this dissertation analyzed data on 4,106 younger adolescents from the Gender and Adolescence, Global Evidence (GAGE) Study in Ethiopia to examine the association between polyvictimization and adolescent mental and physical health and the mediating role of resilience using linear regression and path analysis. We hypothesized that adolescents experiencing polyvictimization would experience worse mental and physical health than those experiencing no types or individual types of victimization, and that resilience would mediate these relationships. The second study analyzed data on 7,483 younger and older adolescents from GAGE in Ethiopia to identify latent groups of adolescents with similar patterns of polyvictimization using latent class analysis, and the risk factors associated with these experiences using latent variable multinomial logistic regression, including how adolescent age and sex may drive these groupings and associations. Results: In study 1, half of sampled girls and over half of boys experienced polyvictimization. Among both sexes, polyvictimization was associated with worse mental but not worse physical health. Resilience mediated the association between polyvictimization and mental health among girls only. In study 2, the latent class analysis results indicated that the number and type of latent classes varied by adolescent age and sex. Among younger adolescent girls and older adolescent girls, four classes of polyvictimization with distinct patterns emerged. Among boys, the number of classes differed across age cohorts. Among younger boys, we identified three classes, and among older boys, we identified two classes. Among each age and sex cohort, we identified severely polyvictimized adolescents, with high probabilities of experiencing multiple forms of violence. Polyvictimization risk factors at individual, interpersonal, household, and community levels were identified, and the significant risk and protective factors varied by age, sex, and class. In some cases, a predictor (e.g., age) that was protective for one class was a risk factor for another class. Discussion: This dissertation contributes to understanding the distinct antecedents, patterns, and experiences of polyvictimized adolescents, and its findings can be used to better orient future research and prevention, identification, and care efforts. Strengthening resilience among girls may be an effective avenue for mitigating polyvictimization’s negative mental health effects, but additional research and programming for preventing and identifying polyvictimized adolescents and linking them to care is needed.
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