Polyvictimization and Adolescent Health and Well-Being in Ethiopia: The Mediating Role of Resilience

Abstract

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 are limited. This study analyzed data on over 4100 adolescents from the Gender and Adolescence, Global Evidence 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. 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. 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.

Keywords: Ethiopia; adolescence; gender; mental health; path analysis; physical health; polyvictimization; resilience.

Figure A1

Path analysis of resilience, sexual victimization and mental health among adolescent females. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A2

Path analysis of resilience, sexual victimization and mental health among adolescent males. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A3

Path analysis of resilience, witnessing violence and mental health among adolescent females. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A4

Path analysis of resilience, witnessing violence and mental health among adolescent males. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A5

Path analysis of resilience, polyvictimization and physical health among adolescent females. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A6

Path analysis of resilience, polyvictimization and physical health among adolescent males. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A7

Path analysis of resilience, sexual violence and physical health among adolescent females. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A8

Path analysis of resilience, sexual violence and physical health among adolescent males. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A9

Path analysis of resilience, witnessing violence against adolescents’ mothers/female guardians and physical health among adolescent females. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure A10

Path analysis of resilience, witnessing violence against adolescents’ mothers/female guardians and physical health among adolescent males. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure 1

The Integrated Framework for Addressing Violence Affecting Children. Adapted from the Child-Centered Integrated Framework for Violence Prevention [43,64,66].

Figure 2

Map of GAGE research sites in Ethiopia; rural research sites are labeled in purple and urban research sites are labeled in orange [69].

Figure 3

Mediation model of resilience, polyvictimization, and mental or physical health. Note that for visual clarity, control variables are omitted. Paths ab = indirect effect of polyvictimization on poorer mental or physical health through resilience. Path c′ = direct effect of polyvictimization on poorer physical or mental health. Term a × b + c′ = total effects.

Figure 4

Path analysis of resilience, polyvictimization, and mental health among adolescent females. Notes: Standardized coefficients are reported with robust standard errors in parentheses.

Figure 5

Path analysis of resilience, polyvictimization, and mental health among adolescent males. Notes: Standardized coefficients are reported with robust standard errors in parentheses.