University of Oxford, Oxford, England, UK.
OPTENTIA, School of Behavioural Sciences, North-West University, Vanderbijlpark, South Africa.
J Glob Health. 2017 Jun;7(1):010410. doi: 10.7189/jogh.07.010410.
Research on emotional child abuse in sub-Saharan Africa is scarce. Few studies thus far have examined prevalence, risk and protective factors for emotional child abuse or the associations between emotional abuse and girls' health.
A nationally representative two-stage, cluster-sampled, household survey of females aged 13-24 years (n = 1244) on childhood abuse victimisation was conducted. Participants completed interviewer-assisted questionnaires. Associations between emotional abuse and putative risk, and protective factors and health outcomes were analyzed using separate logistic regression models accounting for sampling design. Marginal effects of cumulative risk factors for emotional abuse victimisation were examined.
Lifetime prevalence of emotional abuse was 28.5% with 58.3% of these girls reporting many abusive incidents. The most common perpetrators were female (27.8%) and male (16.7%) relatives and, more rarely, biological parents. Risk factors associated with emotional abuse were frequent caregiver changes (odds ratio (OR) 1.42, 95% confidence interval (CI) 1.03-1.970, poverty (OR 1.51, 95% CI 1.12-2.03), and physical abuse (OR 1.98, 95% CI 1.45-2.71) and sexual abuse (OR 2.22, 95% CI 1.57-3.10) victimisation. Being close to one's mother was a protective factor (OR 0.88, 95% CI 0.80-0.97). Risk for emotional abuse increased from 13% with no risk factors present to 58.4% -with all four risk factors present. Health outcomes associated with emotional child abuse were suicidal ideation (OR 1.85, 95% CI 1.30-2.63) and feeling depressed (OR 1.89, 95% CI 1.31-2.71).
Girls in Swaziland experience high levels of emotional abuse victimisation. Emotional abuse is associated with economic disadvantage, family factors, other types of abuse victimisation and poor mental health. Therefore, a holistic approach to prevention is needed, incorporating poverty reduction and programmes to improve parent-child relationships, reduce the use of harsh criticism, and change parenting social norms.
撒哈拉以南非洲地区关于情感虐待儿童的研究很少。迄今为止，很少有研究调查情感虐待儿童的流行率、风险和保护因素，也没有研究情感虐待与女孩健康之间的关联。
采用两阶段、聚类抽样、家庭调查方法，对年龄在 13-24 岁的女性（n=1244 人）进行了童年期受虐待情况的调查。参与者完成了访员协助的问卷调查。使用单独的逻辑回归模型分析情感虐待与假定的风险和保护因素以及健康结果之间的关联，这些模型考虑了抽样设计。还检查了情感虐待受害的累积风险因素的边际效应。
终生情感虐待的流行率为 28.5%，其中 58.3%的女孩报告有多次虐待事件。最常见的施虐者是女性（27.8%）和男性（16.7%）亲属，更罕见的是亲生父母。与情感虐待相关的风险因素包括频繁更换照顾者（比值比[OR] 1.42，95%置信区间[CI] 1.03-1.970）、贫困（OR 1.51，95% CI 1.12-2.03）、身体虐待（OR 1.98，95% CI 1.45-2.71）和性虐待（OR 2.22，95% CI 1.57-3.10）。与母亲亲近是一种保护因素（OR 0.88，95% CI 0.80-0.97）。情感虐待的风险从没有风险因素的 13%增加到有所有四个风险因素的 58.4%。与情感虐待儿童有关的健康结果包括自杀意念（OR 1.85，95% CI 1.30-2.63）和感觉抑郁（OR 1.89，95% CI 1.31-2.71）。
斯威士兰的女孩经历了高水平的情感虐待。情感虐待与经济劣势、家庭因素、其他类型的虐待受害以及心理健康不良有关。因此，需要采取整体预防方法，包括减少贫困和改善亲子关系、减少使用严厉批评以及改变育儿社会规范的方案。
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