Mental Health, Quality of Life and Violence Exposure in Low-Socioeconomic Status Children and Adolescents of Guatemala

Abstract

Growing up in vulnerable conditions has an impact on children and adolescents’ mental health and well-being outcomes. However, this evidence has rarely been obtained in middle and low-income countries like Guatemala, where food insecurity and exposure to violence frequently threaten childhood development. The aim of this study was to analyse the relations that sociodemographic and socioeconomic factors have with psychological adjustment of low-socioeconomic status (SES) Guatemalan children and adolescents, and how these relations were mediated by food insecurity and exposure to violence. A total of 185 participants (50.8% girls; aged between 6 to 17, M = 11.82, SD = 3.7) from three vulnerable schools located in rural and urban areas of Guatemala were assessed. The results indicated that exposure to violence significantly moderates the effect of sociodemographic and socioeconomic variables in measures of depression, anxiety and health-related quality of life. Adolescents more exposed to violence reported higher levels of depression and anxiety, as well as lower levels of health-related quality of life. In contrast, food insecurity did not seem to influence psychological adjustment outcomes in this low-SES sample. These findings highlight the relevance of exposure to violence for mental health and well-being, and is a factor that should be considered when designing public health policies to promote children and adolescents’ welfare.

How Living in Vulnerable Conditions Undermines Cognitive Development: Evidence from the Pediatric Population of Guatemala

“…Considering the importance that attentional, linguistic, and executive processes have in academic performance, our results contribute to understanding the impact that vulnerability conditions may add in these children and adolescent cognitive development and school trajectories. This unequal situation represents a real threat for their present and future psychosocial adjustment and well-being [ 12 ], and we believe that these findings could provide relevant information for specific educational interventions and public health policies to enhance vulnerable children and adolescent cognitive development and quality of life.…”

“…This results in increased cortisol levels, which especially affect prefrontal areas that are involved in cognitive functions such as working memory, cognitive flexibility, and inhibition, along with more general functions, such as self-regulation cognitive and emotional processes. Those factors end up negatively affecting children’s health and psychological wellbeing as well as quality of life [ 12 ]. In turn, this results in difficulties for children in escaping the effects of these early negative influences, even once adulthood has been reached [ 13 ].…”

“…This sample showed higher cortisol levels and less activation of the right hemisphere areas involved in social perception as well as cognition. A more recent study examined the effects of exposure to violence along with food concern on the relationship between socioeconomic characteristics and mental health indicators in children and adolescents living in vulnerable conditions in Guatemala [ 12 ]. These authors found a moderating effect of exposure to violence on the relationship between socioeconomic characteristics and depression, anxiety, and health-related quality of life such that higher exposure to violence resulted in higher scores in depression and anxiety indicators.…”

Editors’ Comments on the Special Issue “Social Determinants of Mental Health”

“…The authors found that students with mental health symptoms were more frequently involved in risky behaviours. The last article analysed the relationships that sociodemographic and socioeconomic factors had with the psychological adjustment of low socioeconomic status (SES) Guatemalan children and adolescents and how these relationships were mediated by food insecurity and exposure to violence [ 18 ]. The results revealed that violence exposure was positively related to both depression and anxiety and negatively related to health-related quality of life.…”

Normative Data for Ten Neuropsychological Tests for the Guatemalan Pediatric Population Updated to Account for Vulnerability

“…Anxiety: Anxiety symptomatology was assessed using the General Anxiety Subscale of the Revised Child Anxiety and Depression Scale, RCADS [32]. Good psychometric properties, such as internal consistency across countries and different languages [40], and adequate internal consistency in the Guatemalan pediatric population [41] were shown by this scale. This study used a subscale of 6 items answered on a scale ranging from 0 to 3, and questions on her/his feelings were assessed only for 3rd grade and above children.…”