The relationship between parent mental health and intimate partner violence on adolescent behavior, stigma and school attendance in families in rural Democratic Republic of Congo

Abstract

Background.Prolonged conflict and economic instability challenge the existing support networks in families and society places significant stress on both adults and adolescents. Exploring individual, family and social factors that increase the likelihood of or protect adolescents from negative outcomes are important to the development of evidence-based prevention and response programing in global settings.Objective.Examine the relationship between parent mental health and experience/perpetration of intimate partner violence (IPV) and adolescent behaviors, stigma, and school attendance. The relationship is further examined for differences by gender.Methods.Secondary analysis of data from an ongoing comparative effectiveness trial of a productive asset transfer program in eastern Democratic Republic of Congo (DRC).Results.Three hundred and eighty-eight adolescent and parent dyads were included in the analysis. The analysis demonstrated that parent mental health and IPV can have a negative impact their children's well-being and the impact is different for boys and girls, likely linked to gender roles and responsibilities in the home and community. Social relationships of adolescents, as reported through experienced stigma, were negatively impacted for both boys and girls. Parent report of symptoms of PTSD and depression had a stronger negative effect on girls’ outcomes, including experienced stigma, externalizing behaviors, and missed days of school than boys. For adolescent boys, their parent's report of IPV victimization/perpetration was associated with more negative behaviors at the 8-month follow-up assessment.Conclusion.The findings reinforce the critical importance of interventions that engage parents and their children in activities that advance health and improve relationships within the family.

Comparative effectiveness of an economic empowerment program on adolescent economic assets, education and health in a humanitarian setting

“…However, the greatest improvement in prosocial behaviors came for adolescents across all age groups in the RFR + PFP group. This is an important finding given that our previous research, as well as others, has demonstrated the potentially negative effects parents' poor mental health and marital violence has on adolescent health and social outcomes [15,29]. Engaging both parents and young adolescents in economic empowerment programs can result in the sharing of workloads to care for the animals (e.g., building the pen/hutch, preparing food for both the pig and rabbits, discussing use of proceeds from selling the animals) and strengthening the relationship not only between the adolescent and the parent, but also with other members of the family.…”

“…Adolescents represent about one-fourth of the world's population [1], with almost 90% living in low-and middleincome countries (LMIC), however, most research on programs to improve health and well-being during adolescence has taken place in high-income countries [2] and with older adolescents (ages [15][16][17][18][19] [3]. Comparatively little attention has been paid to young adolescents (10-14 years) living in low-resource and humanitarian settings, although this is beginning to change with global efforts to build knowledge and evidence for interventions in diverse LMICs specific to the needs of younger adolescents with the recognition that this is a time of significant and rapid physical, emotional, social, and cognitive changes in their lives [4].…”

“…To illustrate this, a study in rural villages experiencing deprivation and trauma associated with the prolonged conflict in DRC found that parent's report of poor mental health and victimization or perpetration of intimate partner violence (IPV) had a negative impact on their young adolescents' well-being, with different impacts for girls and boys. Specifically, parent's symptoms of post-traumatic stress disorder (PTSD) and depression had a stronger negative effect on girls, including experienced stigma (i.e., called names or insulted), internalizing behaviors (i.e., symptoms of depression), and school attendance (missed two or more days of school in past month) than boys [15]. These differences in health and educational outcomes for girls and boys are related to multiple factors including gender norms (e.g., informal rules and shared social expectations) that are defined and enacted during adolescence [16][17][18].…”

Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania

“…For mental health agencies, reducing psychological distress in the absence of efforts to prevent IPV, a major risk factor for psychological distress, may undermine the potential for sustained psychological benefits for women who remain at risk for ongoing violence [38, 39]. Therefore, an integrated multi-sectoral strategy that incorporates intervention elements to address both IPV and mental health may operate synergistically and enhance the magnitude and longevity of intervention impacts on both health and protection outcomes [40]. Additionally, integrating health and protection services for IPV survivors may increase the efficiency of service delivery by improving the allocation of trained providers and reducing the need for referrals to other sectors.…”

Understanding Stigmatisation: Results of a Qualitative Formative Study with Adolescents and Adults in DR Congo

“…Twenty-one have concentrated on sex-related stigma, such as female survivors of stigma concerning sexual violence (Greiner et al 2014;Verelst et al 2014;Babalola et al 2015;Scott et al 2015;Murray et al 2018a, b;Wachter et al 2018) and male survivors, (Christian et al 2011), and HIV (Newman et al 2012;Musumari and Feldman 2013;Gebremedhin and Tesfamariam 2017;Tshingani et al 2017;Venables et al 2019). Other studies have discussed stigma related to intimate partner violence (Kohli et al 2015;Glass et al 2018), abortion (Casey et al 2019;Steven et al 2019), syphilis (Nkamba et al 2017), fistula (Young-Lin et al 2015) and contraception-use (Muanda et al 2018). A large-scale DRC-based study on maternal-child relationships of children born out of sexual violence indicated the need for interventions to reduce stigma and increase acceptance for children conceived from sexual violence and their mothers alike (Rouhani et al 2015).…”