Poly-victimisation and mental health and quality of life of adolescents in Vietnam
2017-02-09T01:23:39Z (GMT) by
<b>Background:</b> Poly-victimisation, defined as exposure to multiple forms of victimisation, has been shown to be prevalent and associated with poor health and wellbeing among adolescents living in high and upper-middle income countries. However, little evidence is available about low and lower-middle income countries, including Vietnam. <br> <br> <b>Aims:</b> The aims of this project were to: 1) review the existing evidence about exposure to violence; 2) determine the prevalence of poly-victimisation and 3) identify the associations between poly-victimisation and health and wellbeing among adolescents in Vietnam. <br> <br> <b>Method:</b> There were two empirical components to this PhD project. The first comprised a secondary-analysis of existing data about exposure to intimate partner violence (IPV) among married adolescents and young adults from the Survey Assessment of Vietnamese Youth 2 2009-10 (SAVY 2). <br> <br> The second comprised an anonymous, self-completed, cross-sectional survey of 1,616 students recruited from ten public and private high schools and centres for continuing education in Hanoi, Vietnam. The survey was designed for this study and assessed lifetime exposure to poly-victimisation, involvement in health-risk behaviours, common mental disorders, suicidal ideation and health-related quality of life. Poly-victimisation was assessed using the Juvenile Victimisation Questionnaire Revised-2 (JVQ R2). Involvement in health risk behaviours and suicidal ideation were assessed using questions adapted from the 2013 Youth Risk Behaviours Survey; mental health symptoms using the Depression, Anxiety and Stress Scale-21 (DASS-21); and health-related quality of life was assessed using the Duke Health Profile Adolescent Version (DHP-A). <br> <br> <b>Results: </b><br> Comp<i>onent one: </i>A total of 1,701 ever-married adolescents and young adults out of 10,044 participants in SAVY 2 provided data about IPV and were included in the secondary analysis. Intimate partner violence, including verbal, physical and sexual abuse, were found to be prevalent among both young women (24.8%) and men (19.2%). For female adolescents, religious affiliation, low socio-economic status, being illiterate, childhood exposure to physical and sexual violence, and marriage before age 18 were associated with an increased risk of IPV. For male adolescents, a significant association was found only for low socio-economic status. <br> <br> There was no assessment of violence perpetrated by peers or siblings, dating violence, cyber bulling or witnessing of family or community violence. This led to the second component of this project. <br> <br> <i>Component two:</i> A total of 1,616/ 1,745 eligible students (92.6%) completed the survey. Lifetime exposure to victimisation was prevalent with 94.3% (95% CI: 92.5-95.4%) students reporting exposure to any victimisation and 31.1% (95% CI: 27.8-33.5%) reporting poly-victimisation, defined as exposure to more than ten forms. Adolescents who lived in a rural location, had a chronic disease/disability, lived with a step-parent, experienced family life as unhappy, or had experienced a high number of adverse life events were more likely to be poly-victimised. <br> <br> Poly-victims were significantly more likely to be involved in risky behaviours, experience symptoms of mental health problems and be at increased risk of suicidal ideation compared to non-victims or victims of fewer forms of victimisation. Poly-victims also had poorer health-related quality of life, compared to non-victims or victims of fewer forms. <br> <br> <b>Conclusions: </b>Poly-victimisation is prevalent and significantly associated with poor mental health and quality of life among adolescents in Vietnam. Future research and intervention programs are needed to assist victims of violence, prevent violence against adolescents and improve the mental health of young people in Vietnam.