Abstract：
OBJECTIVE: This study assessed associations between experiences of physical or sexual violence in childhood and self-harm, suicidal ideation, and suicide attempts among young people in low- and middle-income countries (LMICs) and whether these associations varied by sex and perpetrator identity.
METHODS: We used nationally representative data from the Violence Against Children and Youth Surveys in eight LMICs (2017-2019). The analytic sample included 33,381 young men and women (ages 13-24 years). Multivariable logistic regressions with country-fixed effects were used to estimate the associations between childhood physical and sexual violence and the three outcomes. Stratified analyses were performed by country, participant\'s sex, and type of perpetrator (parent/caregiver, other adults, peers, and intimate partner).
RESULTS: About 40% of the participants reported physical childhood violence, and 10% experienced childhood sexual violence. Childhood violence was associated with increased odds of self-harm (physical violence: adjusted odds ratio [aOR]: 2.2, 95% confidence interval [CI]: 2.0-2.4; sexual violence: aOR: 2.7, 95%, CI: 2.3-3.0), suicidal ideation (physical: aOR: 3.0, 95% CI: 2.7-3.3; sexual: aOR: 4.0, 95%, CI: 3.6-4.5), and suicide attempts (physical: aOR: 3.6, 95% CI: 3.2-4.1; sexual: aOR: 4.9, 95%, CI: 4.3-5.7). Consistent findings were observed in country-specific analyses. The odds of all outcomes were highest among those who experienced childhood physical violence by intimate partners and childhood sexual violence by parents or caregivers. Young women who experienced childhood sexual violence had higher odds for all outcomes than young men.
CONCLUSIONS: Violence prevention and mental health programs for young people in LMICs should consider the types of violence experienced, the perpetrator, and the sex of the survivor.
METHODS: We used nationally representative data from the Violence Against Children and Youth Surveys in eight LMICs (2017-2019). The analytic sample included 33,381 young men and women (ages 13-24 years). Multivariable logistic regressions with country-fixed effects were used to estimate the associations between childhood physical and sexual violence and the three outcomes. Stratified analyses were performed by country, participant\'s sex, and type of perpetrator (parent/caregiver, other adults, peers, and intimate partner).
RESULTS: About 40% of the participants reported physical childhood violence, and 10% experienced childhood sexual violence. Childhood violence was associated with increased odds of self-harm (physical violence: adjusted odds ratio [aOR]: 2.2, 95% confidence interval [CI]: 2.0-2.4; sexual violence: aOR: 2.7, 95%, CI: 2.3-3.0), suicidal ideation (physical: aOR: 3.0, 95% CI: 2.7-3.3; sexual: aOR: 4.0, 95%, CI: 3.6-4.5), and suicide attempts (physical: aOR: 3.6, 95% CI: 3.2-4.1; sexual: aOR: 4.9, 95%, CI: 4.3-5.7). Consistent findings were observed in country-specific analyses. The odds of all outcomes were highest among those who experienced childhood physical violence by intimate partners and childhood sexual violence by parents or caregivers. Young women who experienced childhood sexual violence had higher odds for all outcomes than young men.
CONCLUSIONS: Violence prevention and mental health programs for young people in LMICs should consider the types of violence experienced, the perpetrator, and the sex of the survivor.
摘要：
目的：这项研究评估了儿童时期身体暴力或性暴力的经历与自我伤害之间的关系，自杀意念,低收入和中等收入国家（LMICs）年轻人中的自杀企图，以及这些关联是否因性别和犯罪者身份而异。
方法：我们使用了来自八个低收入国家（2017-2019年）的暴力侵害儿童和青少年调查的全国代表性数据。分析样本包括33,381名年轻男女（13-24岁）。使用具有国家固定效应的多变量逻辑回归来估计儿童身体暴力和性暴力与三个结果之间的关联。分层分析按国家进行，参与者的性别，和犯罪者的类型(父母/看护人，其他成年人,同行,和亲密伴侣）。
结果：大约40％的参与者报告了儿童时期的身体暴力，10%的儿童经历过性暴力。儿童暴力与自我伤害的几率增加有关（身体暴力：调整后的优势比[aOR]：2.2，95％置信区间[CI]：2.0-2.4；性暴力：aOR：2.7，95％，CI：2.3-3.0），自杀意念（身体：aOR：3.0，95％CI：2.7-3.3；性：aOR：4.0，95％，CI:3.6-4.5),和自杀未遂（身体：aOR：3.6，95％CI：3.2-4.1；性：aOR：4.9，95％，CI:4.3-5.7)。在针对具体国家的分析中观察到一致的结果。在经历过亲密伴侣的童年身体暴力和父母或照顾者的童年性暴力的人中，所有结果的几率最高。经历过童年性暴力的年轻女性对所有结果的可能性都高于年轻男性。
结论：针对中低收入国家年轻人的暴力预防和心理健康计划应考虑所经历的暴力类型，肇事者,以及幸存者的性别.
方法：我们使用了来自八个低收入国家（2017-2019年）的暴力侵害儿童和青少年调查的全国代表性数据。分析样本包括33,381名年轻男女（13-24岁）。使用具有国家固定效应的多变量逻辑回归来估计儿童身体暴力和性暴力与三个结果之间的关联。分层分析按国家进行，参与者的性别，和犯罪者的类型(父母/看护人，其他成年人,同行,和亲密伴侣）。
结果：大约40％的参与者报告了儿童时期的身体暴力，10%的儿童经历过性暴力。儿童暴力与自我伤害的几率增加有关（身体暴力：调整后的优势比[aOR]：2.2，95％置信区间[CI]：2.0-2.4；性暴力：aOR：2.7，95％，CI：2.3-3.0），自杀意念（身体：aOR：3.0，95％CI：2.7-3.3；性：aOR：4.0，95％，CI:3.6-4.5),和自杀未遂（身体：aOR：3.6，95％CI：3.2-4.1；性：aOR：4.9，95％，CI:4.3-5.7)。在针对具体国家的分析中观察到一致的结果。在经历过亲密伴侣的童年身体暴力和父母或照顾者的童年性暴力的人中，所有结果的几率最高。经历过童年性暴力的年轻女性对所有结果的可能性都高于年轻男性。
结论：针对中低收入国家年轻人的暴力预防和心理健康计划应考虑所经历的暴力类型，肇事者,以及幸存者的性别.
