{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:34:04Z","timestamp":1777854844308,"version":"3.51.4"},"reference-count":76,"publisher":"SAGE Publications","issue":"21-22","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Interpers Violence"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    Adverse childhood experiences (ACEs) are a global public health concern. Little research exists on the prevalence and health consequences of ACEs in Zambia. The current study examined associations between individual and cumulative ACEs, mental distress, and suicide risk among Zambian youth.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Data from Zambia Violence Against Children and Youth Survey were used (18-24 years old, n=1034). Bivariate and adjusted logistic models were performed with independent variables (i.e., experienced physical violence (PV), sexual violence (SV), and emotional violence (EV); witnessed intimate partner violence (IPV) and community violence (CV); orphan status; cumulative ACE exposure) and dependent variables (i.e., mental distress and suicide risk). Adjusted models controlled for demographic and social characteristics.\n                    <jats:bold>Results:<\/jats:bold>\n                    76.8% of Zambian youth experienced one or more ACEs, and more than 30% witnessed CV (38.4%) or IPV (30.2%), or experienced PV (35.1%), prior to age 18. 27.5% were orphans, and less than 20% experienced EV (17.3%) or SV (15.4%) in childhood. 42.4% experienced mental distress in the past 30 days, and 12.5% reported lifetime suicidal thoughts or suicide attempts. PV, EV, cumulative ACE exposure, older age, being single, and stronger friendships were significantly related to experiencing mental distress. Cumulative ACEs exposure was associated with significantly higher suicide risk.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Preventing ACEs can reduce mental distress and suicide risk among Zambian youth. Youth with cumulative ACE exposure can be prioritized for mental health intervention. More research is warranted to investigate the broad-based prevention of ACEs, especially PV and EV, and protective factors that can promote resilience among youth who have experienced ACEs.\n                  <\/jats:p>","DOI":"10.1177\/08862605211056726","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:18:28Z","timestamp":1639527508000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Adverse Childhood Experiences and Associated Mental Distress and Suicide Risk: Results From the Zambia Violence Against Children Survey"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-3656","authenticated-orcid":false,"given":"NaeHyung","family":"Lee","sequence":"first","affiliation":[{"name":"Copial Business Strategists"},{"name":"Georgia State University"},{"name":"Georgia State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3813-9839","authenticated-orcid":false,"given":"Greta M.","family":"Massetti","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth W.","family":"Perry","sequence":"additional","affiliation":[{"name":"Georgia State University"},{"name":"Georgia State University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Self-Brown","sequence":"additional","affiliation":[{"name":"Georgia State University"},{"name":"Georgia State University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2017.02.027"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2010.03.015"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2020.104510"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.12.018"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2010.12.026"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.13.129247"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077559511428353"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-019-0969-9"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2008.02.003"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jegh.2013.02.006"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1891\/0886-6708.VV-D-18-00099"},{"key":"e_1_3_3_13_1","unstructured":"CDC (2019a). Preventing adverse childhood experiences: Leveraging the best available evidence. National Center for Injury Prevention and Control Centers for Disease Control and Prevention. https:\/\/www.cdc.gov\/violenceprevention\/pdf\/preventingACES.pdf"},{"key":"e_1_3_3_14_1","unstructured":"CDC (2019b November 5). Preventing adverse childhood experiences. https:\/\/www.cdc.gov\/vitalsigns\/aces\/index.html"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu268"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211850"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2015-041820"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2017-000533"},{"key":"e_1_3_3_19_1","volume-title":"Africa: Zambia\u2014The World Factbook\u2014Central Intelligence Agency","author":"CIA","year":"2020","unstructured":"CIA (2020). Africa: Zambia\u2014The World Factbook\u2014Central Intelligence Agency. https:\/\/www.cia.gov\/library\/publications\/the-world-factbook\/geos\/za.html"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2015.03.001"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-4458-3-26"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2009.09.005"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077559514543354"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-698X-14-6"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2011.10.006"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2004.11.001"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2006.06.008"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1037\/0008-400X.29.1.28"},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afw129"},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/10615806.2016.1271876"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10964-017-0729-x"},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00420"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4079"},{"key":"e_1_3_3_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2016.1153679"},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/02796015.2005.12086289"},{"key":"e_1_3_3_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2018.1441353"},{"key":"e_1_3_3_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(17)30118-4"},{"issue":"3","key":"e_1_3_3_38_1","first-page":"070","article-title":"Sexual risk behaviours among young people with adverse childhood experiences in Ibadan, Nigeria","volume":"2","author":"Ige O. K.","year":"2012","unstructured":"Ige O. K., Ilesanmi O. S., Adebayo A. M. (2012). Sexual risk behaviours among young people with adverse childhood experiences in Ibadan, Nigeria. Greener Journal of Medical Sciences, 2(3), 070\u2013076. https:\/\/www.researchgate.net\/profile\/Olayinka-Ilesanmi-2\/publication\/293489148_Sexual_Risk_Behaviours_among_Young_People_with_Adverse_Childhood_Experiences_in_Ibadan_Nigeria\/links\/571525c308ae8ab56695a52a\/Sexual-Risk-Behaviours-among-Young-People-with-Adverse-Childhood-Experiences-in-Ibadan-Nigeria.pdf.","journal-title":"Greener Journal of Medical Sciences"},{"key":"e_1_3_3_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0164790"},{"key":"e_1_3_3_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/02673843.2017.1377089"},{"key":"e_1_3_3_41_1","doi-asserted-by":"publisher","DOI":"10.2989\/17280583.2019.1678476"},{"key":"e_1_3_3_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2021.104993"},{"key":"e_1_3_3_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.08.028"},{"key":"e_1_3_3_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1953-y"},{"issue":"12","key":"e_1_3_3_45_1","first-page":"455","article-title":"Mental health of HIV\/AIDS orphans: A review","volume":"5","author":"Lata S.","year":"2013","unstructured":"Lata S., Verma S. (2013). Mental health of HIV\/AIDS orphans: A review. Journal of AIDS and HIV Research, 5(12), 455\u2013467. https:\/\/doi.org\/10.5897\/JAHR2013.0271","journal-title":"Journal of AIDS and HIV Research"},{"key":"e_1_3_3_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524838016659489"},{"key":"e_1_3_3_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2002.tb01671.x"},{"key":"e_1_3_3_48_1","volume-title":"Land of million orphans: Zambia\u2019s forgotten kids tell their stories","author":"Martosko D.","year":"2019","unstructured":"Martosko D. (2019 July 11). Land of million orphans: Zambia\u2019s forgotten kids tell their stories. Dailymail Online. https:\/\/www.dailymail.co.uk\/news\/article-7229475\/LAND-MILLION-ORPHANS-Zambias-forgotten-children-tell-stories.html"},{"key":"e_1_3_3_49_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.07.010410"},{"key":"e_1_3_3_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2017.03.016"},{"key":"e_1_3_3_51_1","volume-title":"Violence against children in Zambia: Findings from a national survey, 2014","author":"Ministry of Youth, Sport and Child DevelopmentMinistry of Community Development and Social ServicesUniversity of ZambiaUnited Nations Children\u2019s Fund, Save the Children International, United StatesCenters for Disease Control and Prevention","year":"2018","unstructured":"Ministry of Youth, Sport and Child DevelopmentMinistry of Community Development and Social ServicesUniversity of ZambiaUnited Nations Children\u2019s Fund, Save the Children International, United StatesCenters for Disease Control and Prevention. (2018). Violence against children in Zambia: Findings from a national survey, 2014. Ministry of Youth, Sport and Child Development. https:\/\/www.unicef.org\/zambia\/sites\/unicef.org.zambia\/files\/2018-11\/Binder%20EMAIL%20thursday%20NEW.pdf."},{"issue":"4","key":"e_1_3_3_52_1","first-page":"202","article-title":"A comparison of the behavioral and emotional disorders of primary school-going orphans and non-orphans in Uganda","volume":"7","author":"Musisi S.","year":"2007","unstructured":"Musisi S., Kinyanda E., Nakasujja N., Nakigudde J. (2007). A comparison of the behavioral and emotional disorders of primary school-going orphans and non-orphans in Uganda. African Health Sciences, 7(4), 202\u2013213. https:\/\/doi.org\/10.4314\/ahs.v7i4.7035","journal-title":"African Health Sciences"},{"key":"e_1_3_3_53_1","doi-asserted-by":"publisher","DOI":"10.1891\/0886-6708.VV-D-17-00182"},{"key":"e_1_3_3_54_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2018-042916"},{"key":"e_1_3_3_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2019.104074"},{"key":"e_1_3_3_56_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.116038"},{"key":"e_1_3_3_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-018-1037-7"},{"key":"e_1_3_3_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2019.104127"},{"key":"e_1_3_3_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1349"},{"key":"e_1_3_3_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.10.028"},{"key":"e_1_3_3_61_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.46.5.1097"},{"key":"e_1_3_3_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-009-0739-7"},{"key":"e_1_3_3_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00938116"},{"key":"e_1_3_3_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2015.11.017"},{"key":"e_1_3_3_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.03.032"},{"key":"e_1_3_3_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/car.2353"},{"key":"e_1_3_3_67_1","doi-asserted-by":"publisher","DOI":"10.1080\/00207594.2012.697165"},{"key":"e_1_3_3_68_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077559511403920"},{"key":"e_1_3_3_69_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08-060061"},{"key":"e_1_3_3_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.02.034"},{"key":"e_1_3_3_71_1","doi-asserted-by":"publisher","DOI":"10.1177\/0886260515586376"},{"key":"e_1_3_3_72_1","volume-title":"Violence against children and mental health outcomes in sub-Saharan Africa: A systematic review and meta-analysis","author":"Uzoezie I. N.","year":"2018","unstructured":"Uzoezie I. N. (2018) Violence against children and mental health outcomes in sub-Saharan Africa: A systematic review and meta-analysis. [Thesis, Georgia State University]."},{"key":"e_1_3_3_73_1","doi-asserted-by":"publisher","DOI":"10.1177\/0886260517752153"},{"key":"e_1_3_3_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2016.08.007"},{"key":"e_1_3_3_75_1","doi-asserted-by":"publisher","DOI":"10.1027\/0227-5910.26.3.112"},{"key":"e_1_3_3_76_1","volume-title":"WHO | adverse childhood experiences international Questionnaire (ACE-IQ)","author":"WHO","year":"2018","unstructured":"WHO (2018). WHO | adverse childhood experiences international Questionnaire (ACE-IQ). World Health Organization. https:\/\/www.who.int\/violence_injury_prevention\/violence\/activities\/adverse_childhood_experiences\/questionnaire.pdf?ua=1"},{"key":"e_1_3_3_77_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-020-09863-y"}],"container-title":["Journal of Interpersonal Violence"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08862605211056726","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08862605211056726","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08862605211056726","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:16:31Z","timestamp":1777504591000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08862605211056726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,14]]},"references-count":76,"journal-issue":{"issue":"21-22","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1177\/08862605211056726"],"URL":"https:\/\/doi.org\/10.1177\/08862605211056726","relation":{},"ISSN":["0886-2605","1552-6518"],"issn-type":[{"value":"0886-2605","type":"print"},{"value":"1552-6518","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,14]]}}}