Maltreatment, social support, and mental well-being: A longitudinal observation study of youth in five low- and middle-income countries.

Addressing the growing child and adolescent mental health crisis is a global priority, particularly in low- and middle-income countries (LMICs). Although the literature demonstrates that experiencing maltreatment may negatively impact mental well-being and experiencing social support may positively impact mental well-being, the relationship between mental well-being and co-occurring maltreatment and social support is unknown.This study examined the relationship between maltreatment, social support, and mental well-being.Study data is from the longitudinal Positive Outcomes for Orphans (POFO) study of orphaned and separated children and youth/young adults (OSC) (n = 2535) from five LMICs (Cambodia, Ethiopia, India, Kenya, and Tanzania).We used bivariable analyses to calculate relationships between 1) mental well-being and maltreatment and 2) mental well-being and social support. Then, we used generalized linear models (GLMs) to examine relationships between 1) mental well-being and maltreatment, 2) mental well-being and social support, and 3) mental well-being, maltreatment, and social support. Models were controlled for age, gender, health, parental status and other traumas.Maltreatment was associated with increased well-being difficulties (Coeff = 2.068, SE = 0.249, CI = 1.579-2.559), while social support was associated with decreased well-being difficulties. In a GLM examining social support and maltreatment, social support reduced well-being difficulties (Coeff = -0.137, SE = 0.010, CI = -0.157- -0.119), even in the concurrent presence of maltreatment (Coeff = -0.131, SE = 0.010, CI = -0.151- -0.111). Three subtypes of social support were associated with reduced mental well-being difficulties: emotional support, tangible support, and positive social support.Findings indicate that measuring both maltreatment and social support may result in a more comprehensive understanding of youth emotional difficulties. Interventions that facilitate social support may promote emotional well-being and may be particularly useful in communities where trauma-informed mental health services are inaccessible.

Duke Scholars

Author Jan Ostermann Duke Global Health Institute

Author Christine L Gray Duke Global Health Institute

Author Kathryn Whetten Sanford School of Public Policy