Mapping the association between exposure to violence and mental health problems among a representative sample of youth in Bangladesh

Objective: To assess the mental health risk associated with exposure to violence among Bangladeshi youth. Methods: Using the 2014 Global School-based Student Health Survey (GSHS) for Bangladesh we estimated the prevalence of common depression and anxiety symptomology as well as violence exposure. We followed with multivariate analysis to estimate whether exposure to violence predicts this symptomology. Results: Sizeable proportions of this population have experienced past-year exposure to violence in the form of being involved in fights (22%) or being attacked (63%). Approximately 12% of the population reports past-year suicidality, with over 40% reporting sleep loss due to anxiety either some, most, or all of the time. Among adolescent girls, being attacked was a significant predictor of both depressive symptoms, greater anxiety, and a combined symptom category. Among adolescent girls, being involved in fights bore these same relationships. Conclusion: Independent of age, sex, and food security, exposure to violence is significantly associated with mental illness symptomology. These relationships are not the same between adolescent boys and girls, or between depressive and anxiety symptoms. We explain the differences using Susan Rosenfield's concept of gender differences in externalization and internalization of problems. Implications are discussed.