Adverse childhood experiences, positive childhood experiences, suicidal thoughts or behaviors and psychological distress among Kenyan youth-an exploratory analysis of the 2019 Kenya Violence Against Children and Youth Survey (VACS)

Background: Early childhood experiences, whether positive or adverse, significantly impact health across the lifespan. Children and youth in low-resource settings face unique challenges that increase their vulnerability to poor mental health. Objective: To examine the relationship between adverse childhood experiences (ACEs) and suicidal thoughts or behaviors as well as psychological distress, and to explore the moderating role of parent-related positive childhood experiences (PPCEs) on this association. Participant and setting: We used data from the 2019 Kenya Violence Against Children and Youth Survey. Methods: Analyses were restricted to youth ages 18-24. ACEs were dichotomized (into those who have experienced at least one ACEs and those who have not), and logistic regression was used to examine the relationship between ACEs, PPCEs, and suicidal thoughts or behaviors and psychological distress stratified by sex. Results: Significantly more males (75.8 %) than females (57.6 %) experienced at least 1 ACE in their lifetime (p = 0.0003). PPCEs are common; however, significantly more males (59.9 %) than females (41.2 %) had a strong father-child relationship (p = 0.0003). ACEs were positively associated with suicidal thoughts or behaviors and psychological distress, with notable sexspecific differences in the associations. Conversely, PPCEs were negatively associated with those outcomes, but there were also sex-specific differences in the associations. No significant interaction effect was observed between ACEs, PPCEs, and the mental health outcomes. Conclusion: Suicidal thoughts or behaviors and psychological distress are pervasive problems that are common among youth in Kenya, and the associations with ACEs vary by sex. A multilevel approach and evidenced-based intervention strategies that consider the context of sociocultural norms are crucial to prevention and response efforts.