The effect of childhood maltreatment on psychological well-being among public high school and preparatory school students, Northwest Ethiopia: using structural equation modeling

Background: Childhood Maltreatment (CM) refers to any form of abuse and neglect as such physical abuse, sexual abuse, emotional abuse, physical neglect, and motional neglect of children below the age of 18 years. It is global public health problem with severe and enduring consequences. Although examining the consequences of CM on psychological well-being can offer valuable insights for the development of targeted interventions, there is a limited body of research both globally and in Ethiopia specifically addressing the impact of each distinct form of CM on psychological well-being. Therefore, this study aims to examine the effect of of each form of CM on psychological well-being among public high school and preparatory school students in Northwest Ethiopia.

Methods: An institution-based cross-sectional study was conducted from April 18 to May 9, 2023. A simple random sampling technique was used to select 1,276 participants. Data were collected using a structured, self-administered questionnaire. Structural Equation Modeling (SEM) was applied to evaluate the direct, indirect, and total effects of CM on psychological well-being.

Results: Approximately 19.76% (95% CI: 17.57%, 22.09%) of students had low psychological well-being. The most prevalent dimension was a sense of purpose in life, reported by 75.87% (95% CI: 73.38%, 78.23%) of respondents. Emotional abuse, sexual abuse, and overall CM had a direct inverse relationship with psychological well-being, with effect sizes of β = -0.325 (95% CI: -0.535, -0.107), β = -0.396 (95% CI: -0.665, -0.123), and β = -0.872 (95% CI: -1.595, -0.448), respectively. Physical neglect, sexual abuse, emotional abuse, and emotional neglect had an indirect inverse relationship with psychological well-being, with effect sizes of β = -0.300 (95% CI: -0.625, -0.159), β = -0.187 (95% CI: -0.362, -0.082), β = -0.281 (95% CI: -0.478, -0.146), and β = -0.240 (95% CI: -0.437, -0.117), respectively.

Conclusion: This study emphasizes that emotional abuse, sexual abuse, and overall CM directly decrease the psychological well-being of adolescents in Gondar Town. Additionally, physical neglect and emotional neglect negatively impact psychological well-being through a indirect effect. These findings highlight the importance of incorporating the prevention and treatment of CM into mental health interventions. Early intervention is crucial to mitigating the long-term psychological consequences of maltreatment.