title: Childhood exposure to emotional abuse and later life stress among Kenyan women: a mediation analysis of cross-sectional data.
abstract: OBJECTIVE
  We explore whether perceived stress among Kenyan mothers is predicted by childhood exposure to emotional abuse - both witnessed among parents and experienced directly. Further, we explore whether this association is mediated by social support, family functioning and polygynous marriage.
  
  
  METHODS
  We used cross-sectional data from a systematic random sample (n = 1974) of mothers in semi-rural Kenya.
  
  
  METHODS
  Data were collected using validated scales and trained interviewers. Analyses were conducted using bootstrapped structural equation models and fixed-effects linear regression models, controlling for age and household wealth.
  
  
  RESULTS
  Reported experience of emotional abuse - both directly experienced and observed among household adults - was high in the present population (72.5% and 69%, respectively). Perceived stress among women was significantly higher if they were exposed to more emotional abuse during childhood (p < .001). Lower social support, worse family functioning and higher rates of polygynous marriage mediated pathways between emotional abuse exposure during childhood and adult perceived stress.
  
  
  CONCLUSIONS
  Future research should investigate whether social integration, identity formation and self-esteem underlie observed dynamics in sub-Saharan Africa. Efforts to promote social integration and support should target children currently experiencing emotional abuse, and may include child-targeted high quality television programing and adult-targeted media and celebrity campaigns.
authors.affiliation: a Department of Internal Medicine, University of Texas Medical Branch , Galveston , TX , USA.|b Sodzo International , Houston , TX , USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Goodman
authors.affiliation: a Department of Internal Medicine, University of Texas Medical Branch , Galveston , TX , USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Gutarra
authors.affiliation: a Department of Internal Medicine, University of Texas Medical Branch , Galveston , TX , USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Billingsley
authors.affiliation: a Department of Internal Medicine, University of Texas Medical Branch , Galveston , TX , USA.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Keiser
authors.affiliation: c Community Health Department , Maua Methodist Hospital , Maua , Kenya.
authors.forename: Stanley
authors.initials: S
authors.lastname: Gitari
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Emotional abuse; Kenya; mediation; perceived stress; social support