Child Marriage in the United States and Its Association With Mental Health in Women

Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
PEDIATRICS (Impact Factor: 5.47). 08/2011; 128(3):524-30. DOI: 10.1542/peds.2011-0961
Source: PubMed


Despite the devastating impact of child marriage (marriage before the age of 18 years) on health, no study has yet evaluated its impact on mental health in the general adult population. This article presents nationally representative data on the prevalence, sociodemographic correlates, and psychiatric comorbidity of child marriage among women in the United States.
Data were drawn from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. We limited our analyses to the sample of women (N = 24 575) with a known age at first marriage, of whom 18 645 had been or were presently married.
The prevalence of child marriage among women was 8.9%. Demographic factors associated with child marriage were black and American Indian/Alaska Native ethnicities, age at interview of >45 years, low educational level, low income, and living in the South and rural areas of the United States. The overall lifetime and 12-month rates of psychiatric disorders were higher for women who married as children, compared with women who married as adults. In addition, women who married as children were more likely to seek and access health services, compared with women who married in adulthood.
Child marriage increases the risk of lifetime and current psychiatric disorders in the United States. Support for psychiatric vulnerabilities among women married in childhood is required.

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    • "Such amplified maternal health vulnerabilities among young brides are thought to be driven by their low social status, minimal decision-making ability within their marital relationships, and pressure to bear children although their bodies are still underdeveloped [8] [9]. A small number of studies have also documented poor mental health outcomes among child brides, including substance abuse and suicidality [10] [11] and increased mortality and morbidities among young children of child brides [12]. Child marriage has also been directly linked with increased risk for intimate partner violence (IPV) victimization [13e16], which in turn can also magnify health risks for child brides [17]. "
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    ABSTRACT: Purpose: Little is known about whether effectiveness of intimate partner violence prevention programming varies for women who were married as child brides, given their additional social vulnerabilities. This subanalysis sought to assess treatment heterogeneity based on child marriage status for an intervention seeking to reduce intimate partner violence. Methods: A randomized controlled trial assessing the incremental effectiveness of gender dialogue groups in addition to group savings on changing past-year intimate partner violence was conducted in Côte d'Ivoire (2010-2012). Stratified models were constructed based on child marriage status to assess for effect modification. Analysis was restricted to married women with data on age at marriage (n = 682). Results: For child brides (N = 202), there were no statistically or marginally significant decreases in physical and/or sexual violence, physical violence, or sexual violence. The odds of reporting economic abuse in the past year were lower in the intervention arm for child brides relative to control group child brides (odds ratio [OR] = .33; 95% confidence interval [CI] = .13-.85; p = .02). For nonchild brides (N = 480), women were less likely to report physical and/or sexual violence (OR = .54; 95% CI = .28-1.04; p = .06), emotional violence (OR = .44; 95% CI = .25-.77; p = .004), and economic abuse (OR = .36; 95% CI = .20-.66; p = .001) in the combined intervention arm than their group savings-only counterparts. Conclusions: Findings suggest that intervention participants with a history of child marriage may have greater difficulty benefiting from interventions that seek to reduce intimate partner violence.
    No preview · Article · Sep 2015 · Journal of Adolescent Health
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    • "However, the same age group of women has been reported and used in other publications related to child marriage [18] [19] [28]. Child marriage has shown to be associated with increased risk of lifetime and current psychiatric disorders compared with women who married in adulthood in an international study [29]. However, because of lack of data, we were unable to assess the impact of child marriage on mental health of women in our study. "
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    ABSTRACT: Purpose Child marriage (before 18 years) is widely prevalent in Pakistan, and disproportionately affects young girls in rural, low-income, and poorly educated households. Our study aims to determine the associations between child marriage and controlling behaviors (CB) and spousal violence by husbands against adolescent and young women in Pakistan beyond those attributed to social vulnerabilities. Methods We analyzed data from the Pakistan Demographic and Health Survey, 2012–2013, of currently married women aged 15–24 years who had participated in the domestic violence module (n = 589, 22.5% [589/2,615] of the subsample aged 15–24 years) to identify differences in CB and spousal violence experiences between early (<18 years) and adult (≥18 years) ages at marriage. Associations between child marriage and CB and spousal violence by husband were assessed by calculating adjusted odds ratios (AOR) using logistic regression models after controlling for demographics, social equity indicators (education, wealth index, and rural residence), spousal age gap, and husband's education. Results Overall, 47.8% of currently married women aged 15–24 years in Pakistan were married before the age of 18 years. About one third of women aged 15–24 years in Pakistan reported experiencing CB (31.8%) and spousal violence (31.1%) by their husbands. Compared with adult marriage, child marriage was significantly associated with CB (AOR = 1.50; 95% confidence interval [CI], 1.042–2.157), any form of spousal violence (physical or emotional) (AOR = 2.03; 95% CI, 1.392–2.969), emotional violence (AOR = 1.86; 95% CI, 1.254–2.767), and physical violence (AOR = 2.44; 95% CI, 1.582–3.760), including severe physical violence (AOR = 2.57; 95% CI, 1.122–5.872). Conclusions Effective interventions are needed to prevent child marriages and raise awareness about their negative consequences, with special reference to spousal violence.
    Full-text · Article · Dec 2014 · Journal of Adolescent Health
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    • "National and international communities are recognizing early marriage as a serious challenge with violation of human rights and as a barrier to key development outcomes as well. Early marriage is associated with some unavoidable predicament like social and physical outcomes, mood disorders, depression, anxiety, obsessive and make dismay [10]. Iron and calcium deficiency is most common in pregnancy under the age of 18 which leads to osteoporosis and anaemia [11] [12]. "
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    ABSTRACT: Early marriage is a key indicator to assess the development of a nation. Early marriage is specifically associated with some unavoidable predicament like social and physical outcomes, mood disorders, depression, anxiety, obsessive and makes dismay. Even the possibilities of iron and calcium deficiency in pregnancy under the age of 18 will be increased which leads to osteoporosis and anaemia. It also enhances the risk of Cervical Cancer as well. A descriptive type of cross sectional study was conducted to assess the knowledge, approach and status of early marriage in Bangladesh where 300 eligible couples of the reproductive age were taken as sample. Data was collected through structured questionnaire by face to face interview and analyzed by SPSS version 17.0 including descriptive statistic using mean, standard deviation, percentage, Chi-square test to describe the association. The respondents got married at the age of 16.19±3.522 (Female) (Mean±SD) years and 22.22±10.532 (Male) years where the frequency of early marriage was 65% in Bangladesh. Only 22% respondents had no standard education and 63.3% female respondents were housewife which showed that the rate of literacy and working women is increasing in Bangladesh even a significant association exists between age of early marriage and occupation of the respondents (x 2 10.433 with P value 0.034). 81.3% respondents were nuclear family and had a significant relation between type of the family and age of the early marriage (x 2 4.136 with P value 0.042). Average monthly household income was 12,226±5,787.366 taka where 10.3% had <5000 taka and 4% had income >20000 taka. 55.33% had no marriage registration and 15.3% had no child birth registration of their child. All the respondents agreed to stop early marriage and showed positive attitude where 99% thought for female <18 years will not suitable for marriage. These study results specifically showed the necessity of Bangladesh to give more attention on this issue to graduate from Least Developed Country (LDC) list.
    Full-text · Article · May 2014
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