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Background: Despite the growing recognition of childhood psychological maltreatment as a public health and human rights concern, it remains rampant in developing countries including Tanzania and has a negative impact on the victim's self-esteem during adolescence. There is a lack of published studies in Tanzania that examine the relationship between childhood psychological maltreatment and self-esteem during adolescence. This study describes the relationship between childhood psychological maltreatment and self-esteem and psychological distress among adolescents in Tanzania., Methods: This was a cross-sectional, community-based study of secondary school students that was conducted in randomly selected secondary schools in five regions in Tanzania between April 2016 and February 2017. A multistage cluster sampling technique was employed to obtain the required number of study participants. The Rosenberg self-esteem scale, Kessler psychological distress scale (K10) and Childhood Trauma Questionnaire (CTQ) questionnaires were used to measure the variables in the study. Pearson correlation analysis was used to analyse the correlation between variables (Psychological maltreatment and self-esteem and psychological distress)., Results: A sample of 1000 secondary school students was recruited for this study, of which 553 (55.3%) were males and 447 (44.7%) were females. The mean age at presentation was 16.45 ± 6.42 years. Out of the 1000 participants, 766 (76.6%) experienced psychological maltreatment. Emotional abuse was reported in 24.7% of the participants, while emotional neglect was reported in 51.9% of cases. There was a strong positive correlation between psychological maltreatment and self-esteem (r = 0.55, p < 0.001), whereas the correlation between psychological maltreatment and psychological distress was significantly but weak (r = - 0.086, p = 0.007). The results also show a strong positive correlation between psychological distress and self-esteem (r = 0.16, p < 0.001)., Conclusion: Finding from this study demonstrated that childhood psychological maltreatment is prevalent in our setting and is associated with psychological distress and low self-esteem during adolescence. Urgent intervention targeting at reducing occurrence of childhood psychological maltreatment is necessary to reduce the incidence of low self-esteem and psychological distress among Tanzanian adolescents.

Background: Child maltreatment is becoming predominantly multi-type in nature. Studies report that multi-type child maltreatment is associated with low self-esteem in adolescence and adulthood. There is a lack of published studies in Tanzania regarding multi-type child maltreatment and its relationship with self-esteem in adolescence. This study investigates the prevalence of multi-type child maltreatment and its relationship with self-esteem among secondary school students in Tanzania., Methods: A cross-sectional, community-based study of secondary school students was conducted in randomly selected secondary schools in Tanzania. A multistage cluster sampling technique was employed to obtain the required number of study participants. The Rosenberg Self-Esteem Scale and the Adverse Childhood Experiences (ACE) questionnaire were used to measure the variables under investigation in the study. A total of 1000 participants (M: F ratio = 1.2:1) were studied. The mean age at presentation was 16.24 ± 7.36 years. The modal age group was 16-18 years (54.2%)., Results: The prevalence of multi-type child maltreatment was 97.6%. The prevalence of physical abuse, physical neglect, emotional neglect emotional abuse and sexual abuse was 82.1, 26.2, 51.9, 21.8 and 24.7%, respectively. Females reported a higher prevalence of physical abuse (84.3%), physical neglect (28.0%) and sexual abuse (26.2%) than their male counterparts. Emotional abuse (53.3%) was reported more often by males. In terms of ACE, participants were classified as having zero (2.4%), one (22.4%), two (20.3%), three (18.2%), four (14.7%), five (12.8%) and over five (9.2%) types of maltreatment. With regard to multi-type child maltreatment, emotional abuse (X 2  = 2.925, p = 0.001), emotional neglect (X 2  = 2.329, p = 0.032), physical neglect (X 2  = 22.508, p < 0.001) and physical abuse (X 2  = 6.722, p = 0.036) were significantly associated with low self-esteem., Conclusion: The current study demonstrates that multi-type child maltreatment exists in Tanzania and has adversely affected self-esteem among secondary school students. We believe that this study has significantly added to the body of literature on child maltreatment by investigating exposure to 10 types of ACEs as opposed to single types, as the majority of previous studies have investigated.