Early exposure to emotional violence “significantly” increases the chances that youths will contemplate suicide, according to new research from three countries conducted by Washington University in St. Louis’ Brown School.

“We find the odds of suicide ideation are consistently and significantly greater for adolescents who report overexposure to emotional violence,” said Lindsay Stark, associate professor and co-author of the study “A Sex-disaggregated Analysis of How Emotional Violence Relates to Suicide Ideation in Low- and Middle-income Countries,” published in the journal Child Abuse & Neglect.

The same consistency is not observed for any other form of maltreatment across countries, found Stark and co-author Ilana Seff of Columbia University.

Stark and Seff reviewed national data drawn from 9,300 adolescents and young adults aged 13-24 in the Violence Against Children Surveys, a collaborative effort by the U.S. Centers for Disease Control and Prevention, UNICEF, country governments and other bilateral and multilateral organizations.

They collected surveys from Haiti, Kenya and Tanzania containing detailed information on young people’s experiences with physical, emotional and sexual violence, as well as their mental health and well-being.

Questions about emotional violence included whether adults had ever threatened to abandon the children, made them feel unwanted, or humiliated them in front of others. Stark and Seff found an association between youth with those experiences and the ones who considered suicide.

Approximately 26%–45% of respondents, depending on sex and country, reported having ever experienced emotional violence. Self-reported suicide ideation was consistently higher for females in all countries; nearly 27%, 15% and 8% of females had ever considered suicide in Haiti, Kenya and Tanzania, respectively, compared to 8%, 7% and 6% of males.

“We find there exists a significant relationship between exposure to emotional violence and suicide ideation for both males and females in all countries in the sample,” the authors wrote in the paper. “No other form of child maltreatment was found to be associated with suicide ideation in more than one country, suggesting that emotional violence may actually be more powerful than physical and sexual abuse in its impact on adolescent suicide behaviors in low- and middle-income countries.”

The analysis suggests that mental health practitioners should offer suicide prevention programs to those with a history of emotional abuse.