The mediating role of self-esteem in the link between childhood adversities and criminality among North African adult males: A case-control study.

BACKGROUND

Adverse childhood experiences (ACEs) significantly influence the physical and mental health of adults, and lead to poor behavioral outcomes such as criminal activities. However, the relationship between ACEs and criminal justice involvement is not fully understood, particularly in the Middle East and North Africa region.

OBJECTIVE

To explore this relationship in the Tunisian context while also examining the potential mediating role of self-esteem.

METHOD: We conducted a case-control study comparing two groups of adult males in Tunisia: A case group of 403 inmates (April 2023) and a control group of 408 matched males from the general population (August 2024). We evaluated ACEs and self-esteem using the validated Arabic versions of the World Health Organization ACE questionnaire and the Rosenberg self-esteem scale.

RESULTS

Five ACE categories significantly increased the likelihood of criminal justice involvement: sexual abuse (ORa = 1.9, 95 %CI [1.31-4.98]), physical abuse (ORa = 2.1, 95 %CI [1.44-2.65]), physical neglect (ORa = 2.2, 95 %CI [1.79-3.35]), collective violence (ORa = 2.8, 95 %CI [2.33-4.15]) and community violence (ORa = 3.3, 95 %CI [2.17-6.04]). The case group exhibited notably higher rates of mental health issues, particularly low self-esteem (9.3 % vs. 3 %, p < 0.001). Mediation analysis revealed that self-esteem significantly mediated the relationship between criminal justice involvement and four ACE categories, with sexual abuse showing the strongest mediation effect (44.1 %).

CONCLUSION

This study emphasizes the need for preventive approaches to address childhood adversities and enhance self-esteem, which will then help reduce criminal behavior.