Abstract
Background The COVID-19 epidemic had a deleterious impact on mental health and substance abuse and led to an increase in several forms of violence, including self-harm and interpersonal violence among youth from low- and middle-income countries. Nevertheless, the relationship between the variables and their directionality has not been recognized. This study describes the relationship directionality between these variables among 18- to 20-year-old Mexican youths during the COVID-19 pandemic. Methods The longitudinal cohort study comprises an evolving group of young Mexican adults: 1390 participants aged 18 in 2021, 654 aged 19 in 2022, and 442 aged 20 in 2023. Proportions by sex-50% were matched in every cohort, and the evolution-age sample accomplishment accounted for 47% in 2022 and 32% in 2023. Results According to a structural equation model, which fit the data from 195 iterations with 246 parameters (X(2)[2722] = 8327.33, p < 0.001), yielding a CFI of 0.946, a TLI of 0.943, and an RMSEA of 0.029 [0.028-0.029]), perpetrating intimate violence, preceded by suffering intimate violence, combined with suffering anxiety symptoms, was associated with self-harm-suicide thoughts and behaviors (ShSTB), marked distress, dysfunction, and somatization symptoms. The relationship was stronger in women and 20-year-old Mexicans. In men, this pathway was exclusively associated with ShSTB. Suffering from intimate violence has been associated with depression, anxiety, and PTSD symptoms, as well as harmful alcohol use. Conclusions During an epidemic, prevention programs should be designed to warn about self-harm-suicide thoughts and behaviors, not only to ensure the safety of the victims of intimate personal-violence but also to prevent the suicidal behavior of perpetrators.