Traumatic Experiences Affecting Children in Institutions of Care for Orphans in Kiambu County, Kenya
##article.subject##:
Trauma, anxiety, panic, depression, orphans
##article.abstract##
Childhood emotional trauma can have negative impact on the individual as adults in many ways. The purpose of this study was to ascertain the traumatic experiences endured by children in institutions of care for orphans in Kiambu County, Kenya. The study was carried out in Kiambu County within institutions of care for orphaned and vulnerable children. The target population for this study was all children in 50 registered institutions of care within Kiambu County aged between 11 and 17 years. Data was collected using a structured researcher-administered questionnaire. Descriptive analysis was conducted with the aid of SPSS. The study found that 37.5% had probable PTSD, 21% had moderate PTSD, 19.1% severe PTSD and 18.5% had below threshold PTSD. Results indicated that 24.8% had traumatic experience and depression at a moderate level and 24.2% and 16.6% had it at a mild and moderately severe level. Results also show that majority of participants (76.3%) were diagnosed with panic disorder. Majority of participants (76.3%) were also diagnosed with anxiety disorder while 71.2% were diagnosed with separation anxiety disorder. The level of education of participants, having ever sought treatment for any psychological problem, history of childhood sexual abuse as well as history of traumatic events were significant to PTSD education and history of traumatic events were significant. The level of education was significant for all 3 conditions signifying that the level of education is an important predictor for trauma in children. The study concludes that children in orphan institutions of care have a high prevalence of PTSD and other comorbidities mainly anxiety and depression. Participants in lower primary had significantly higher trauma scores than their upper primary counterparts. This calls for interventions to manage PTSD in this population.
References
Adler-Tapia, R., & Settle, C. (2008). EMDR and the art of psychotherapy with children. Springer Publishing Company New York.
Atwoli, L., Stein, D. J., Koenen, K. C., & McLaughlin, K. A. (2015). Epidemiology of posttraumatic stress disorder: prevalence, correlates and consequences. Current Opinion in Psychiatry, 28(4), 307–311. https://doi.org/10.1097/YCO.0000000000000167
Azami-Aghdash, S., Azar, F. E., Azar, F. P., Rezapour, A., Moradi-Joo, M., Moosavi, A., & Oskouei, S. G. (2015). Prevalence, etiology, and types of dental trauma in children and adolescents: systematic review and meta-analysis. Medical journal of the Islamic Republic of Iran, 29(4), 234.
Bouras G, Lazaratou E (2012), Emergence of early childhood trauma in adult psychiatric symptomatology].2nd Department of Psychiatry, "Attikon" University General Hospital, of Athens, Athens.
Cluver, L., & Gardner, F. (2006). The psychological well-being of children orphaned by AIDS in Cape Town, South Africa. Annals of General Psychiatry, 5, 8. https://doi.org/10.1186/1744-859X-5-8
Cluver, L., & Gardner, F., (2007). The mental health of children orphaned by AIDS: A review of international and southern African research. Journal of Child and Adolescent Mental Health. 19. 10.2989/17280580709486631.
Cornine, C. K. (2013). EMDR, sexual confusion, and God-image: a case study. Journal of Psychology and Christianity, 32(1), 83–90.
Crespo, M., & Fernández-Lansac, V. (2016). Memory and narrative of traumatic events: A literature review. Psychological Trauma: Theory, Research, Practice, and Policy, 8(2), 149.
Denton, R., Frogley, C., Jackson, S., John, M., & Querstret, D. (2017). The assessment of developmental trauma in children and adolescents: A systematic review. Clinical child psychology and psychiatry, 22(2), 260-287.
Diagnostic and Statistical Manual of Mental Disorders. (2013). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Edwards, D. J. A. (2009). Responsive treatment of posttraumatic stress disorder in South Africa: An integrative model grounded in case-based research. Journal of Psychology in Africa, 19, 189–198.
Gabbay, V., Oatis, M. D., Silva, R. R., & Hirsch, G. (2004). Epidemiological aspects of PTSD in children and adolescents. In S. R. Raul (Ed.), posttraumatic stress disorder in Children and Adolescents: Handbook (pp. 1–17). New York: Norton.
Gearing, R. E., Brewer, K. B., Elkins, J., Ibrahim, R. W., MacKenzie, M. J., & Schwalbe, C. S. J. (2015). Prevalence and correlates of depression, posttraumatic stress disorder, and suicidality in Jordanian youth in institutional care. The Journal of Nervous and Mental Disease, 203(3), 175–181. https://doi.org/10.1097/NMD.0000000000000267
Gillihan, S. J., Cahill, S. P., & Foa, E. B. (2014). Psychological theories of PTSD. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 166–184). The Guilford Press
Gore, F. M., Bloem, P. J., Patton, G. C., Ferguson, J., Joseph, V., Coffey, C., … Mathers, C. D. (2011). Global burden of disease in young people aged 10–24 years: a systematic analysis. The Lancet, 377(9783), 2093–2102. https://doi.org/10.1016/S0140-6736(11)60512-6
Harder, V. S., Mutiso, V. N., Khasakhala, L. I., Burke, H. M., & Ndetei, D. M. (2012). Multiple traumas, postelection violence, and posttraumatic stress among impoverished Kenyan youth. Journal of Traumatic Stress, 25(1), 64–70. https://doi.org/10.1002/jts.21660
Jarero, I., Artigas, L., Montero, M., & Lena, L. (2008). The EMDR integrative group treatment protocol: Application with child victims of a mass disaster. Journal of EMDR Practice and Research, 2(2), 97-105.
Kavanaugh, B. C., Dupont-Frechette, J. A., Jerskey, B. A., & Holler, K. A. (2017). Neurocognitive deficits in children and adolescents following maltreatment: Neurodevelopmental consequences and neuropsychological implications of traumatic stress. Applied Neuropsychology: Child, 6(1), 64-78.
Khan, A. A., Haider, G., Sheikh, M. R., Ali, A. F., Khalid, Z., Tahir, M. M., ... & Saleem, S. (2016). Prevalence of post-traumatic stress disorder due to community violence among university students in the world’s most dangerous megacity: A cross-sectional study from Pakistan. Journal of interpersonal violence, 31(13), 2302-2315.
Kieling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., … Rahman, A. (2011). Child and adolescent mental health worldwide: evidence for action. Lancet (London, England), 378(9801), 1515–1525. https://doi.org/10.1016/S0140-6736(11)60827-1
Kolaitis, G. (2017) Trauma and post-traumatic stress disorder in children and adolescents, EuropeanJournalof Psychotraumatology, 8:sup4, 1351198, DOl:10.1080/20008198.2017.1351198. https://doi.org/10.1080/20008198.217.1351198
Kraan, T., Velthorst, E., Smit, F., de Haan, L., & van der Gaag, M. (2015). Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta-analysis. Schizophrenia Research, 161(2), 143–149.
Makaya, J., Mboussou, F., Bansimba, T., Ndinga, H., Latifou, S., Ambendet, A., & Puruehnce, M. (2002). Assessment of psychological repercussions of AIDS, next to 354 AIDS orphans in Brazzaville. In XIV International AIDS Conference. Barcelona.
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.
Moreno-Alcázar A, Treen D, Valiente-Gómez A, Sio-Eroles A, Pérez V, Amann BL and Radua J (2017) Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adolescent with Post-traumatic stress disorder: A Meta-Analysis of Randomized Controlled Trials. Front. Psychol. 8:1750. doi: 10.3389/fpsyg.2017.01750
Murunga, G. R. (2011). Spontaneous or premeditated? Post-election Violence in Kenya. Nordiska Afrikainstitutet.
Mutiso, V. N., Musyimi, C. W., Tele, A., & Ndetei, D. M. (2017). Epidemiological patterns and correlates of mental disorders among orphans and vulnerable children under institutional care. Social Psychiatry and Psychiatric Epidemiology, 52(1), 65–75.
Paul, O. (2019). Perceptions of family relationships and post-traumatic stress symptoms of children exposed to domestic violence. Journal of family violence, 34(4), 331-343.
Perfect, M. M., Turley, M. R., Carlson, J. S., Yohanna, J., & Saint Gilles, M. P. (2016). School-related outcomes of traumatic event exposure and traumatic stress symptoms in students: A systematic review of research from 1990 to 2015. School Mental Health, 8(1), 7-43.
Polanczyk, G. V, Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345–365. JOUR. https://doi.org/10.1111/jcpp.12381
Skinner, D., Tsheko, N., Mtero-Munyati, S., Segwabe, M., Chibatamoto, P., Mfecane, S., … Chitiyo, G. (2006). Towards a definition of orphaned and vulnerable children. AIDS and Behavior, 10(6), 619–626.
Van der Kolk, B. A. (2017). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401–408.
Atwoli, L., Stein, D. J., Koenen, K. C., & McLaughlin, K. A. (2015). Epidemiology of posttraumatic stress disorder: prevalence, correlates and consequences. Current Opinion in Psychiatry, 28(4), 307–311. https://doi.org/10.1097/YCO.0000000000000167
Azami-Aghdash, S., Azar, F. E., Azar, F. P., Rezapour, A., Moradi-Joo, M., Moosavi, A., & Oskouei, S. G. (2015). Prevalence, etiology, and types of dental trauma in children and adolescents: systematic review and meta-analysis. Medical journal of the Islamic Republic of Iran, 29(4), 234.
Bouras G, Lazaratou E (2012), Emergence of early childhood trauma in adult psychiatric symptomatology].2nd Department of Psychiatry, "Attikon" University General Hospital, of Athens, Athens.
Cluver, L., & Gardner, F. (2006). The psychological well-being of children orphaned by AIDS in Cape Town, South Africa. Annals of General Psychiatry, 5, 8. https://doi.org/10.1186/1744-859X-5-8
Cluver, L., & Gardner, F., (2007). The mental health of children orphaned by AIDS: A review of international and southern African research. Journal of Child and Adolescent Mental Health. 19. 10.2989/17280580709486631.
Cornine, C. K. (2013). EMDR, sexual confusion, and God-image: a case study. Journal of Psychology and Christianity, 32(1), 83–90.
Crespo, M., & Fernández-Lansac, V. (2016). Memory and narrative of traumatic events: A literature review. Psychological Trauma: Theory, Research, Practice, and Policy, 8(2), 149.
Denton, R., Frogley, C., Jackson, S., John, M., & Querstret, D. (2017). The assessment of developmental trauma in children and adolescents: A systematic review. Clinical child psychology and psychiatry, 22(2), 260-287.
Diagnostic and Statistical Manual of Mental Disorders. (2013). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Edwards, D. J. A. (2009). Responsive treatment of posttraumatic stress disorder in South Africa: An integrative model grounded in case-based research. Journal of Psychology in Africa, 19, 189–198.
Gabbay, V., Oatis, M. D., Silva, R. R., & Hirsch, G. (2004). Epidemiological aspects of PTSD in children and adolescents. In S. R. Raul (Ed.), posttraumatic stress disorder in Children and Adolescents: Handbook (pp. 1–17). New York: Norton.
Gearing, R. E., Brewer, K. B., Elkins, J., Ibrahim, R. W., MacKenzie, M. J., & Schwalbe, C. S. J. (2015). Prevalence and correlates of depression, posttraumatic stress disorder, and suicidality in Jordanian youth in institutional care. The Journal of Nervous and Mental Disease, 203(3), 175–181. https://doi.org/10.1097/NMD.0000000000000267
Gillihan, S. J., Cahill, S. P., & Foa, E. B. (2014). Psychological theories of PTSD. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (pp. 166–184). The Guilford Press
Gore, F. M., Bloem, P. J., Patton, G. C., Ferguson, J., Joseph, V., Coffey, C., … Mathers, C. D. (2011). Global burden of disease in young people aged 10–24 years: a systematic analysis. The Lancet, 377(9783), 2093–2102. https://doi.org/10.1016/S0140-6736(11)60512-6
Harder, V. S., Mutiso, V. N., Khasakhala, L. I., Burke, H. M., & Ndetei, D. M. (2012). Multiple traumas, postelection violence, and posttraumatic stress among impoverished Kenyan youth. Journal of Traumatic Stress, 25(1), 64–70. https://doi.org/10.1002/jts.21660
Jarero, I., Artigas, L., Montero, M., & Lena, L. (2008). The EMDR integrative group treatment protocol: Application with child victims of a mass disaster. Journal of EMDR Practice and Research, 2(2), 97-105.
Kavanaugh, B. C., Dupont-Frechette, J. A., Jerskey, B. A., & Holler, K. A. (2017). Neurocognitive deficits in children and adolescents following maltreatment: Neurodevelopmental consequences and neuropsychological implications of traumatic stress. Applied Neuropsychology: Child, 6(1), 64-78.
Khan, A. A., Haider, G., Sheikh, M. R., Ali, A. F., Khalid, Z., Tahir, M. M., ... & Saleem, S. (2016). Prevalence of post-traumatic stress disorder due to community violence among university students in the world’s most dangerous megacity: A cross-sectional study from Pakistan. Journal of interpersonal violence, 31(13), 2302-2315.
Kieling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., … Rahman, A. (2011). Child and adolescent mental health worldwide: evidence for action. Lancet (London, England), 378(9801), 1515–1525. https://doi.org/10.1016/S0140-6736(11)60827-1
Kolaitis, G. (2017) Trauma and post-traumatic stress disorder in children and adolescents, EuropeanJournalof Psychotraumatology, 8:sup4, 1351198, DOl:10.1080/20008198.2017.1351198. https://doi.org/10.1080/20008198.217.1351198
Kraan, T., Velthorst, E., Smit, F., de Haan, L., & van der Gaag, M. (2015). Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta-analysis. Schizophrenia Research, 161(2), 143–149.
Makaya, J., Mboussou, F., Bansimba, T., Ndinga, H., Latifou, S., Ambendet, A., & Puruehnce, M. (2002). Assessment of psychological repercussions of AIDS, next to 354 AIDS orphans in Brazzaville. In XIV International AIDS Conference. Barcelona.
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.
Moreno-Alcázar A, Treen D, Valiente-Gómez A, Sio-Eroles A, Pérez V, Amann BL and Radua J (2017) Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adolescent with Post-traumatic stress disorder: A Meta-Analysis of Randomized Controlled Trials. Front. Psychol. 8:1750. doi: 10.3389/fpsyg.2017.01750
Murunga, G. R. (2011). Spontaneous or premeditated? Post-election Violence in Kenya. Nordiska Afrikainstitutet.
Mutiso, V. N., Musyimi, C. W., Tele, A., & Ndetei, D. M. (2017). Epidemiological patterns and correlates of mental disorders among orphans and vulnerable children under institutional care. Social Psychiatry and Psychiatric Epidemiology, 52(1), 65–75.
Paul, O. (2019). Perceptions of family relationships and post-traumatic stress symptoms of children exposed to domestic violence. Journal of family violence, 34(4), 331-343.
Perfect, M. M., Turley, M. R., Carlson, J. S., Yohanna, J., & Saint Gilles, M. P. (2016). School-related outcomes of traumatic event exposure and traumatic stress symptoms in students: A systematic review of research from 1990 to 2015. School Mental Health, 8(1), 7-43.
Polanczyk, G. V, Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345–365. JOUR. https://doi.org/10.1111/jcpp.12381
Skinner, D., Tsheko, N., Mtero-Munyati, S., Segwabe, M., Chibatamoto, P., Mfecane, S., … Chitiyo, G. (2006). Towards a definition of orphaned and vulnerable children. AIDS and Behavior, 10(6), 619–626.
Van der Kolk, B. A. (2017). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401–408.
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2022-06-16
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