Four decades following the Khmer rouge: sociodemographic factors impacting depression, anxiety and PTSD in Cambodia

Seponski, Desiree M.; Lahar, Cindy J.; Khann, Sareth; Kao, Sovandara; Schunert, Tanja

doi:10.1080/09638237.2018.1466039

Cited by 23 publications

(35 citation statements)

References 37 publications

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“…These rates are significantly higher than the general Cambodian population and are higher than found in previous studies of FEWs. A recent study of the general Cambodian population found the prevalence of depression to be 27.4% [35], much lower than the 67% found in the current study. A study of female street workers in Miami, USA found the prevalence of depression to be 53% [36], still much lower than found in the current study where rates are more comparable to a clinical sample found in China which found 72% prevalence of depression [37].…”

Section: Discussioncontrasting

confidence: 92%

“…The current study's finding of anxiety level of 61% among FEWs is much higher than found (a) among the Cambodian general population (16.7%, [35]) (b) among sex worker samples in Miami (37.4%; [36]) and (c) compared to sex worker in India (42%; [38]). This is likely due to high levels of risk and stress associated with Cambodian FEWs' lives.…”

Section: Discussioncontrasting

confidence: 72%

“…The current study finds higher rates of clinically concerning PTSD symptoms in 54.4% of FEWs. This is far higher than that found within the Cambodian general population (7.6%; [35]). However, in a study of FEWs in Miami, the US, Surratt and colleagues report 69.2% of stress based sex worker for symptoms related to acute traumatic stress (69.2%).…”

Section: Discussioncontrasting

confidence: 63%

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Mental Health and Functioning in School Age Children of Female Entertainment Workers in Cambodia

Ean¹,

Pollack²,

Ngoc³

2019

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Globally, approximately 10% - 20% of children and adolescents experience mental health problems and the majority of them are living in low- and middle-income countries. Children of female sex workers are often exposed to unsafe environments, traumatic experiences and a mentally ill parent, putting them at risk for developing mental health problems themselves. Research on the mental health and functioning of children of female sex workers during their school age is limited. This paper will explore the mental health and functioning of female sex workers’ children. Method: The study included 160 female entertainment workers (FEWs) and 60 of their children from four provinces of Cambodia. FEW’s mental health, and children’s mental health and functioning were measured. Result: FEWs demonstrated high rates of depression (67%) and anxiety (61%), and 54.38% reported symptoms of post-traumatic stress disorder. Of the 60 children, the majority got their education at primary school (68%) and secondary school (25%). 46.7% of them reported symptoms of functional impairment, 18.33% suffered from psychological distress, and 36.67% have PTSD symptoms above the clinical threshold. Children’s psychological distress was significantly predicted by mothers’ early childhood traumatic experiences, mothers’ current mental health problems, mothers’ anxiety and PTSD. Mother’s PTSD predicted children’s psychological distress [β = 0.282, R2 = 0.079] and functioning [β = 0.285, R2 = 0.081]. Conclusion: School age children of FEWs have high rates of depression, anxiety and PTSD. Children’s psychological problems impair their functioning at school and home. FEW’s PTSD predicts their children’s psychological distress and functioning. Further research on the mental health and functioning of FEW’s children should be continued with a larger sample size. Mental health professionals and educators should provide mental health care for FEWs and their children, and develop evidence-based approaches to improving children’s mental health and functioning

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Section: Discussioncontrasting

confidence: 92%

Section: Discussioncontrasting

confidence: 72%

Section: Discussioncontrasting

confidence: 63%

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Mental Health and Functioning in School Age Children of Female Entertainment Workers in Cambodia

Ean¹,

Pollack²,

Ngoc³

2019

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“…Cambodia is home to largest youth and adolescent population in the South East Asia region, with approximately two third of population between age of 15-24 and nearly a quarter between 10-19 year old [14]. Previous studies suggested a high prevalence of mental health-related problems among both Cambodian children and adults [15][16][17]. In a nationally representative study, 8.2% of households with children reported one or more children were having school problems, 11.5% reported child aggressive behavior, and 4.9% reported children were experiencing other mental health-related problems [15].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Effectiveness of Teachers’ Mental Health Literacy Training in Cambodia: A Randomized Controlled Trial

Phoeun

Nguyen

Dang

et al. 2019

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School-based mental health literacy (MHL) programs are used to reduce stigma and promote help-seeking among students and teachers. This study aimed to adapt and evaluate a teacher-delivered MHL program in Cambodia, where the impact of MHL programs has not previously been evaluated. 67 teachers and 275 students from a high school in Phnom Penh voluntarily completed the study. School staff were randomly assigned, and classrooms purposively assigned, to either a 2-day MHL training program or a control condition. Four teachers in the intervention condition were also pragmatically selected to deliver a 6-week classroom MHL curriculum to students; these teachers receive an extra day of implementation training. Teacher and student MHL were assessed before and after the intervention. Results showed significant improvements in all indicators of teacher and student knowledge and attitudes about mental illness; largest improvements were in teachers’ perceptions of dangerousness and willingness to interact. This pilot RCT supports the potential benefits of school-based MHL training in Cambodia, where there is substantial mental health stigma and discrimination. However, small to moderate effect sizes, particularly for students outcomes, suggest a need for further refinement and testing of the curriculum to optimize impact, including further consideration of implementation strategies and supports.

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“…Cambodia provides a unique context in which to investigate trauma development. From 1975 to 1979, Cambodia experienced genocide at the hands of the KR, with losses estimated between 1.5 and 3 million people (Seponski, Lahar, Khann, Kao, & Schunert, 2018). Following the genocide, the country entered into a period of civil war and was under the direction of several unstable regimes before entering into a period of relative political stability.…”

mentioning

confidence: 99%

Exploring Contextual Trauma in Cambodia: A Sociointerpersonal Perspective on Posttraumatic Stress Disorder

Armes

Seponski

Kao

et al. 2019

Journal of Traumatic Stress

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Trauma literature has proposed multiple theories of trauma development, maintenance, and transmission, which has led to a lack of clarity surrounding trauma in individuals, families, and communities. We investigated the impact of community‐level trauma experiences on individual posttraumatic stress disorder (PTSD) symptoms using a sociointerpersonal model of PTSD (Maerker & Horn, 2013). A nationally representative sample (N = 2, 690) of Cambodian households across all regions of the country was surveyed regarding individual trauma experiences during and after the Khmer Rouge regime, symptoms of PTSD, and current stressors. Individual experiences of war trauma and current stressors were aggregated based on the district in which each individual lived. District mean and individual war trauma and current stressors were included in a multilevel model as predictors of individual levels of PTSD. Findings indicated that mean trauma experiences, β = .05, p < .001, and current stressors, β = .10, p < .001, in the district in which individuals live were positively and significantly associated with their individual PTSD symptoms. Individual war trauma, β = .02, p < .001, and current stressors, β = .08, p < .001, were also positively and significantly associated with individual PTSD symptoms. District trauma experiences accounted for 7% of the variance in individual PTSD symptoms, R2Level 1 = .21, R2Level 2 = .80. Additionally, current stressors at both the individual and district levels had a greater impact on individual PTSD symptoms than war trauma at either level of the model. Implications for policy and intervention are presented.

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Four decades following the Khmer rouge: sociodemographic factors impacting depression, anxiety and PTSD in Cambodia

Abstract: These findings can inform Cambodian mental health policies and development strategies, especially targeting the most vulnerable groups.

Cited by 23 publications

References 37 publications

Mental Health and Functioning in School Age Children of Female Entertainment Workers in Cambodia

Mental Health and Functioning in School Age Children of Female Entertainment Workers in Cambodia

Assessing the Effectiveness of Teachers’ Mental Health Literacy Training in Cambodia: A Randomized Controlled Trial

Exploring Contextual Trauma in Cambodia: A Sociointerpersonal Perspective on Posttraumatic Stress Disorder

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