Mechanisms associated with maternal adverse childhood experiences on offspring’s mental health in Nairobi informal settlements: a mediational model testing approach

Abstract

BackgroundAdverse childhood experiences (ACEs) is a significant public health and social welfare problem in low-and middle income countries (LMICs). However, most ACEs research is based on developed countries, and little is known about mechanisms of early ACEs on adulthood health and offspring’s wellbeing for populations in LMICs. This area is needed to guide social welfare policy and intervention service planning. This study addresses these research gaps by examining patterns of ACEs and understanding the role of ACEs on adulthood health (i.e., physical, mental health, experience of underage pregnancy) and offspring’s mental health in Kenya. The study was guided by an Integrated Family Stress and Adverse Childhood Experiences Mediation Framework.MethodsThree hundred ninety four mothers from two informal communities in Kariobangi and Kangemi in Nairobi were included in this study. The Adverse Childhood Experiences International Questionnaire (ACE-IQ), the Kessler Psychological Distress Scale (K10), Overall Health and Quality of Life items, and Child Behavior Checklist were used to study research questions. Data was gathered through a one-time interview with mothers. Structural Equational Modeling (SEM) was applied for mediational mechanism testing.ResultsAmong 13 ACE areas, most mothers experienced multiple adversity during their childhood (Mean (SD) = 4.93 (2.52)), with household member treated violently (75%) as the most common ACE. SEM results showedthat all domains of ACEs were associated with some aspects of maternal health, and all three domains of maternal health (maternal mental health, physical health, and adolescent pregnancy) were significantly associated with development of offspring’s mental health problems.ConclusionACEs are highly prevalent in Kenyan informal settlements. Consistent with cross cultural literature on family stress model, maternal ACEs are robust predictors for poor child mental health. Preventive interventions for child mental health need to address maternal adverse childhood traumatic experiences as well as their current health in order to effectively promote child mental health.

Adverse Childhood Experiences and Depression Among Women in Rural Pakistan

“…These exposures to violence and interpersonal trauma in childhood are known to be associated with poor mental health in adulthood. Yet, our study did not align with previous studies regarding the importance of neglect (24).…”

“…Prevalence of ACEs in this sample was higher than in most high-income settings (7) but lower than in other LMIC (i.e., Kenya) (7,24). High prevalence of both abuse and neglect in childhood signal child maltreatment that can lead to mental health problems in adulthood (6).…”

“…Family psychological distress, community violence, and home violence are related to MDE and symptom severity. Community and home violence were associated with maternal depression in Kenya and family psychological distress was in Canada (9,24). These exposures to violence and interpersonal trauma in childhood are known to be associated with poor mental health in adulthood.…”

“…Our ndings also indicate a need to develop context-speci c interventions that prevent ACEs from occurring. Perinatal depression and early childhood parenting interventions can reduce ACEs for the next generation (24). Among women exposed to ACEs, it is important to mitigate their impact on mental illness in adulthood (24,35).…”

Influence of Socio-Economic Status on Psychopathology in Ecuadorian Children

“…Numerous theoretic models have focused on the influence of low SES and poverty on the interaction between parents and children, acknowledged to be a crucial factor (16,17). Although no unified model has been published that considers all stressors associated with a low SES, certain key factors have been identified (18), including parental investment, parental practices, levels of chronic stress, and coping (8,19,20).…”