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Incidence of Self-Esteem Among Children Exposed to Sexual Abuse in Kenya

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Abstract

It has been established that sexual abuse against children is a global problem and quite widespread. Sexual abuse against children is a public health concern given that its outcomes are not only detrimental to the health of children, but also to the health of their families and society. Often, poor mental health functioning among children is identified late and in very low numbers by health professionals. In view of the fact that children exposed to sexual abuse are one group in Sub-Saharan Africa that exhibits serious mental health problems, this article examined self-esteem among children exposed to sexual abuse in Kenya. The study used data collected between June 2015 and July 2016 from 191 children and their legal parents/guardians. Specifically, the study adopted a longitudinal research design. Children who had experienced sexual abuse and their parents/legal guardians were followed up for a period of 1 year and interviewed at 4-month intervals. Participants were recruited from the Kenyatta National Teaching and Referral Hospital and Nairobi Women’s Hospital in Kenya. Findings indicated that low and average self-esteem was significantly associated with frequency of abuse (p < 0.001) and how long ago the abuse had taken place (p = 0.005), also how long it took to receive medical attention (p < 0.001), change of attitude towards school (p < 0.0001), and use of school to escape abuse (p = 0.01). The study concludes that sexual abuse against children has negative mental health outcomes. These outcomes have detrimental effects on children’s development and therefore suggest the need for psychosocial support for victims.

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References

  • Ayoub, C. C., O’connor, E., Rappolt-Schlichtmann, G., Fischer, K. W., Rogosch, F. A., Toth, S. L., & Cicchetti, D. (2006). Cognitive and emotional differences in young maltreated children: A translational application of dynamic skill theory. Development and Psychopathology, 18(3), 679–706. https://doi.org/10.1017/S0954579406060342.

    Article  Google Scholar 

  • Azad, A., & Leander, A. (2015). Children’s reporting about sexual versus physical abuse patterns of reporting, avoidance and denial. Psychiatry, Psychology and Law, 22(6), 890–902. https://doi.org/10.1080/13218719.2015.1016392.

    Article  Google Scholar 

  • Bridgewater, G. (2016). Physical and sexual violence against children in Kenya within a cultural context. Community Practitioner, 89(2), 30–36.

    Google Scholar 

  • Brown, W. D., Riley, L., Butchart, A., Meddings, R. D., Kann, L., & Harvey, A. P. (2009). Exposure to physical and sexual violence and adverse health behaviors in African children: Results from the global school based student health survey. Bulletin of the World Health Organization, 87, 447–455. https://doi.org/10.2471/BLT.07.047423.

    Article  Google Scholar 

  • Burack, J. A., Flanagan, T., Peled, T., Sutton, H. M., Zygmuntowicz, C., & Manly, J. T. (2006). Social perspective-taking skills in maltreated children and adolescents. Developmental Psychology, 42(2), 207–217. https://doi.org/10.1037/0012-1649.42.2.207.

    Article  Google Scholar 

  • Cancian, M., Shook Slak, K., & Yang, M. (2010). Effect of family income on risk of child maltreatment. Madison: Institute for Research on Poverty.

    Google Scholar 

  • Daigneault, I., He’bert, M., & Tourigny, M. (2006). Attributions and coping in sexually abused adolescents referred for group treatment. Journal of Child Sexual abuse against children, 15(3), 35–59. https://doi.org/10.1300/J070v15n03_03.

    Article  Google Scholar 

  • DePrince, A. P., Chu, A. T., & Combs, M. D. (2008). Trauma-related predictors of deontic reasoning: a pilot study in a community sample of children. Child Abuse & Neglect, 32(7), 732–737. https://doi.org/10.1016/j.chiabu.2007.10.006.

    Article  Google Scholar 

  • Dorahy, M. J., & Clearwater, K. (2012). Shame and guilt in men exposed to childhood sexual abuse: A qualitative investigation. Journal of Child Sexual Abuse, 21(2), 155–175. https://doi.org/10.1080/10538712.2012.659803.

    Article  Google Scholar 

  • Dyer, A., Borgmann, E., Feldmann, R. E., Kleindienst, N., Priebe, K., Bohus, M., & Vocks, S. (2013). Body image disturbance in patients with borderline personality disorder: impact of eating disorder and perceived childhood sexual abuse against children. Body Image, 10(2), 220–225. https://doi.org/10.1016/j.bodyim.2012.12.007.

    Article  Google Scholar 

  • Finkelhor, D., Turner, H. A., Shattuck, A., & Hamby, S. L. (2013). Violence, crime and abuse exposure in a national sample of children and youth: an update. JAMA Pediatrics, 167(7), 614–621. https://doi.org/10.1001/jamapediatrics.2013.42.

    Article  Google Scholar 

  • Fontes, L. A., & Plummer, C. (2010). Cultural issues in disclosure of child sexual abuse. Journal of Child Sexual Abuse, 19(5), 491–518. https://doi.org/10.1080/10538712.2010.512520.

    Article  Google Scholar 

  • Ford, J. D., & Courtois, C. A. (2009). Defining and understanding complex trauma and complex traumatic stress disorders. In C. A. Courtois & J. D. Ford (Eds.), Treating complex traumatic stress disorders: an evidence-based guide (pp. 13–30). New York: Guilford Press.

    Google Scholar 

  • Fry, D., Anderson, J., & Hidalgo, R. (2016). Prevalence of violence in childhood and adolescence and the impact on educational outcomes: evidence from the 2013 Peruvian national survey on social relations. International Health, 8, 44–52. https://doi.org/10.1093/inthealth/ihv075.

    Article  Google Scholar 

  • Girgira, T., Tilahun, B., & Bacha, T. (2014). Time to presentation, pattern and immediate health effects of alleged child sexual abuse at two tertiary hospitals in Addis Ababa, Ethiopia. BMC Public Health, 14(1), 92–98. https://doi.org/10.1186/1471-2458-14-92.

    Article  Google Scholar 

  • Grant, R., & Brito, A. (2010). Chronic illness and school performance: a literature review. Focusing on Asthma and Mental Health Conditions. A Children’s Health Fund Monograph. doi: https://doi.org/10.1177/0003122410374822.

  • Green, J., McLaughlin, K., Berglund, P., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychopathology in the stress sensitization in a national sample. National Comorbidity Survey Replication (NCS-R) I: associations with first onset of DSM-IV disorders. Archives of General Psychiatry, 67(2), 113–123. https://doi.org/10.1001/archgenpsychiatry.2009.186.

    Article  Google Scholar 

  • Guelzow, J. W., Cornett, P. F., & Dougherty, T. M. (2003). Child sexual abuse victims’ perception of paternal support as a significant predictor of coping style and global self-worth. Journal of Child Sexual Abuse, 11(4), 53–72. https://doi.org/10.1300/J070v11n04_04.

    Article  Google Scholar 

  • Hillis, S., Mercy, J., Amobi, A., & Kress, H. (2016). Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics, 137(3), 1–13. https://doi.org/10.1542/peds.2015-4079.

    Article  Google Scholar 

  • Holt, M. K., Finkelhor, D., & Kantor, G. K. (2007). Multiple victimization experiences of urban elementary school students: associations with psychosocial functioning and academic performance. Child Abuse & Neglect, 31, 503–515. https://doi.org/10.1016/j.chiabu.2006.12.006.

    Article  Google Scholar 

  • Isely, P. J., Isely, P., Freiburger, J., & McMackin, R. (2008). In their own voices: a qualitative study of men abused as children by Catholic clergy. Journal of Child Sexual Abuse, 17(4), 201–215.

    Article  Google Scholar 

  • Ismayilova, L., Gaveras, E., Blum, A., To-Camier, A., & Nanema, R. (2016). Maltreatment and mental health outcomes among ultra-poor children in Burkina Faso: a latent class analysis. PLoS One, 11(10), e0164790. https://doi.org/10.1371/journal.pone.0164790.

    Article  Google Scholar 

  • Ji, K., Finkelhor, D., & Dunnes, M. (2013). Child sexual abuse in China: a meta-analysis of 27 studies. Child Abuse & Neglect, 27(9), 613–622.

    Article  Google Scholar 

  • Jonas, S., Bebbington, S., McManus, S., Meltzer, H., Jenkins, R., & Kuipers, E. (2011). Sexual abuse against children and psychiatric disorder in England: Results from the 2007 Adult Psychiatric Morbidity Survey. Psychological Medicine, 41(4), 709–719. https://doi.org/10.1017/S003329171000111X.

    Article  Google Scholar 

  • Kasomo, D. (2012). Psychological assessment of the visually impaired children in intergrated and special schools. Journal of Scientific Publishing. 2(1), 35–40.

  • Kim, J., & Cicchetti, D. (2006). Longitudinal trajectories of self-esteem processes and depressive symptoms among maltreated and non-maltreated children. Child Development, 77(3), 624–639. https://doi.org/10.1016/j.talanta.2006.01.020.

    Article  Google Scholar 

  • Lalor, K., & McElvaney, R. (2010). Child sexual abuse, links to later sexual exploitation high risk sexual behavior, and prevention/ treatment programs. Journal of Trauma, Violence & Abuse, 11(4), 159–177. https://doi.org/10.1177/1524838010378299.

    Article  Google Scholar 

  • Lippert, T., Cross, T., Jones, L., & Walsh, W. (2009). Telling interviewers about child sexual abuse: predictors of child disclosure at forensic interviews. Child Maltreatment, 14(1), 100–113. https://doi.org/10.1177/1077559508318398.

    Article  Google Scholar 

  • Madu, S. N., Ndom, R. E., & Ramashia, C. L. (2010). Depression among female survivors of domestic violence in Thohoyandou, South Africa. Gender & Behaviour, 8(1), 2871–2885. https://doi.org/10.4314/gab.v8i1.54706.

    Google Scholar 

  • Mandrup, L., & Elkit, A. (2014). Victimization and PTSD in Ugandan youth. Open Journal of Epidemiology, 4, 141–156.

  • Maniglio, R. (2009). Severe mental illness and criminal victimization: a systematic review. Acta Psychiatrica Scandinavia, 119(3), 180–191.

    Article  Google Scholar 

  • Meinck, F., Cluver, L., Boyes, M., & Mhlongo, E. (2015). Risk and protective factors for physical and sexual abuse of children and adolescents in Africa: a review and implications for practice. Trauma, Violence & Abuse, 16(1), 81–107.

    Article  Google Scholar 

  • Minzenberg, J., Poole, J., & Vinogradov, S. (2008). A neurocognitive model of borderline personality disorder: effects of childhood sexual abuse against children and relationship to adult social attachment disturbance. Development and Psychopathology, 20(1), 341–368. https://doi.org/10.1017/S0954579408000163.

    Article  Google Scholar 

  • Mishra, K., Ransing, R., Khairkar, P., & Gajanan, S. (2016). Association between childhood abuse and psychiatric morbidities among hospitalized patients. Indian Journal of Social Psychiatry, 32(1), 50–55. https://doi.org/10.4103/0971.176769.

    Article  Google Scholar 

  • Nagar, S., Sharma, S., & Chopra, G. (2008). Self- esteem among rural adolescent girls in Kangra district of Himachal Pradesh. Anthropologist, 10(2), 151–154.

    Article  Google Scholar 

  • Ndetei, D., Khasakhala, L., Mutiso, V., & Mbwayo, A. (2009). Recognition of depression in children in general hospital-based pediatric units in Kenya: practice and policy implications. Annals of General Psychiatry, 8(1), 25. https://doi.org/10.1186/1744-859X-8-25.

    Article  Google Scholar 

  • Nolin, P., & Ethier, L. (2007). Using neuropsychological profiles to classify neglected children with or without physical abuse. Child Abuse & Neglect, 31(6), 631–643. https://doi.org/10.1016/j.chiabu.2006.12.009.

    Article  Google Scholar 

  • Olsen, J. M., Breckler, S. J., & Wiggins, E. C. (2008). In 1st (Ed.), Social psychology alive. Canada: Nelson. https://doi.org/10.1007/s12308-008-0014-8.

    Google Scholar 

  • Ombok, C., Obondo, A., Kangethe, R., & Atwoli, L. (2013). The prevalence of post –traumatic stress disorder among sexually abused children at Kenyatta National Hospital in Nairobi, Kenya. East African Medical Journal, 90(10), 332–337.

    Google Scholar 

  • Omondi, S. (2014). An evaluation of child sexual abuse trial procedures in Kenya. Journal in Humanities and Social Science, 2(4), 11–63.

    Google Scholar 

  • Pereda, N., Guilera, G., Forns, M., & Gomez-Benito, J. (2009). The prevalence of child sexual abuse in community and student samples: a meta- analysis. Clinical Psychology Review, 29(4), 328–338. https://doi.org/10.1016/j.cpr.2009.02.007.

    Article  Google Scholar 

  • Perlman, S. B., Kalish, C. W., & Pollak, D. (2008). The role of maltreatment experience in children’s understanding of the antecedents of emotion. Journal of Cognition & Emotion, 22(4), 651–670. https://doi.org/10.1080/02699930701461154.

    Article  Google Scholar 

  • Piaget, J. (1965). The moral judgment of the child. New York: Free Press.

    Google Scholar 

  • Pier, E., & Herzberg, D. (2002). Piers- Harris children self-concept scale (2nd ed.). Los Angeles: western psychological services. https://doi.org/10.1016/S1369-5274(02)00290-4.

    Google Scholar 

  • Pullmann, H., & Allik, J. (2008). Relations of academic and general self-esteem to school achievement. Personality & Individual Differences, 45(6), 559–564. https://doi.org/10.1016/j.paid.2008.06.017.

    Article  Google Scholar 

  • Roberts, B., Ocaka, K., Browne, J., Oyok, T., & Sondrop, E. (2008). Factors associated with post- traumatic stress disorder and depression amongst internally displaced persons in northern Uganda. BMC Psychiatry, 8(1), 38. https://doi.org/10.1186/1471-244X-8-38.

    Article  Google Scholar 

  • Roberts, B., Damundu, E., Lomoro, O., & Sondorp, E. (2009). Post-conflict mental health needs: a cross-sectional survey of trauma, depression and associated factors in Juba, Southern Sudan. BMC Psychiatry, 9(1), 7. https://doi.org/10.1186/1471-244X-7-9.

    Article  Google Scholar 

  • Schonbucher, V., Maier, T., Mohler-kuo, M., Schnyder, U., & Landolt, M. (2012). Disclosure of child sexual by adolescents: a qualitative in-depth study. Journal of Interpersonal Violence, 27(17), 3486–3513. https://doi.org/10.1177/0886260512445380.

    Article  Google Scholar 

  • Sedlack, A., Mettenburg, J., Basena, M., Petta, L., Mcpherson, K., Greene, A., & Li, S. (2010). Fourth National incident study of child abuse & neglect (NIS-4). Report to congress. Washington DC: US department of health & human services, administration for children & families. https://doi.org/10.1016/j.gie.2010.09.001.

    Google Scholar 

  • Stoltenborgh, M., Van Ijzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. (2011). A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreatment, 16(2), 79–101. https://doi.org/10.1177/1077559511403920.

    Article  Google Scholar 

  • Sumner, A. S., Mercy, A. J., Saul, J., Motza-Nzuza, N., Kwesigabo, G., Buluma, R., et al. (2015). Prevalence of sexual violence against children and use of social services-seven countries, 2007-2013.MMWR. Morbidity & Mortality Weekly Report, 64(21), 565–569.

    Google Scholar 

  • Swanston, H. Y., Plunkett, A. M., O’Toole, B., Shrimpton, S., Parkisn, P., & Oates, K. (2003). Nine years after (SVAC). Child Abuse & Neglect, 27(8), 967–984. https://doi.org/10.1016/S0145-2134(03)00143-1.

    Article  Google Scholar 

  • Syengo, M., Kathuku, M., & Ndetei, M. (2008). Psychiatric morbidity among sexually abused children and adolescents. East African Medical Journal, 85(2), 85–91.

    Google Scholar 

  • Tebbutt, J., Swanston, H., Oates, R., & O’Toole, B. (1997). Five years after (SVAC): persisting dysfunction and problems of prediction. Journal of American Academy of Child Adolescent Psychiatry, 36(3), 330–339. https://doi.org/10.1111/j.1445-5994.1997.tb00932.x.

    Article  Google Scholar 

  • Tomoda, A., Navalta, C. P., Polcari, A., Sadato, N., & Teicher, M. H. (2009). Childhood sexual abuse against children is associated with reduced gray matter volume in visual cortex of young women. Biological Psychiatry, 66(7), 642–648. https://doi.org/10.1016/j.biopsych.2009.04.021.

    Article  Google Scholar 

  • Valentino, K., Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2008). True and false recall and dissociation among maltreated children: the role of self-schema. Development & Psychopathology, 20(1), 213–232. https://doi.org/10.1017/S0954579408000102.

    Article  Google Scholar 

  • Whitehead, J. (2010). Back to basics: sexual abuse. Protecting Children Update, 71, 8–9.

  • Wiens, V., Kyngäs, H., & Pölkki, T. (2014). A descriptive qualitative study of adolescent girls’ well-being in Northern Finland. International Journal of Circumpolar Health, 73, 24792. https://doi.org/10.3402/ijch.v73.24792.

    Article  Google Scholar 

  • Wondie, Y., Zemene, W., Tafesse, B., Reschke, K., & Schroder, H. (2011). The psychosocial consequences of child sexual abuse against children in Ethiopia: a case-control comparative analysis. Journal of Interpersonal Violence, 26(10), 2025–2041. https://doi.org/10.1177/0886260510372937.

    Article  Google Scholar 

  • Young, T., Riggs, M., & Robinson, J. L. (2011). Childhood sexual abuse and severity reconsidered: a factor structure of CSA characteristics. Journal of Child Sexual Abuse, 20(4), 373–395. https://doi.org/10.1080/10538712.2011.590124.

    Article  Google Scholar 

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Funding

This study was carried out and funded within the “Mental Health Research for Better Outcomes,” a project funded from the National Institute of Mental Health (NIMH) through award no. 4R34MH09913. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health. The University of Washington, provided oversight and resources around child mental health and quantitative research.

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Authors and Affiliations

  1. Department of Psychiatry, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya

    Teresia Mutavi, Anne Obondo & Muthoni Mathai

  2. Department of Mental Health, School of Medicine, Masinde Muliro University of Science and Technology, Kakamega, Kenya

    Donald Kokonya

  3. Department of Social Work, University of Ghana, Accra, Ghana

    Mavis Dako-Gyeke

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  1. Teresia Mutavi
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  2. Anne Obondo
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  5. Mavis Dako-Gyeke
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Correspondence to Teresia Mutavi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments. The study was approved by the Ethical and Research Committee (ERC) of the Kenyatta National Hospital/University of Nairobi in Kenya with approval number (P577/09/2014). Informed consent and assent from children were obtained from all the participants.

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Mutavi, T., Obondo, A., Mathai, M. et al. Incidence of Self-Esteem Among Children Exposed to Sexual Abuse in Kenya. Glob Soc Welf 5, 39–47 (2018). https://doi.org/10.1007/s40609-017-0107-3

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