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Multi-informant perspective on psychological distress among Ghanaian orphans and vulnerable children within the context of HIV/AIDS

Published online by Cambridge University Press:  07 June 2016

P. N. Doku  and
H. Minnis
P. N. Doku*
Affiliation:
Department of Psychology, University of Ghana, Box LG 84, Legon, Accra, Ghana University of Glasgow, Institute of Mental Health and Wellbeing, Glasgow G12 0XH, UK
H. Minnis
Affiliation:
University of Glasgow, Institute of Mental Health and Wellbeing, Glasgow G12 0XH, UK
*
*Address for correspondence: P. N. Doku, Department of Psychology, University of Ghana, Box LG 84, Legon, Accra, Ghana. (Email: pndoku@ug.edu.gh)
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Abstract

Background

There is little knowledge about the psychosocial distress of children affected by human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) in Ghana, to aid the planning of services. This study investigated mental health problems among children affected by HIV/AIDS, compared with control groups of children orphaned by other causes, and non-orphans.

Method

The study employed a cross-sectional survey that interviewed 291 children and their caregivers. Both children and caregivers completed the Strengths and Difficulties Questionnaire that measured children's psychosocial wellbeing. Verbal autopsy was used to identify whether children lost one or both parents from AIDS.

Results

The results indicated that controlling for relevant sociodemographic factors, both children's self-reports and caregivers’ reports indicate that both children living with HIV/AIDS-infected caregivers and children orphaned by AIDS were at heightened risk for mental health problems than both children orphaned by other causes and non-orphans. The findings further indicated that a significant proportion of orphaned and vulnerable children exhibited symptoms for depression and other psychiatric disorders (approximately 63%) compared with 7% among the non-orphaned group. Caregivers gave higher ratings for children on externalizing problems and lower on internalizing problems, and vice versa when the children's self-reports were analysed.

Conclusions

The findings suggest that both children and their informants have diverse yet complementary perspectives on psychological outcomes. The study discusses the theoretical and practical implications of these findings and urgently calls for necessary intervention programmes that target all children affected by HIV/AIDS to effectively alleviate psychological distress and enhance the mental health of these children.

Keywords

AfricaGhanaHIV/AIDSmental healthpsychological distressorphansvulnerable children
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 11 , August 2016 , pp. 2329 - 2336
Copyright
Copyright © Cambridge University Press 2016 

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References

Achenbach, TM, McConaughy, SH, Howell, CT (1987). Child/adolescent behavioural and emotional problems: implications of cross-informant correlations for situational specificity. Psychological Bulletin 101, 213–232.CrossRefGoogle ScholarPubMed
Ampofo, TK, Nyarko, W, Asare, R, Antwi, P, Essah, K (2014). Antiretroviral Therapy in Ghana: Patients’ Presentation and Response. Paper presented at the International Conference on AIDS, Bangkok, Thailand. Abstract no. B10872.Google Scholar
Braitstein, P (2015). Institutional care of children in low- and middle-income settings: challenging the conventional wisdom of Oliver Twist. Global Health Science Practice 3, 330–332.CrossRefGoogle ScholarPubMed
Cluver, L, Gardner, F, Operario, D (2007). Psychological distress amongst AIDS-orphaned children in urban South Africa. Journal of Child Psychology and Psychiatry 48, 755–763.CrossRefGoogle ScholarPubMed
Cluver, L, Orkin, M, Boyes, ME, Sherr, L, Makasi, D, Nikelo, J (2013). Pathways from parental AIDS to child psychological, educational and sexual risk: developing an empirically-based interactive theoretical model. Social Science Medicine 87, 185–193.CrossRefGoogle ScholarPubMed
Cluver, L, Orkin, M, Gardner, F, Boyes, ME (2012). Persisting mental health problems among AIDS-orphaned children in South Africa. Journal of Child Psychology and Psychiatry 53, 363–370.CrossRefGoogle ScholarPubMed
Delva, W, Vercoutere, A, Dehaene, I, Willems, S, Temmerman, M, Annemans, L (2005). Thinking ahead – the rising tide of AIDS orphans. South African Medical Journal 95, 656–658.Google ScholarPubMed
Doku, PN (2009). Parental HIV/AIDS status and death, and children's psychological wellbeing. International Journal of Mental Health Systems 3, 26.Google Scholar
Doku, PN (2010). Psychosocial adjustment of children affected by HIV/AIDS in Ghana. Journal of Child and Adolescent Mental Health 22, 31–40.CrossRefGoogle ScholarPubMed
Doku, PN, Dotse, JE, Akohene, KM (2015). Perceived social support disparities among children affected by HIV/AIDS in Ghana: a cross-sectional survey. BMC Public Health 15, 538.CrossRefGoogle ScholarPubMed
Ferdinand, RF, Hoogerheide, KN, van der Ende, J, Heijmens Visser, JH, Koot, HM, Kasius, MC, Verhulst, FC (2003). The role of the clinician: three-year predictive value of parents', teachers' and clinicians' judgment of childhood psychopathology. Journal of Child Psychology and Psychiatry 44, 867–876.CrossRefGoogle ScholarPubMed
Goodman, R, Meltzer, H, Bailey, V (2003). The Strengths and Difficulties Questionnaire: a pilot study of the validity of the self-report version. International Review of Psychiatry 15, 173–177.CrossRefGoogle ScholarPubMed
Govender, K, Reardon, C, Quinlan, T, George, G (2014). Children's psychosocial wellbeing in the context of HIV/AIDS and poverty: a comparative investigation of orphaned and non-orphaned children living in South Africa. BMC Public Health 14, 615.Google Scholar
He, Z, Ji, C (2007). Nutritional status, psychological wellbeing and the quality of life of AIDS orphans in rural Henan Province, China. Tropical Medicine and International Health 12, 1180–1190.Google Scholar
International Household Survey Network (2013). South Africa – General Household Survey 2005 (http://www.ihsn.org/home/projects/survey-methods). Accessed May 2016.Google Scholar
Kirkpatrick, SM, Rojjanasrirat, W, South, BJ, Sindt, JA, Williams, LA (2012). Assessment of emotional status of orphans and vulnerable children in Zambia. Journal of Nursing Scholarship 44, 194–201.CrossRefGoogle ScholarPubMed
Lochman, JE (2004). Contextual factors in risk and prevention research. Merrill Palmer Quarterly 50, 311–325.CrossRefGoogle Scholar
Lopman, B, Cook, A, Smith, J, Chawira, G, Urassa, M, Kumogola, Y, Isingo, R, Ihekweazu, C, Ruwende, J, Ndege, M, Gregson, S, Zaba, B, Boerma, T (2010). Verbal autopsy can consistently measure AIDS mortality: a validation study in Tanzania and Zimbabwe. Journal of Epidemiology and Community Health 64, 330–334.CrossRefGoogle ScholarPubMed
Meintjes, H, Giese, S (2006). Spinning the epidemic: the making of mythologies of orphanhood in the context of AIDS. Childhood 13, 407–430.CrossRefGoogle Scholar
Mwinituo, PP, Mill, JE (2006). Stigma associated with Ghanaian caregivers of AIDS patients. Western Journal of Nursing Research 28, 369–382.CrossRefGoogle ScholarPubMed
Myers, K, Winters, NC (2002). Ten-year review of rating scales. II: scales for internalizing disorders. Journal of the American Academy of Child and Adolescent Psychiatry 41, 634–659.CrossRefGoogle ScholarPubMed
Nyamukapa, CA, Gregson, S, Lopman, B, Saito, S, Watts, HJ, Monasch, R, Jukes, MC (2008). HIV-associated orphanhood and children's psychological distress: theoretical framework tested with data from Zimbabwe. American Journal of Public Health 98, 133–141.CrossRefGoogle ScholarPubMed
Rotheram-Borus, MJ, Weiss, R, Alber, S, Lester, P (2005). Adolescent adjustment before and after HIV-related parental death. Journal of Consulting and Clinical Psychology 73, 221–228.Google Scholar
Synhorst, L, Buckley, J, Reid, B, Epstein, MH, Ryser, G (2005). Cross informant reliability of the Behavioral and Emotional Rating Scale-2 (BERS-2). Child and Family Behavior Therapy 27, 1–11.CrossRefGoogle Scholar
Tenkorang, EY, Owusu, GA (2010). Correlates of HIV testing among women in Ghana: some evidence from the Demographic and Health Surveys. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV 22, 296–307.CrossRefGoogle ScholarPubMed
Thomas, F (2006). Stigma, fatigue and social breakdown: exploring the impacts of HIV/AIDS on patient and carer well-being in the Caprivi Region, Namibia. Social Science and Medicine 63, 3174–3187.CrossRefGoogle ScholarPubMed
Ulasi, CI, Preko, PO, Baidoo, JA, Bayard, B, Ehiri, JE, Jolly, CM, Jolly, PE (2009). HIV/AIDS-related stigma in Kumasi, Ghana. Health and Place 15, 255–262.Google Scholar
UNAIDS (2006). Sub-National Distribution and Situation of Orphans: Analysis of the President's Emergency Plan for AIDS Relief Focus Countries. UNAIDS: Washington, DC.Google Scholar