Chronic Interpersonal Trauma in Kenyan Adolescents: a Culturally Grounded Model

Abstract

The exposure to chronic interpersonal trauma during developmentally critical periods can have pervasive impacts on social, psychological, biological and cognitive functioning. Interpersonal trauma has been associated with a complex range of risk factors at the individual, family, community, and societal levels. However, little research has focused on the interplay between culture and trauma, especially in low- and middle-income countries. The current study is a qualitative investigation to develop a culturally grounded model of interpersonal trauma in Kenyan adolescents. Fourteen focus groups were conducted in three ethnically diverse communities surrounding Eldoret, Kenya with adolescents ages 12 to 18 (n=67) and caregivers (n=54). Focus Group participants identified community leaders and providers and three additional focus groups were conducted with these key informants (n=28). A grounded theory approach was used for data collection and analysis. A culturally grounded model of interpersonal trauma exploring both exposure and symptomatic presentation is proposed. From this investigation, it is apparent that adolescents who experience chronic interpersonal trauma in these communities experience dysregulation symptoms similar to those described in complex trauma theory. However, poverty, martial conflict, caregiver stress, caregiver substance abuse and favoritism emerged as risk factors for interpersonal trauma and indicate measures and interventions developed for the assessment and treatment of symptoms resulting from interpersonal trauma must be adapted for use in this population.