Neglect and perceived stigmatization impact psychological distress of orphans in Tanzania

Abstract

Background

Research has shown that orphans in sub-Saharan Africa are at increased risk for mental health problems. Exposure to maltreatment and HIV/AIDS-related stigmatization are related to orphans’ psychological distress. Yet, researchers stress the need for more research in low-income countries to identify which factors of being an orphan may lead to psychological distress.

Objectives

The present study aims to systematically investigate orphans’ experiences of maltreatment and stigmatization to identify factors that relate to their psychological distress.

Methods

In total, 89 Tanzanian children who had lost at least one parent were compared to 89 matched non-orphans (mean age: 11 years; 51% boys). We measured exposure to maltreatment and perceived stigmatization as an orphan. Mental health was assessed using the Strengths and Difficulties Questionnaire, the Children's Depression Inventory, the UCLA PTSD Index for Children, and the Reactive–Proactive Questionnaire.

Results

Orphans reported significantly more experiences of neglect, but not of abuse. A group comparison revealed more depressive symptoms, posttraumatic stress symptoms, and aggressive behavior among orphans. Neglect, abuse, and stigmatization correlated with orphans’ internalizing and externalizing problems, yet only neglect and stigmatization were related to orphans’ depression severity. Perceived stigmatization moderated the relationship between neglect and depression.

Conclusions

Our findings suggest that orphans in Tanzania are at increased risk of experiencing neglect. Maltreatment and perceived stigmatization may play a role in orphans’ psychological distress. Culturally appropriate and evidence-based interventions may help to prevent maltreatment and stigmatization of orphans.

• Orphans
• maltreatment
• neglect
• mental health
• stigmatization
• sub-Saharan Africa

For the abstract or full text in other languages and supplementary material for this article, please see Supplementary files under ‘Article Tools’

For the abstract or full text in other languages and supplementary material for this article, please see Supplementary files under ‘Article Tools’

Acknowledgements

This research was supported by the Deutsche Forschungsgemeinschaft (DFG) and by the NGO vivo international. The authors thank all of the children who participated in this study for their readiness to participate and willingness to discuss intimate and painful subjects. They are very grateful to their highly motivated and reliable research team, including Manswab Geho, Dorothea Isele, Huruma Kipagile, Getrude Mkinga, Andrew Mtitu, Zephania Ngowi, Lulu Nziku, Astrid Pabst, Charlotte Salmen, and Leila Samson. They also thank Justin Preston who critically reviewed the manuscript and Thomas Elbert for his continuous support.

Notes

For the abstract or full text in other languages and supplementary material for this article, please see Supplementary files under ‘Article Tools’