Mental Health and Functioning in School Age Children of Female Entertainment Workers in Cambodia

Abstract

Globally, approximately 10% - 20% of children and adolescents experience mental health problems and the majority of them are living in low- and middle-income countries. Children of female sex workers are often exposed to unsafe environments, traumatic experiences and a mentally ill parent, putting them at risk for developing mental health problems themselves. Research on the mental health and functioning of children of female sex workers during their school age is limited. This paper will explore the mental health and functioning of female sex workers’ children. Method: The study included 160 female entertainment workers (FEWs) and 60 of their children from four provinces of Cambodia. FEW’s mental health, and children’s mental health and functioning were measured. Result: FEWs demonstrated high rates of depression (67%) and anxiety (61%), and 54.38% reported symptoms of post-traumatic stress disorder. Of the 60 children, the majority got their education at primary school (68%) and secondary school (25%). 46.7% of them reported symptoms of functional impairment, 18.33% suffered from psychological distress, and 36.67% have PTSD symptoms above the clinical threshold. Children’s psychological distress was significantly predicted by mothers’ early childhood traumatic experiences, mothers’ current mental health problems, mothers’ anxiety and PTSD. Mother’s PTSD predicted children’s psychological distress [β = 0.282, R2 = 0.079] and functioning [β = 0.285, R2 = 0.081]. Conclusion: School age children of FEWs have high rates of depression, anxiety and PTSD. Children’s psychological problems impair their functioning at school and home. FEW’s PTSD predicts their children’s psychological distress and functioning. Further research on the mental health and functioning of FEW’s children should be continued with a larger sample size. Mental health professionals and educators should provide mental health care for FEWs and their children, and develop evidence-based approaches to improving children’s mental health and functioning

Long-term affective and non-affective brain alterations across three generations following the genocide in Cambodia

“…Of the survivors interviewed, ten had roles within the Khmer Rouge regime associated with potential violence against others (e.g., soldiers, prison guards). However, none met the PTSD criteria (score ≥ 33 3 ) and could thus not be introduced as a factor in our full factorial design.…”

“…Experiencing trauma can lead to post-traumatic stress disorder (PTSD) and negatively impact brain function in early automatic and late conscious processing in both affective and nonaffective contexts 1 . For example, a trauma can lead to an increased fear response due to an overactive limbic system 2 , a difficulty to regulate memories due to an alteration of the hippocampal function 3 , and a deficit in emotion regulation and attentional bias towards threatening stimuli due to a deficit in prefrontal cortical inhibition of the amygdala 4 . It can also lead to a deficit in information processing, including (pre-)attentive processing of unexpected stimuli [5][6][7] , encoding new stimuli 8 , or filtering out irrelevant information 8,9 .…”

Concurrent and convergent validity of culture-specific psychopathology syndromes among Cambodian adolescents

“…The CSSI, PHQ-9, and GAD-7 had pre-existing Khmer versions widely used clinically and in research in Cambodia (Ean et al, 2019) that are generally considered as valid assessment instruments (Foundation for Psychocultural Research, 2022; U.S. AID, 2022).…”

“…Measure translation and validation. The CSSI, PHQ-9, and GAD-7 had pre-existing Khmer versions widely used clinically and in research in Cambodia (Ean et al, 2019) that are generally considered as valid assessment instruments (Foundation for Psychocultural Research, 2022; U.S. AID, 2022). For the other three measures, which did not have pre-existing versions, the questionnaires were first reviewed and translated by the second author who is a native Khmer speaker fluent in English, a clinical psychologist, and university psychology professor, with consultation from the last author who is a native English speaker and university professor of clinical psychology.…”