According to Dr Grace Nduku Wambua, a Kenyan Postdoctoral Research Fellow at the Africa Health Research Institute who graduated with a PhD in Psychiatry from UKZN on 6 May, levels of resilience might explain why although there is a high incidence of psychosis among victims of childhood trauma, not all individuals exposed to it develop mental health problems when they become adults.
Psychosis refers to a collection of symptoms that affect the mind, where there has been some loss of contact with reality. A clinical psychologist by training, Wambua felt it was important to understand how the processes involved in child development interacts with individuals to develop resilience. Her doctoral research thus aimed to add knowledge to the field of mental health research by exploring the role played by resilience in individuals exposed to childhood trauma by comparing patients with first-episode psychosis with healthy controls.
Co-supervised by UKZN’s Psychiatry Chief Specialist and Head of Department, Associate Professor Bonga Chiliza and clinical psychologist, Dr Sanja Kilian, 14 participants who had experienced adversity in their childhood were recruited to Wambua’s study using a multiple-case study design. They were interviewed to understand how they conceptualised trauma and how they coped during and after the traumatic experience. The data was analysed using Braun and Clark’s reflexive thematic approach, the findings providing a local portrait of childhood adverse events and coping strategies, providing a qualitative understanding of the role of early experiences and their subsequent impact on perception and adaptation.
‘This study concurred with previous literature, suggesting that resilience processes are complex and contextual. In addition, consistent with the literature, the study supported the notion that the negative sequelae of childhood trauma may be prevented or moderated if appropriate support through necessary prevention and interventions was put in place at all ecological levels and provided at the right time for those confronted with adversity, especially those in vulnerable environments,’ Wambua said.
‘With most knowledge on the topic having been generated in the Global North, this study in sub-Saharan Africa (specifically Kenya) adds a unique addition to the field of resilience in psychosis. Our findings emphasised the multidimensional nature of mental illness, adversity, and subsequent positive adaptation that need to be considered for the successful management of mental disorders and the promotion of mental health in our communities,’ Wambua added. ‘Future research on resilience should take a more contextual approach to enable a wholesome understanding of the dynamic process of adaptation in the presence of any form of adversity and across a lifespan.’
Wambua said her passion for child and adolescent mental health, with a particular interest in developing or adapting psychological interventions that are contextually and culturally appropriate, was undoubted. ‘For this to be possible, it was important for me to understand how mental health develops, especially after exposure to adversities in childhood and what happens to those who experience such adversities, not becoming mentally unwell.’
‘I’m very excited about this accomplishment; it’s quite humbling. I’m looking forward to developing into an independent researcher in the Global South.’ She thanked her parents and siblings for their unyielding support, also thanking her supervisors whom she said were patient with her.
Wambua’s motto in life is: ‘One day at a time. One foot in front of the other.’
Words: Lunga Memela
Photograph: Sethu Dlamini
