Psychopathology, Resilience, and Risk Factors Among Deaf and Hard of Hearing Adolescents: A Mixed Methods Study of the Special Unit Schools in Nairobi County, Kenya.

Abstract

Background- Hearing disability is associated with challenges that may predispose one to psychopathology. There is little evidence on the population’s prevalence of psychopathology. Too much focus in research has been on the risks faced by the group rather than their resilience. Study Objective–To determine the prevalence, patterns of psychopathology, associated risk and resilience factors among Deaf and Hard of Hearing adolescents in Nairobi County Special Unit Schools. Methodology: The study is a mixed methods cross-sectional research design targeting a population of Deaf and Hard of Hearing Adolescents aged 11-17years enrolled at special unit schools in Nairobi County. 8 primary schools and 1 secondary school took part in the study with a total 107 adolescents, 96 teachers and 68 parents response. Sampling was done using convenience sampling for the quantitative section and purposive sampling for the qualitative section. Data Collection was achieved through the use of the following tools:  Researcher designed Socio-Demographic Questionnaire  Strengths and Difficulties Questionnaire (Self, Teacher and Parent Reported)  DSM-5 Cross-Cutting Symptom Measure (11-17yrs)  Semi-Structured in-depth interview guide- researcher developed Data Analysis: Quantitative- Descriptive and correlation analysis to test for association between hearing disability and psychopathology was done. Software used was IBM SPSS version 23 software for windows. Qualitative- Interpretive Phenomenological Analysis to represent the different risk and resilience and adjustment issues xvi Results: The results are presented in tables, graphs, charts and narratives. Generally, moderate to high internalizing and externalizing problems as well as psychiatric symptomatology was prevalent across 12 domains of the DSM-5 tool while for the SDQ recorded 68.2% Peer problems, 47.7% emotional problems, 34.6% conduct problems, 21.5% prosocial problems and 19.6% hyperactivity problems. DSM-5 CCM also recorded prevalence of different symptoms as: psychosis 57%, depression 51.4%, 49.5% inattention, 48.6% anxiety, 43% repetitive thoughts and behavior, 38.3% mania, 37.4% somatic symptoms, 27.1% anger, 18.7% sleep problems, 15.9% irritability, 11.2% substance use and 6.5% suicidal ideation Qualitative results highlighted risk factors of stigma, language barrier, poverty, adverse childhood events among others for mental health problems. Respondents also illustrated future aspirations, Deaf community and its advocacy as protective factors alleviating mental health distress. Dissemination: Dissemination is aimed to be through publishing, mental health talks and sharing the findings with relevant stakeholders