Trauma of Poverty and its Psychological Impact: A Case of Kenya

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International Journal of Research and Innovation in Social Science (IJRISS) |Volume V, Issue IX, September 2021|ISSN 2454-6186
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Trauma of Poverty and its Psychological Impact: A
Case of Kenya
Elijah Macharia Ndung‟u (PhD)
Department of Counselling Psychology, Catholic University of Eastern Africa
Abstract: Extreme poverty is a tormenting, dehumanizing and
distressing daily phenomenon for the poor and vulnerable in
society, which may cause extreme distress to the non-resilient
poor hence a predisposing factor to trauma. The study argues
that much as poverty and the associated trauma can be explained
in economic terms, interventions ought to be more elastic,
stretching beyond economic limits and hence, take cognizance of
the psychological dimension whose effects and impacts cannot be
underestimated. The study assessed how trauma arising from
poverty is indeed traumatizing to the poor, marginalized and less
resilient poor people in society. The researcher adopted a cross-
sectional research design and triangulation method (mixes both
qualitative and quantitative approach of research). The study
areas were Nairobi and Nakuru Counties representative of the
urban and rural setting respectively. The study population
included social work practitioners, social work clients and key
social work informants. The research study covered a total of 141
respondents (n=141). This comprised of 91 social work
practitioners, 10 key informants and 40 social work clients. Data
collection involved structured and semi-structured
questionnaires and interview guides. SPSS (ver. 20 for Windows)
was used for data analysis. The key findings of the study were;
trauma of poverty was noted as a major issue among the social
work clients by social workers and had a high prevalence rate of
64.8%. As such almost all social workers (94.5%) were in
agreement that addressing trauma of poverty should be given
key priority while addressing poverty related issues.
Keywords: Trauma, Poverty, Trauma of Poverty, Resilience,
Psychological Wellbeing
I. INTRODUCTION
arely is trauma emanating from poverty seen as a major
area of concern, yet the ramifications of poverty to the
individual especially the poor and vulnerable in society need
not to be overemphasized. As trauma literature reveals, there
is a predominant tendency that trauma is viewed as emanating
from conventionally perceived causes such as war
and terrorism, natural disasters (drought, floods, and
earthquakes), accidents, political violence, rape and sexual
abuse, alcohol, drug and substance abuse, health issues, death
of loved ones among others (Herman,1992; Bracken & Petty,
1998; Tedeschi, Park & Calhoun, 1998; Ntomchukwu et al,
1999; Ryle & Kerr, 2002; Laungani, 2002; Stricker &
Widiger, 2003; Taylor 2006; Kirmayer et al.2007; Covington,
2008;). However, there is another cause of trauma that is
rarely given much consideration to. Trauma emanating from
poverty is a relatively new aspect towards trauma that has not
gained much attention especially from the psychologists,
psychiatrist and social workers. Incidentally, trauma of
poverty may not be universally recognized as such but is
equally traumatizing as other conventionally held causes of
trauma. Even though trauma of poverty may be subtler than
other forms of trauma (natural disasters or physical assault) its
effects, suffered by too many in the country, are no less
traumatic nor significant (Bussey & Wise, 2007).
Trauma arising from poverty is more visible in circumstances
where poverty rules supreme over other social problems. It
may thus be more eminent in some regions of the world where
extreme poverty rates are tremendously high for instance in
Sub-Saharan Africa and Southern Asia as compared to other
regions in the world. In such countries poverty is a major
cause of psychological stress and suffering which torments the
poor and helpless individuals with detrimental consequences
on their psychological well-being. Most of the affected poor
have nowhere to turn for assistance or support and worse still
there are ineffective or non-existent mechanisms in these
countries to cushion them from such circumstances. Such is
the predicament faced by the chronically poor affecting their
psychological functionality and hinders their capability to
socio-economic development. The affected poor may as well
experience severe psychological distress which is a
predisposing factor to psychological dysfunction including
traumatization. Therefore, the long-term effects of chronic
economic struggle coupled with the multi-dimensional aspect
of poverty (Manda et al, 2000; Keriga & Burja, 2009), creates
a complex multiple systems interaction that affects
psychological wellbeing of individuals (Edin & Lein, 1997;
Friis et al. 2002).
Thus, this paper goes beyond the conventionally known
meaning and causes of trauma to define and describe trauma
of poverty and its psychological impact on social work clients
who are the most vulnerable in society. The complexities and
divergent trauma related problems associated with poverty,
especially in the African context may be a key predisposing
factor to causing trauma of poverty. The study sought to
assess the psychological impact of poverty among social work
clients. Views were gotten from the social workers helping the
social work clients, key informants in social work practice and
the social work clients affected by trauma emanating from
poverty related issues.
As global literature indicates, there are various definitions to
trauma that have been developed and obtaining a common
definition to the term is still elusive. Trauma has been
investigated from several different theoretical perspectives
R

International Journal of Research and Innovation in Social Science (IJRISS) |Volume V, Issue IX, September 2021|ISSN 2454-6186
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and disciplines, each with its own concepts, meaning, research
methodologies, diagnostic nomenclature, therapeutic
strategies and outcome measures, thus, it is difficult to have a
single one discipline that can solely claim possession of the
term and its definition (Laungani, 2002).
In the context of Post-Traumatic Stress Disorder (PTSD),
trauma is an extreme traumatic stressor involving direct
personal experience of an event that involves actual
threatened death or serious injury, or other threat to one‟s
physical integrity (DSM-IV-TR, 2000, p.463). Similarly,
James (1989) adds that, trauma is an overwhelming
uncontrollable experience that psychologically impacts on
victims by creating in them feelings of helplessness,
vulnerability, loss of safety and loss of control (Ntomchukwu
et al, 1999. p.70). Trauma can also be seen as a socio-political
event, a psycho-physiological process, a physical and
emotional experience, and a narrative theme in explanations
of individual and social suffering (Kirmayer et al., 2007).
Hence, traumatic events are regarded as extraordinary
stressors by their intensity and tendency to cause helplessness,
overwhelming fear, involve threats to life or bodily integrity,
and suffering in most people, regardless of personal
characteristics (Gutlove & Thompson, 2003; Covington,
2008; Herman, 1992).
In this paper trauma of poverty is defined as: “Traumatic
events, experiences or stressors caused by poverty related
issues that threaten the psychosocial wellbeing and or
physical integrity of the individual rendering him/her
powerless and in a state of hopelessness”.
The development of trauma definitions, diagnostic assessment
and treatment measurements are more widely applied in the
Western world (Laungani, 2002). More so, research on trauma
is rather subjective and generally based largely on the
nomenclature for PTSD (DeLoach & Petersen, 2010). Much
of the research focuses on the conventionally known causes of
trauma (war, political violence, natural disasters, and
terrorism), whilst trauma of poverty is rarely given adequate
attention despite the evidence of poverty, financial problems
and social deprivation being major socio-economic risk
factors for mental health problems and disorders (Fryers et al,
2005; Laaksonen et al, 2007 cited in WHO, 2011).
There has been much expression of interest of Western
psychologists, psychiatrists and medical professionals to
venture into studies on assessing causes, effects, impacts and
also interventions to trauma in non-western countries.
However, there should be caution towards this endeavor;
models developed in Western psychiatry with regard to the
effects of trauma should not be exported uncritically to non-
western societies (Bracken & Petty, 1998). This is because,
favoring Western diagnostic conceptualizations rather than
honoring indigenous understandings of trauma further propels
the forces of structural oppression, thus silencing African
views in deference to Western models (Petersen-Coleman &
Swaroop, 2011).
For one to understand, trauma of poverty then one has to
clearly understand the context in which it occurs, since trauma
can only be understood and addressed with reference to the
specific contexts in which it occurs (Becker, 2004). The
diversity of contextual occurrence is very vital to the
understanding of the trauma. There are different applications
to the term trauma depending on the nature, magnitude and
culture where it is applied and may be country specific
(Laungani, 2002. Hence, trauma concepts need to be
continually reinvented and always contextualized within the
specific social reality in which the traumatization occurs
(Becker, 2004, p.2).
Even though there seems to be a wide consensus on a general
definition to trauma, need to apply it to specific situations is
imperative. There is need to broaden the current definition of
a traumatic stressor to include experiences that are distressing
but not necessarily directly associated with physical threat or
injury (Gold et al, 2005). The trauma concept should not only
be confined to its clinically Western conventional
conceptualization but to also encompass broader aspects of
traumatic events and meaning which is culture specific.
Therefore, trauma and its associated interventions ought to be
addressed from an intrinsic perspective factoring in the
dynamic nature of traumatic events including those arising
from poverty. Consequently, it is imperative to have in mind
that the description and manifestation of poverty related
traumatic experiences encountered in the developing world
especially in Sub Saharan Africa where poverty rates are high
may not fit that of the Western conceptualization and
description. Thus, trauma can be seen as being country and
culture specific. Therefore, if one is to wholly grasp the
meaning of trauma of poverty in the African context, then one
would have to go beyond the conventionally held meaning
and description of trauma and a traumatic event.
The PTSD, diagnosis has undergone various modifications
over time. For instance, the Diagnostic and Statistical Manual
for Mental Disorders-DSM-IV-TR (APA, 2000) categorizes
symptoms for PTSD into four main clusters namely; exposure
to a traumatic event, re-experiencing intrusive thoughts,
avoidance of stimuli associated with the trauma and emotional
numbing, and hyper-arousal. In the DSM-V there are more
amendments to PTSD including an addition of three
symptoms namely; negative expectation of oneself/world
/others, distorted blame, and recklessness. It also has four
rather than the earlier three symptom groups in DSM-IV-TR
(APA, 2013). Table 1 illustrates the diagnostic criterion for
PTSD.

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Table 1 : PTSD DSM-IV-TR and DSM V Diagnostic Criterion
PTSD DSM-IV-TR Diagnostic Criterion
PTSD-DSM V Diagnostic Criterion
A. The person has been exposed to a traumatic event in which both of
the following were present:
(1) the person experienced, witnessed, or was confronted with an
event or events that involved actual or threatened death or
serious injury, or a threat to the physical integrity of self or
others
(2) the person's response involved intense fear, helplessness, or
horror. Note: In children, this may be expressed instead by
disorganized or agitated behavior.
B. The traumatic event is persistently re-experienced in one (or more) of
the following ways:
(1) recurrent and intrusive distressing recollections of the event,
including images, thoughts, or perceptions. Note: In young
children, repetitive play may occur in which themes or aspects
of the trauma are expressed.
(2) recurrent distressing dreams of the event. Note: In children,
there may be frightening dreams without recognizable content.
(3) acting or feeling as if the traumatic event were recurring
(includes a sense of reliving the experience, illusions,
hallucinations, and dissociative flashback episodes, including
those that occur on awakening or when intoxicated). Note: In
young children, trauma-specific reenactment may occur.
(4) intense psychological distress at exposure to internal or externa
l cues that symbolize or resemble an aspect of the traumatic
event.
(5) physiological reactivity on exposure to internal or external cues
that symbolize or resemble an aspect of the traumatic event
C. Persistent avoidance of stimuli associated with the trauma and
numbing of general responsiveness (not present before the trauma),
as indicated by three (or more) of the following:
(1) efforts to avoid thoughts, fee lings, or conversations associated
with the trauma
(2) efforts to avoid activities, places, or people that a rouse
recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant
activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of a foreshortened future (e.g., does not expect to have a
career, marriage, children, or a normal life span)
D. Persistent symptoms of increased arousal (not present before the
trauma), as indicated by two (or more) of the following:
(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C, and D) is
more than 1 month.
F. The disturbance causes clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
A. Exposure to actual or threatened death, serious injury, or sexual violence in one
(or more) of the following ways:
1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or
close friend. In cases of actual or threatened death of a family member or
friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the
traumatic event(s) (e.g., first responders collecting human remains: police
officers repeatedly exposed to details of child abuse). Note: Criterion A4
does not apply to exposure through electronic media, television, movies,
or pictures, unless this exposure is work related.
B. Presence of one (or more) of the following intrusion symptoms associated with
the traumatic event(s), beginning after the traumatic event(s) occurred:
1. Recurrent, involuntary, and intrusive distressing memories of the
traumatic event(s). Note: In children older than 6 years, repetitive play
may occur in which themes or aspects of the traumatic event(s) are
expressed.
2. Recurrent distressing dreams in which the content and/or affect of the
dream are related to the traumatic event(s). Note: In children, there may be
frightening dreams without recognizable content.
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or
acts as if the traumatic event(s) were recurring. (Such reactions may occur
on a continuum, with the most extreme expression being a complete loss
of awareness of present surroundings.) Note: In children, trauma-specific
reenactment may occur in play.
4. Intense or prolonged psychological distress at exposure to internal or
external cues that symbolize or resemble an aspect of the traumatic
event(s).
5. Marked physiological reactions to internal or external cues that symbolize
or resemble an aspect of the traumatic event(s).
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning
after the traumatic event(s) occurred, as evidenced by one or both of the
following:
1. Avoidance of or efforts to avoid distressing memories, thoughts, or
feelings about or closely associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external reminders (people, places,
conversations, activities, objects, situations) that arouse distressing
memories, thoughts, or feelings about or closely associated with the
traumatic event(s).
D. Negative alterations in cognitions and mood associated with the traumatic
event(s), beginning or worsening after the traumatic event(s) occurred, as
evidenced by two (or more) of the following:
1. Inability to remember an important aspect of the traumatic event(s)
(typically due to dissociative amnesia and not to other factors such as head
injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself,
others, or the world (e.g., “I am bad,” “No one can be trusted,” „The world
is completely dangerous,” “My whole nervous system is permanently
ruined”).
3. Persistent, distorted cognitions about the cause or consequences of the
traumatic event(s) that lead the individual to blame himself/herself or
others.
4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or
shame).
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions (e.g., inability to
experience happiness, satisfaction, or loving feelings).
E. Marked alterations in arousal and reactivity associated with the traumatic
event(s), beginning or worsening after the traumatic event(s) occurred, as
evidenced by two (or more) of the following:
1. Irritable behavior and angry outbursts (with little or no provocation)
typically expressed as verbal or physical aggression toward people or
objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.

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4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless
sleep).
F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
G. The disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
H. The disturbance is not attributable to the physiological effects of a substance
(e.g., medication, alcohol) or another medical condition.
Source: APA, DSM-IV-TR, 2000, pp. 467-468 & APA, DSM V, 2013, pp.271-272
It is important to note that, although the criterion for
assessment of PTSD as indicated by the DSM-IV-TR (APA,
2000) may include some of the major symptoms, it may not
be exhaustive enough, not factoring in cultural specific
traumatic symptoms and stressors. Thus, trauma emanating
from poverty related issues can be contextualized and framed
within the PTSD assessment criteria, though in different
magnitudes and non-mutually exclusive ways.
Trauma of poverty may not be perceived as „single blow‟
traumas such as rape, violent crime, or life threatening
accidents but rather as long-term exposure to chronic poverty
situations. For instance, the poor and vulnerable especially
those in Sub Saharan Africa living in the cyclic poverty trap
may endure severe traumatic experiences emanating from
extreme poverty and hunger (lack of basic human needs, like
food, shelter, clothing, safe drinking water, inaccessibility to
basic social and health services), leaving behind an indelible
psychological scar affecting their psychosocial wellbeing.
These continuous traumatic experiences they are exposed to
threaten their psychological functioning and may lead to more
severe psychological problems including PTSD. Some of
these traumatic experiences occur instantly, or in certain
instances, may remain repressed in one‟s psychic system for
several months and even years, before emerging to the surface
of one‟s consciousness, as PTSD (Laungani, 2002).
Traumatic events are part and passel of our existence, they are
inevitably escapable. More so, James & Gilliland (2001)
acknowledge that, during the course of a lifetime all people
experience a variety of personal traumas, such as divorce or
illness, and many others will also live through cataclysmic
events, like natural disasters or experiencing acts of violence
which are catastrophic (cited in Stricker & Widiger, 2003,
p.431).
In addition, Edin & Lein (1997) and Friis, Lieb, Pfister &
Wittchen (2002) argue that, those living in poverty are
predisposed to stress resulting to deviant behaviors such as
teen pregnancy, crime, substance abuse, chronic addiction and
may cause health problems (cited in Hawkins & Kim, 2011).
They further state that, poverty and economic struggle have a
psychological impact that works in a cyclical way. The long-
term effects of chronic economic struggle coupled with the
multi-dimensional aspect of poverty (Manda et al, 2000;
Keriga & Burja, 2009), suggest that there is a complex
multiple systems interaction that affects psychological
wellbeing of individuals (Edin & Lein ,1997; Friis et al.
2002).
To have a closer glimpse of how poverty can be devastating to
the psychological wellbeing of individuals, one can look at a
study conducted by Kjeill Underlid (2007) a Norwegian
psychologist who set out to study the “subjective meaning of
relative poverty in affluent welfare states as experienced by
the poor themselves” (cited in Anand & Lea 2011, p.285). He
explored the mental dimensions of poverty in particular
feelings of insecurity to examine people‟s experience of
unsatisfied needs including unsatisfied psychological needs
which he saw as deep-seated, general, continuous and
widespread urges, desires or wants that may be more or less
conscious/unconscious. Underlid‟s study clearly indicates that
poverty can create feelings of distress, anxiety and insecurity
that may impede the individuals to attain their full
functionality. He also notes that feelings of anger, sadness,
frustration, devalued self-images, social devaluation, shame
and loss of autonomy may be key aspects of the experience of
poverty (Anand & Lea 2011).
Goldestein (1973) argues that, stress can occur when there is a
wide gap between an individual‟s achievements and their
ambitions, a situation that is familiar to those living in poverty
(cited in Turner & Lehning, 2006), which is also a prevalent
feature among the poor and vulnerable in Kenya. Similarly, in
a study conducted by Ssebunnya et al (2009) on Stakeholders
Perceptions of Mental Health Stigma and Poverty in Uganda
indicates that, poverty was reported to be a major cause of
distress with potential for significant mental health problems,
as many poor and unemployed people especially the
uneducated result to alcohol and other illicit drugs to cope
with their frustrations, thus making them susceptible to mental
health problems. This indicates that, poverty as a risk factor
for mental health issues and more so psychological problems
are inevitably a cause for alarm in the Sub-Saharan Africa
region.
Poverty deprives of the individual‟s freedom, dignity, self-
esteem and capability to live a healthy decent standard of
livelihood, and the denial of opportunities for living a
tolerable life (Sen, 1999; UNDP, 1997). Life can be
prematurely shortened. It can be made difficult, painful or
hazardous (UNDP, 2011, p. 5). Poverty is highly stigmatizing,
isolating and damaging with severe effects on people‟s lives
(Wilkinson & Pickett, 2009; Ridge, 2009 cited in Batty &
Flint, 2010). It hampers the affected individuals‟ actualization
of their full potential, hinders psychosocial and economic
progress and is inevitably deterrence to social development.
Consequently, the concomitant effects of such deprivations in

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addition to the long-term vicious cycle of chronic poverty
gravely undermines the affected poor individual‟s resilience
with detrimental effects to their psychosocial well-being.
Bussey & Wise (2007) have conceptualized poverty in terms
of its psychological impact on the individual. They argue that,
poverty as social trauma is an important perspective that
should not be underestimated. Likewise, poverty and
economic struggle have a psychological impact that works in
a cyclical way (Edin & Lein, 1997: Friis et al., 2002 cited in
Hawkins & Kim, 2011) and may lead to mental health
disorders exhibited through pathways such as stress or
deprivation (Johnson, Cohen, Dohrenwend, Link, & Brook,
1999; Miech, Caspi, Moffitt, Wright, & Silva, 1999 cited in
Das et al, 2007. p. 468).
Although there seems to be a general consensus among
psychiatrists, mental health practitioners, psychologists and
social workers on a significant relationship between poverty
and mental health, especially on mental disorders (Patel &
Kleinman, 2003; Bradshaw et al,2004; Miranda & Patel
,2005;Anand & Lea ,2011;WHO,2011; Yoshikawa et al,
2012; Jenkins et al, 2012; Lund, 2012), little attention has
been given towards trauma of poverty, yet the significant
consequences of poverty including distress, helplessness,
threatened physical integrity and psychological impairment of
the individual are well too known.
Trauma emanating from poverty has not received much
attention in recent years and may not be seen as a major area
of concern, yet the psychological ramifications of poverty on
the poor and vulnerable in society are dire and need not to be
overemphasized. For instance, as people find themselves in
the center of compression by income poverty, inability to
access and/or afford services, absence of social protection
systems, social class stratification, structural violence, amid
weakening traditional support systems and heightening
individualistic tendencies, such people get to a point when
they feel nothing seems to make a difference. This straining
and stressful cyclic poverty trap which many poor individuals
find themselves in weakens their coping mechanism and may
as well result to psychological dysfunction including
traumatization. Though, some individuals with strong resilient
capabilities may be able to persevere and with stand the
existing circumstances, hence surviving regressing into
trauma. However, the non-resilient poor trapped in the vicious
cycle of chronic poverty become overwhelmed with the
prevailing circumstances succumbing to a state of
helplessness with nowhere to run or anyone to turn to
resulting to extreme distress, frustration, depression,
hopelessness and traumatization. Such conditions render them
helpless, and as human beings we cannot tolerate
helplessness; it is against our instinct for survival (Bloom,
1999, p. 3). For example, the cognitive impact exhibited by
living in poverty is well illustrated by a man from Guinea
Bissau;
When I don‟t have [any food to bring my family] I
borrow, mainly from neighbors and friends. I feel
ashamed standing before my children when I have
nothing to help feed my family. I„m not well when I
have nothing to help feed my family. I‟m not well
when I‟m unemployed. It is terrible (Narayan et al,
2000 cited in Patel & Kleinman, 2003, p.611).
Such precarious situations due to living in the vicious cycle of
chronic poverty results to extreme distress, frustration and
helplessness among the non-resilient poor individuals; they
find themselves in a state of dispiritedness and having lost
their nerve, energy and liveliness (Wilson, 2004).
The multifaceted web of poverty exemplified by
unemployment, low wages, lack of markets for the little
and/or poor produce, low commodity prices, lack of
supportive production and marketing institutions, lack of
access to credit, inaccessibility to health services, drought,
floods, human wildlife conflict and deforestation (GoK, 2007
& 2001; Ndiku, 2007, p. 159; Nafula et al, 2005) and absence
of meaningful social protection, among other things leave
many chronically poor Africans with limited or no
alternatives. The resultant myriad of potential stressors of
trauma that emanate from poverty affect thousands if not
millions of people, and may be equated to being the single
most detrimental cause of various traumatic experiences in
Sub-Saharan Africa. This poses tremendous challenges and is
a big threat to the psychological wellbeing of the poor and
vulnerable in addition to being a predisposing factor to mental
health issues including trauma.
The non-resilient individuals unable to cope with the
tormenting and distressing experiences resultant from chronic
poverty are more at risk of being severely affected
psychologically and may end up being traumatized. The non-
resilient individuals may become more easily paralyzed or
isolated rendering them helpless (Herman (1992). Therefore,
the non-resilient individuals become more at risk of being
traumatized since both their internal and external resources
are inadequate to cope with external threat (Van der Kolk,
1989 cited in Bloom, 1999. p.2). Consequently, the risk of
developing more psychological complications later is
imminent including impairment from their normal functioning
and may eventually lead to developing PTSD (Ryle & Kerr,
2002, p.145).
II. METHODOLOGY
The study used a cross-sectional research design, in order to
assess trauma of poverty from a cross-section of the
population (social workers, key social work informants and
clients from Nairobi and Nakuru counties). The study adopted
a triangulation method which mixed both qualitative and
quantitative approach of research. The choice was informed
by the fact that, this method is used by researchers in
comparing quantitative results with qualitative findings to
attain valid and well substantiated conclusions about a single
phenomenon (Creswell & Clark, 2007, p.65). The population

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under study included respondents from Nairobi and Nakuru
Counties; these were social workers, social work clients and
key informants in the social work profession.
The target population was 200 social work practitioners, 10
key social work informants and 40 social work clients (100
from Nairobi and Nakuru County). Simple random sampling
was used to get the actual sample size of 100 social work
practitioners (50 from each county). Non-probability sampling
method (purposive sampling) was applied to get the 10 key
social work informants and 40 social work clients from
Nairobi and Nakuru counties. Total sample size was 150
respondents. However, 91 questionnaires were received at the
end of the data collection process fully filled. Hence, the
actual respondents were 141 respondents (n=141). This
comprised of 91 social work practitioners, 10 key informants
and 40 social work clients from Nairobi and Nakuru counties.
Table 2 shows the sample distribution of respondents.
Structured and semi-structured questionnaires, and interview
guides were used for the study. Quantitative data was
analyzed using Statistical Package for Social Sciences (SPSS)
version 20 for Windows and Qualitative data using content
analysis through thematization process.
Table 2: Sample distribution of respondents
Type of
respondent
Sample
size
Number of respondents interviewed
Social work
practitioners
100
91 (Nairobi and Nakuru county)
Key informants
10
10 (Nairobi and Nakuru county)
Social work
clients
40
40 (4 FGDs – 2 from Nairobi and
Nakuru county, comprising 10 clients
each)
Total
150
141
III. FINDINGS AND DISCUSSION
Trauma of poverty as a major problem among social work
clients
Trauma of poverty is well understood by those affected most
by it, who include the poor and marginalized in society. The
study sought to assess this aspect of trauma of poverty from
the social work practitioners and social work clients. From the
findings, the social workers and social work clients
interviewed had a good understanding of the trauma concept,
they generally defined trauma of poverty as:-
 The effect of extreme levels of poverty over long
periods resulting to helplessness and extreme
distress.
 Emotional disability or mental restlessness due to
lack of basic needs propelled by chronic poverty
causing extreme distress and psychological
problems.
The research study sought to assess the prevalence of trauma
of poverty among the social work clients. The research
findings indicate that the prevalence rate of trauma of poverty
among social work clients was high with 64.8% of the social
work practitioners affirming this, 31.9% said it was moderate
while 2.2% noted it was low. Figure 1 shows the findings.
Figure: 1 Prevalence rate of trauma of poverty among social work clients
The findings in figure 1 confirm that, indeed trauma of
poverty is a major issue of concern among the social work
clients and also has a high prevalence rate. There was a
general consensus from the social work practitioners
interviewed on some of the main reasons for the high
prevalence of trauma of poverty. They indicated that; -
extreme poverty leads to incapacitation among the poor in
society, whereby one is unable to fend for him/herself or the
family and this may cause extreme distress to the individual.
This is similarly supported by Sen (1999) and UNDP (1997)
whereby, poverty deprives of the individual‟s basic
capabilities, freedom, dignity, self esteem and capability to
live a healthy decent standard of livelihood. For instance, the
social work practitioners noted that;-
Lack of basic needs leads to clients being vulnerable
to trauma of poverty e.g many clients are
psychologically affected because they are not able to
meet their needs especially food, payment of rent and
school fees (Social Work Practitioner, R22). Most
poor people especially parents get traumatized when
they cannot provide for basic needs of their children
and families. A traumatized caregiver/parent cannot
think straight and end up developing some behaviors
that affect other society members indirectly like
engaging into alcoholism, drug abuse or prostitution
(Social Work Practitioner, R73).
Such desperation pushes some of the clients into risky
behaviors in order to get some money to support themselves
and their families. For example one social worker noted;-
High risk behaviors like prostitution and drug abuse
expose the clients to vulnerability to HIV/AIDs thus
leading to trauma. Commercial sex workers engage
in such activities due to unemployment and hence
see it as a quick way to earn money (Social Work
Practitioner, R25).
1.1%
2.2%
31.9%
64.8%
0.00% 10.00%20.00%30.00%40.00%50.00%60.00%70.00%
No Response
Low
Moderate
High
Prevalence rate of trauma of poverty among social
work clients
No Response
Low
Moderate
High

International Journal of Research and Innovation in Social Science (IJRISS) |Volume V, Issue IX, September 2021|ISSN 2454-6186
www.rsisinternational.org Page 912
It is such traumatic stressors as described above that inflict
severe psychological torment on the poor and vulnerable in
society with weak resilience capabilities, hence developing
feelings of powerlessness, hopelessness, anger, depression and
low-self esteem. Hence, trauma of poverty is a real problem
that is affecting the poor and marginalized people in society
with detrimental consequences on their psychological well-
being. The above findings correspond with those of Underlid
(2007) on how relative poverty psychologically affects the
poor individuals living in affluent (cited in Anand & Lea
2011, p.285). He noted that feelings like, social devaluation,
loss of autonomy, devalued self-images, anger, shame, guilt
and sadness may be core facets of the experience of poverty
(Anand & Lea 2011). And as described by the Diathesis Stress
Theory (Blueler, 1963; Rosenthal, 1963 cited in Ingram &
Luxton, 2005), it is such pre-dispositional stressors that
weaken the people‟s resilience against stressful circumstances
as those caused by poverty and may lead to development of
severe psychological problems including trauma.
Psychological effect of trauma of poverty among social work
clients
In terms of the effects that trauma of poverty has on the
individual, it was well exemplified by the social work clients
giving their experiences of distress due to extreme poverty.
For instance, one client from Nairobi County noted; -
I have problems in supporting my own children and
for my sister who are orphans. It distresses me so
much. I think poverty makes one traumatized and
distressed (Social work Clients, FGD).
Another from Nakuru County had this to say; “sometimes we
skip meals due to lack of money”. In general it was clear from
the clients perspective that, extreme distress (trauma) caused
by poverty makes one become helpless and hopeless (there is
no hope for living). This may lead the individual to engage in
other deviant behaviours like alcoholism, drug abuse,
prostitution and even suicidal ideation in an effort to escape
from such distress. Thus there is need especially for the social
work practitioners to urgently address it.
In assessing the psychological impact of trauma of poverty,
the researcher asked the social work clients to give factors that
contribute to extreme distress due to poverty in their lives that
may lead to trauma. Some of the major issues given were;-
lack of adequate food for my family, lack of descent clothing,
poor health due to inaccessible medical services,
discrimination from society due to poverty, lack of support
from relatives and family members, lack of finances to sustain
my family due to unemployment, lack of school fees to
educate my children leading to school dropout, teenage
pregnancies due to engagement into drugs and substance
abuse, alcoholism and prostitution as a substitute to earn a
living among the youth.
Consequently, such situations as indicated above contribute to
the chronic cycle of poverty that affects the non-resilient
individuals. These individuals look for an escape from such
devastating situations by engaging in socially inappropriate
and mal-adaptive activities and bevarioural tendencies. Due to
hopelessness, some engage in risky deviant behaviors and end
up suffering slowly not realizing the dangers they expose
themselves to including psychological and health problems. In
support of the issues social work clients go through, social
workers noted that; -
The clients I deal with are mostly from the slums and
are traumatized as a result of lack of basic amenities,
though they are in denial. This is normally identified
during the counseling sessions (Social Work
Practitioner, R35). Most of the clients who have
being traumatized by poverty usually exhibit
behavioral problems and are socially and emotionally
not well adjusted which affects their ability to come
to terms with life, some end up committing suicide if
not well counseled (Social Work Practitioner, R7).
Poverty leads to trauma making the person
incapacitated. Trauma pre-disposes them to other
challenges such as illiteracy, unemployment,
helplessness among others hence making clients
vulnerable and susceptible to other social problems
(Social Work Practitioner, R50).
Such issues faced by the social work clients are indeed
predisposing factors to trauma and may lead to psychological
dysfunction of the individuals affected, hampering their socio-
economic capabilities for a stable and decent livelihood. For
instance, some of the social work practitioners observed that; -
During the period when one is traumatized one
cannot think clear, make concrete choices, feels
stigmatized have low self-esteem which should first
be addressed (Social Work Practitioner, R5). Many
people especially the poor suffer from trauma
without really knowing until it takes a toll on their
daily life (Social Work Practitioner, R62). Similarly,
it was noted that;- Trauma causes people not to
realize their full potential and their capabilities. If
trauma of poverty is addressed most of those
suffering from it will be made to accept their
situation and empowering them will be much easier
and sustainable (Social Work Practitioner, R35).
In an attempt to escape from the chronic cyclic poverty trap,
the social work clients at times use strategies that are risky,
detested, result from no better options and traumatizing in
nature. For instance, many poor Africans with limited
alternatives resort to; alcoholism, commercial sex work, early
marriages and teenage pregnancies, withdrawing children
from school, child labor to supplement household income,
child trafficking, drug trafficking and abuse. Due to high
levels of unemployment especially among the youth, they end
up falling prey to other socially mal-adaptive practices and
behaviors engaging in easy but dangerous avenues for
sustainability such as drug and substance trade and abuse,

International Journal of Research and Innovation in Social Science (IJRISS) |Volume V, Issue IX, September 2021|ISSN 2454-6186
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alcoholism, and prostitution among others (Hawkins & Kim,
2011; Ssebunnya et al, 2009; Gutlove & Thompson, 2003).
The conspicuous consequences of poverty impel the poor to
extremities in their lives with detrimental psychological and
health issues and may result to traumatization. Such
experiences as a result of poverty related problems may result
to very traumatic events affecting every part of a person‟s
being, thoughts, emotions, behaviors and physical reactions
(Sonderup, 1996, p. 13 cited in Ntomchukwu et al 1999 p.70).
The situation of living in chronic poverty results to a
continuous process of traumatic stressors inflicting
psychological pain among the affected poor. This in turn
results to sequential traumatization as described by Hans
Keilson, trauma is a continuous process that develops even
after the specific traumatic event is past; hence, trauma is a
process, which develops sequentially (Becker, 2004, p.6).
This is as the result of the sequence of individual incidents the
poor endure due to the long-term vicious cycle of chronic
poverty leading to eventual breakdown of the individual‟s
coping capabilities and resilience resulting to traumatization.
These tormenting experiences the poor endure as a result of
extreme poverty hamper the attainment of their full
potentiality and self-actualization in life and deprive them off
opportunities to engage in meaningful economic activities and
ultimately is an impediment to social development.
Differences between Women and Men in Relation to Trauma
of Poverty
The research findings indicated that women do suffer more
than men due to trauma of poverty. Figure 2 shows the
illustration that women are more prone to trauma of poverty
the men. Majority (91.2%) of the social work practitioners
noted that women are more affected differently by trauma of
poverty than men while only 6.6% said they are not.
Figure 2: Differences among women and men being affected by trauma of
poverty
From the FGD discussions with social work clients, it came
out strongly that, women do suffer more than men because
men do not care of the issues in the house; they brush them
away and avoid or neglect their responsibilities as heads of the
family. For instance, one client respondent noted; “most men
nowadays want to be married and stay comfortable. They
want to marry women who are more financially stable”
(Social Work Clients FGD). They also noted that women are
left with the heaviest burden to fend for the children. One
client noted; - “A woman may not abandon her children but a
man may easily marry another woman and abandon the first
wife and children” (Social Work Clients FGD). One social
work practitioner noted that; “women are more overwhelmed
and show signs of hopelessness than men who tend to hang on
to their power/strength of being a man ((Social Work
Practitioner, R35)”. The above illustrates the women‟s
endurance, determination and will power to take care of their
families regardless of whatever circumstance they are in. The
women try effortless to keep their house in order and provide
for their children however best they can. For example, one
client said; “mama mwerevu hujenga nyumba yake, mjinga
huibomoa” –a wise woman builds her house/family but a
foolish one destroys it” (Social Work Clients FGD) . From the
above it is clear on the different symptomatic signs and
behaviors exhibited in men and women suffering from trauma
emanating from poverty related issues. Therefore, as clearly
indicated women suffer more than men and have
differentiated characteristic behavior from the men.
Extreme poverty elicits feelings of frustration, hopelessness
and emotional distress which are feasible stressors that may
cause trauma among the chronically poor and vulnerable in
society. The poor have immense challenges as a direct result
from poverty, especially so in situations where the gap
between an individual‟s achievements and their ambitions is
very wide, a situation that is familiar to those living in poverty
(Goldestein, 1973 cited in Turner & Lehning, 2006). This is a
prevalent feature among the poor in the developing world
especially in Sub Saharan Africa. It is no wonder that the
psychological impact of those living in poverty is
characterized by feelings of shame, stigma and humiliation
(Narayan et al 2000 cited in Patel & Kleinman (2003, p. 611).
Such environments the non-resilient poor get entangled may
as well be predisposing factors to trauma of poverty.
Consequently, trauma develops as a continuous stress of
extreme intensity, resultant from the permanent situation of
vital threat that reigns in the social fabric (Madariaga, 2002,
p.5). Therefore, the state of hopelessness the non-resilient
poor find themselves in exacerbated by chronic poverty which
is a scenario eminent in Sub-Saharan Africa and is a
predisposing risk factor for trauma of poverty.
IV. CONCLUSION
The dehumanizing and distressing phenomenon the poor
trapped in the long-term vicious cycle of chronic poverty
inevitably causes traumatic stressors inducing severe
psychological torment on the non-resilient individuals. These
tormenting experiences result to development of negative
psychological repercussions including feelings of
powerlessness, hopelessness, helplessness, low-self-esteem,
depression and traumatization. Therefore, it is imperative that
social scientists take cognizance of the psychological
dimension of poverty whose affect and impact has severe
2.2%
5.6%
91.2%
0.00% 20.00% 40.00% 60.00% 80.00% 100.00%
No Response
No
Yes
Are women and men affected differently by
trauma of poverty?
No Response
No
Yes

International Journal of Research and Innovation in Social Science (IJRISS) |Volume V, Issue IX, September 2021|ISSN 2454-6186
www.rsisinternational.org Page 914
psychological consequences on the individual and robs
him/her the opportunity to a decent meaningful livelihood.
Even though the impact of trauma seems to be universal on a
biological expression both attribution and conceptualization of
traumatic experiences are culture based (Drozdek & Wilson,
2007, p.381). Therefore, conceptualization and manifestation
of trauma is indeed culture and regional specific. What may
be traumatic in one community may not be to another, thus
there is need to understand the diverse nature and
manifestation of trauma other than the conventionally
perceived and recognized causes of traumatic experiences.
There is need to incorporate other diverse culture specific
traumatic stressors like extreme poverty which afflicts
majority of the chronically poor with detrimental
psychological consequences, especially in the developing
world including Sub Saharan Africa where poverty rates are
still extremely high.
The need to have a broader conceptualization of the trauma
concept is now more necessary than ever due to the
multidimensionality of poverty and its associated problems
which cause havoc on the psychological wellbeing of the poor
in society. Hence, a continuous reinvention and
contextualization of the trauma concept within its specific
social reality where the traumatization occurs is inevitable
(Becker, 2004). The conceptualization of the trauma concept
needs a reevaluation to include the broader intricate aspects of
traumatic events and meaning which is culture specific. Thus
trauma of poverty should be considered as equally
traumatizing as the clinically perceived Western conventional
causes of trauma. Perhaps it is time psychologists,
psychiatrists and social workers take cognizance of the
imminence of trauma emanating from poverty in addition to
the well-known conventional causes of trauma. Research into
trauma of poverty discourse needs to be given consideration
due to the dynamism of poverty in the 21st Century. Trauma is
culture specific and needs to be understood within the
different contexts it occurs. Hence, it is only appropriate to
give significant attention to trauma of poverty due to its
enormity and detrimental psychological consequences among
the chronically poor and non-resilient in society especially in
regions where poverty rates are still extremely high. In order
to effectively alleviate poverty and attain sustainable social
development, it is only prudent to tackle poverty from its
multidimensional facets including addressing trauma of
poverty.
REFERENCES
[1] American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental Disorders, (5th ed.). Washington, DC:
Author
[2] American Psychiatric Association. (2000). Diagnostic and
statistical manual of mental disorders, (4th text revised edition).
Washington DC: Author
[3] Anand, P. & Lea, S. (2011). The psychology and behavioural
economics of poverty. Journal of Economic Psychology,32(2),
284-293
[4] Batty, E. & Flint, J. (2010). Self-esteem, comparative poverty and
neighbourhoods. Research paper No. 7. Centre for regional
economic and social research: Sheffield Hallam University
[5] Becker, D. (2004). Dealing with the consequences of organised
violence in trauma work. (Edited version, August 2004. 1st launch
January 2001). Berghof research center for constructive conflict
management. Retrieved from http://www.berghof-handbook.net
[6] Bloom, S. L. (1999). Trauma theory abbreviated. Retrieved from
http://www.dhs.vic.gov.au/__data/assets/pdf_file/0005/587966/tra
uma_theory_abbreviated_sandra_bloom.pdf
[7] Bracken, P.J. & Petty, C. (Eds.). (1998). Rethinking the trauma of
war. London: Free Association Books
[8] Bradshaw, J., Kemp, P., Baldwin, S. & Rowe, A. (2004). The
drivers of social exclusion:A review of the literature for the social
exclusion unit in the breaking the cycle series. London: Crown
[9] Bussy, M. &Wise J. B. (Eds.). (2007).Trauma transformed: An
empowerment response.Empowering the powerless, a social work
series. New York: Columbia University Press
[10] Covington, S. S. (2008).Women and addiction: A trauma-informed
approach journal of psychoactive drugs, SARC supplement 5.
Retrieved from
http://www.stephaniecovington.com/pdfs/CovingtonSARC5.pdf
[11] Creswell, J. W. & Clark P.V. L. (2007). Designing and conducting
mixed methods research.Thousand Oaks, CA: Sage Publications
[12] Das, J_, Do,. Q.T, Friedman, J., McKenzie, D., & Scott, K. (2007).
Mental health and poverty in developing countries: Revisiting the
relationship .Social Science & Medicine 65 (2007) 467–480
[13] DeLoach, C., & Petersen, M. (2010). African spiritual methods of
healing: The use of candomble‟ in traumatic response. Journal of
Pan African Studies, 3(8), 40-65
[14] Drozdek, B. & Wilson, J.P. (Eds.). (2007). Voices of trauma:
Treating psychological trauma across cultures. New York:
Springer Science Publishers
[15] Edin, K., & Lein, L. (1997). Making ends meet. New York:
Russell Sage Friis, R. H, Wittchen, H. U, Pfister, H, & Lieb, R.
(2002). Life events and changes in the course of depression in
young adults. European Psychiatry, 17(5), 241-253
[16] Gold, S.D., Marx, B.P, Soler-Baillo, J.M. & Sloan, D.M. (2005).
Is life more traumatic than traumatic stress? Journal of Anxiety
Disorders 19(6), 687-698
[17] Government of Kenya. (2007). Basic report of fourth participatory
poverty assessment report (PPA-IV). Nairobi: Government Printer
[18] Government of Kenya, (2001). Poverty reduction strategy paper
2001. Nairobi. Government Printer.
[19] Gutlove, P. & Thompson, G. (2003). Psychosocial healing: A
guide for practitioners.Massachusetts: Institute for Resource and
Security Studies Cambridge.
[20] Hawkins, R.L. & Kim, E.J. (2011). The socio-economic
empowerment assessment: addressing poverty and economic
distress in clients. Clinical Social Work Journal, 40(1), 194-202
[21] Herman, J. L. (1992). Trauma and recovery. New York: Basic
Books Ingram, R. E., & Luxton, D.D. (2005). Vulnerability-stress
models. In B.L. Hankin & J.R.Z. Abela (Eds.), Development of
psychopathology: A vulnerability-stress perspective (pp. 32-46).
Thousand Oaks, CA: Sage Publications
[22] Jenkins, R., Njenga, F., Okonji, M., Kigamwa, P., Baraza, M.,
Ayuyo, J., … Kiima, D. (2012). Prevalence of common mental
disorders in a rural district of Kenya, and socio-demographic risk
factors. International Journal of Environment, Research and
Public Health, 9(5), 1810-1819
[23] Keriga, L. & Bujra, A. (2009) Social policy, development and
governance in Kenya. A profile on healthcare provision in Kenya.
Nairobi: Development Policy Management Forum (DPMF)
[24] Kirmayer, L.J, Lemelson, R. & Barad M. (Eds.) (2007).
Understanding trauma: Integrating biological, clinical and
cultural perspectives. New York: Cambridge University Press
[25] Laungani, P. (2002) Stress, Trauma, and coping strategies: Cross-
cultural variations. International Journal of Group Tensions,
31(2), 127-154
[26] Lund, C. (2012). Poverty and mental health: A review of practice
and policies. Neuropsychiatry, 2(3), 213-219

International Journal of Research and Innovation in Social Science (IJRISS) |Volume V, Issue IX, September 2021|ISSN 2454-6186
www.rsisinternational.org Page 915
[27] Madariaga, C. (2002). Psychosocial trauma, post- traumatic stress
disorder and torture. Retrieved from
http://www.cintras.org/textos/monografias/monog_trauma_psicoso
cial_ingles.pdf
[28] Manda, D. K., Kimenyi, S. M. & Mwabu, G. (2000). A review of
poverty and antipoverty initiatives in Kenya. Nairobi: Kenya
Institute for Public Policy Research and Analysis (KIPPRA)
[29] Miranda, J.J. & Patel, V. (2005). Achieving the millennium
development goals: Does mental health play a role? PLoS
Medicine, 2(10), e291. doi:10.1371/journal.pmed.0020291
[30] Nafula, N. N., Onsomu, E. N., Mwabu, G.& Muiruri, S. (2005).
Review of policy options for poverty reduction in Kenya. Nairobi:
Kenya Institute for Public Policy Research and Analysis
(KIPPRA)
[31] Ndiku, J. M. (2007). The issue of poverty in the provision of
quality education in Kenyan secondary schools. Educational
Research and Review, 2(7), 157-164
[32] Ntomchukwu, M.S, Kakubeire,B.P & Pritz, A. (Eds.). (1999).
Cross-cultural dialogue on psychotherapy in Africa. South Africa:
The University of the North Press
[33] Patel, V. & Kleinman, A. (2003). Poverty and common mental
disorders in developing countries. Bulletin of the World Health
Organization, 81, 609-615
[34] Petersen-Coleman, M. N. & Swaroop, S. R. (2011). Complex
trauma. A critical analysis of the Rwandan fight for liberation. The
Journal of Pan African Studies, 4(3), 1-19
[35] Ryle, A. & Kerr I.B. (2002). Introducing cognitive analytic
therapy: Principles and practice. New York: John Wiley & Sons
Ltd
[36] Sen, A. K. (1999). Development as freedom. New York: Oxford
University Press Ssebunnya, J. , Kigozi, F., Lund, C., Kizza, D. &
Okello, E. (2009). Stakeholder perceptions of mental health stigma
and poverty in Uganda. BioMed Central International Health and
Human Rights, 9(5)
[37] Stricker, G. & Widiger, T. A. (Eds.). (2003). Handbook of
psychology. Clinical psychology. (Vol.8). Hoboken New Jersey:
John Wiley & Sons Inc
[38] Taylor, S. (2006). Clinician's guide to treating PTSD: A cognitive-
behavioral approach. In R. G. Tedeschi, C. L. Park, & L. G.
Calhoun (Eds.). (1998). Posttraumatic growth: positive changes in
the aftermath of crisis. Mahwah: New Jersey. Erlbaum
[39] Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (Eds.). (1998).
Posttraumatic growth: positive changes in the aftermath of crisis.
Mahwah, New Jersey. Erlbaum.
[40] Turner, K. & Lehning, A. (2004) Psychological theories of
poverty. In M.J. Austin, (2006). Understanding Poverty from
multiple social science perspectives: A learning resource for staff
development in social service agencies. Retrieved from
http://cssr.berkeley.edu/bassc/public/CompletePovertyReport0823
06.pdf
[41] United Nations Development Programme. (2011) Human
development report 2011. Sustainability and equity: A better
future for all. New York: United Nations
[42] United Nations Development Programme. (1997). Human
development report 1997. New York: Oxford University Press
[43] Wilson, J.P., & Drozdek, B. (Eds.). (2004). Broken spirits: The
treatment of traumatized asylum seekers, refugees, and war and
torture victims. New York: Brunner-Routledge
[44] World Health Organization, (2011). Impact of economic crises on
mental health: WHO Regional Office for Europe
[45] Yoshikawa, H., Aber, J. L. & Beardslee, W. R. (2012). The effects
of poverty on the mental, emotional and behavioral health of
children and youth: Implications for prevention. American
Psychologist Issue, 67(4), 272-284