Ongoing Projects

  1. Biological Memories of Apartheid: Intergenerational effects of prenatal stress on birth outcomes, HPA axis function, and adult mental health in Soweto and Johannesburg, South Africa (Birth to Twenty)
  2. Perceptions, Experiences, and Impacts of the COVID-19 Pandemic among Patients and Healthcare Workers in Tertiary Hospitals and Community Settings in Gauteng Province
  3. Prenatal exposures, fetal development, and infant birth outcomes in Soweto, South Africa (Soweto First 1000 Days [S1000] Study)
  4. Qualitative research on stress, comorbidities, and resilience in adult cancer patients in Soweto, South Africa

Biological Memories of Apartheid: Intergenerational effects of prenatal stress on birth outcomes, HPA axis function, and adult mental health in Soweto and Johannesburg, South Africa (Birth to Twenty)

Drawing from data from a 30-year multigenerational birth cohort study based in Soweto and 20 months of ethnographic research with mental health patients, professionals and NGOs in South Africa between June 2017-October 2020, this dissertation examines the biocultural transmission of embodied trauma from apartheid and its impacts on human biology and mental health in subsequent generations among families in Soweto, South Africa. This study examine sthe intergenerational and lifecourse impacts of early life stress during prenatal development on adolescent mental health. Using a 30-year birth cohort study called Birth to Twenty (n=3273), I follow up on a subset of second generation adults and third generation children to assess how prenatal stress experienced by first generation gestating mothers affect birth outcomes, HPA axis function, inflammation, and mental illness risk across these subsequent generations. Secondary data show that prenatal stress from apartheid predict greater adolescent psychiatric morbidity children who experience greater recent life stress and whose mothers were of younger age during pregnancy in 1990.

The COVID-19 pandemic interrupted our study, but we are planning to launch data collection as soon as it’s safe for all. My dissertation presented secondary data analyses with comparative data from the Philippines. Stay tuned!

For more information, see:

Kim, A.W. (2020). How should we study intergenerational trauma? Reflections from a 30-year birth cohort study in Soweto, South Africa. Somatosphere.

Kim, A.W., Adam, E.K., Bechayda, S.A., Kuzawa, C.W. (2020). Early life exposure to domestic violence and HPA axis function independently predict adult depression in metropolitan Cebu, Philippines. American Journal of Physical Anthropology.

(Submitted) Kim, A.W., Mohamed, R.S., Norris, S.A., Richter, L.M., Kuzawa, C.W. Psychological Legacies of Intergenerational Trauma under South African Apartheid: Prenatal Stress Predicts Increased Psychiatric Morbidity during Late Adolescence and Early Adulthood in Soweto, South Africa.

Perceptions, Experiences, and Impacts of the COVID-19 Pandemic among Patients and Healthcare Workers in Tertiary Hospitals and Community Settings in Gauteng Province

In collaboration with the Department of Psychiatry at the University of the Witwatersrand in Johannesburg, this study examines the perceptions, experiences, and mental health impacts of the COVID-19 pandemic on patients, healthcare workers, and facility managers in five tertiary psychiatric hospitals in Johannesburg. We combine survey measures with qualitative interviews and ethnography in public mental healthcare facilities to understand the psychiatric sequelae of COVID-19 infection, psychological needs of healthcare staff, and new strategies to prepare for the second wave of COVID-19 pandemic and future public health emergencies. I am leading a group of students and senior researchers to administer telephonic interviews, analyze data, and provide psychological containment-based counseling for participants most affected by COVID-19.

For more information, see:

Kim, A.W., Nyengerai, T., Mendenhall, E. (2020). Evaluating the Mental Health Impacts of the COVID-19 Pandemic in Urban South Africa: Perceived Risk of COVID-19 Infection and Childhood Trauma Predict Adult Depressive Symptoms. Psychological Medicine.

Kim, A.W. (2020). Promoting mental health in community and research settings during COVID-19: Perspectives and experiences from a South African epidemiological study. Invited Commentary. American Journal of Human Biology.

Kim. A.W. (2020). Is it time to rethink how we deliver mental healthcare services? Mental Health Matters. 7(3), 30-32.

Subramaney, U., Kim, A.W.,  Chetty, I., Chetty, S., Jayrajh, P., Govender, M., Maharaj, P., Pak, E. Coronavirus Disease 2019 (COVID-19) and Psychopathology in South Africa: Anxiety and Beyond. Wits Journal of Clinical Medicine.

(In press) Kim, A.W., Subramaney, U. Psychiatric Morbidity and Mental Healthcare during the Coronavirus Pandemics in South Africa. In Dhai, A., Ballot, D. Veller, M. (Eds.) Pandemics in Healthcare: Principles, Processes and Practice. Cape Town: JUTA Academic.

Kim. A.W. COVID-19 has changed the way South Africa’s only toll-free mental health hotline works. Here’s why it matters. 8 August 2020. Bhekisisa Centre for Health Journalism. https://bhekisisa.org/article/2020-08-11-covid19-mental-health-south-africa-telemedicine-depression-anxiety-group/

Prenatal exposures, fetal development, and infant birth outcomes in Soweto, South Africa (Soweto First 1000 Days [S1000] Study)

In South Africa, 14% of infants are born low birthweight (<2500g), a major lifetime risk factor for physical and mental illnesses across the lifecourse. Despite the relatively high rates of low birthweight, the process by which complex environmental conditions alter the physiological mechanisms that shape poor fetal development are not well-known, especially in contexts of high physical and socioeconomic adversity. This research examines the physical, psychological, and social environments that alter fetal growth patterns and infant birth outcomes in a large cohort of women in Soweto, South Africa. We have found that prenatal stress may be a potential risk factor for lower birthweights in this sample and plan to examine how a variety of intersecting life history cues – including maternal nutrition, energetic status, stress exposure, and disease status – cause variation in birth outcomes and infant health. S1000 is part of the larger INTERBIO-21st study comprised of numerous partner universities worldwide.

(Revise & Resubmit) Kim, A.W., Mohamed, R.S., Kuzawa, C.K., Norris, S.A. (2020). Maternal prenatal stress during the first trimester and infant birthweight in Soweto, South Africa.

Qualitative research on stress, comorbidities, and resilience in adult cancer patients in Soweto, South Africa

Through my collaboration with the Developmental Pathways for Health Research Unit, I have conducted extensive qualitative research on stress, disease comorbidity, and mental health in a sample of 80 adult cancer patients living in Soweto and Johannesburg. This study examined the lived experiences of cancer patients as they navigated the cascade of care to receive attention and treatment for their illness. My primary focus centered around a critical reflection of the concept of “resilience” among our interlocutors. I argue that the presupposed moral judgements imbued in contemporary meanings of resilience and the subjectivity of the observer generate false assessments of ability, well-being, and political-economic context of the “non-resilient” individual or community, which facilitate the hegemonic victim blaming attitudes towards such people.

Lambert, M., Mendenhall, E.M., Kim, A.W., Cubasch, H., Joffe, M., Norris, S.A. (2020). Health System Experiences of Breast Cancer Survivors in urban South Africa. Women’s Health.

Kim. A.W., Kaiser, B., Bosire, E., Shahbazian, K., Norris, S., Mendenhall E. (2019). Idioms of Resilience among Cancer Patients in Urban South Africa: An Anthropological Heuristic for the Study of Culture and Resilience. Transcultural Psychiatry.

Mendenhall, E., Kim, A.W. (2019). How to Fail a Scale: Reflections on a Failed Attempt to Assess Resilience. Culture, Medicine, and Psychiatry.

Mendenhall, E., Bosire, E., Kim, A.W., Norris, S.A. (2019). Cancer, chemotherapy, and HIV: Living with Cancer amidst Comorbidity in a South African Township. Social Science & Medicine.

(In press) Mendenhall, E., Kim, A.W., Bosire, E. (2020). Qualitative Research in Mental Health in the African Context. In Ndetei, D. (Eds.) African Textbook of Clinical Psychiatry and Mental Health. Second Edition. Nairobi: The African Medical and Research Foundation.

(In press) Mendenhall, E., Kim, A.W. (2020). Rethinking Idioms of Distress and Resilience in Anthropology and Global Mental Health. In Dyer, A., Kohrt, B., Candilis, P., & Cratsley, K. (Eds.) Textbook of Global Mental Health: Ethical Principles and Best Practices. New York: Springer.

(Revise & Resubmit) Kim, A.W., Lambert, M., Norris, S.A. Mendenhall, E. Barriers to treatment and social experiences of prostate cancer treatment among black South African men in Soweto, South Africa.

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