The Prevalence of Post Traumatic Stress Disorder (PTSD) among Flood Affected School Children in Pakistan

8/3/2019 The Prevalence of Post Traumatic Stress Disorder (PTSD) among Flood Affected School Children in Pakistan

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INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS

COPYRIGHT 2011 Institute of Interdisciplinary Business Research 445

JUNE 2011VOL 3,NO 2

The Prevalence of Post Traumatic Stress Disorder (PTSD) among Flood Affected School

Children in Pakistan

Nasir Ahmad

PhD scholar (Education) Foundation University Islamabad, Pakistan

Dr.Tayyab Alam Bukhari

Chairman Department of Education, Foundation University Islamabad, Pakistan

Nargis Munir

M.Sc (Clinical Psychology) FFH Rawalpindi, Pakistan

Abstract

The present study was designed to determine the prevalence of Post traumatic stress disorder(PTSD) among flood affected school children in Pakistan. The sample of the study was

comprised of 522 randomly selected students aged 10-16 years from five flood affected districts

of Khyber Pukhtunkhwa. The instrument used in the study was The Impact of Event Scale-

Revised (IES-R) to measure Post traumatic stress disorder (PTSD) among flood affected schoolchildren in Pakistan.. The main findings of the study were; secondary school students were

highly affected by Post traumatic stress disorder (PTSD); Female secondary school students were

highly affected by Post traumatic stress disorder (PTSD; Displaced secondary school studentswere highly affected by Post traumatic stress disorder (PTSD); female students developed more

PTSD as compared to male students; and displaced students developed more PTSD as comparedto non-displaced students.

Key words: Post traumatic stress disorder (PTSD), Flood, The Impact of Event Scale-Revised

(IES-R)

INTRODUCTION

Natural disaster affected the lives of many people all over the world. The affectess of such

disasters faces different calamities in term of deaths, physical injuries, property lose and

psychological injuries. Post traumatic stress disorder (PTSD) is one of the most commonpsychological injuries that the victims of natural disasters faced. Post traumatic stress disorder

(PTSD) may be described as characteristic set of symptoms resulting from exposure to traumatic

stressors. DSM-IV described Post traumatic stress disorder (PTSD) as exposure to a traumaticevent in which person has responded with intense fear, helplessness or horror. (Clark, 1999)

Walsh (1994) observed that Post traumatic stress disorder (PTSD) is usually provoked

by a traumatic events that is outside the rang of usual human experiences such as bereavement,chronic illness, business losses or marital conflicts.

The events that caused Post traumatic stress disorder (PTSD) are war, see or experience physical violence and natural disaster like earth quick, hurricane and flood. Smith (2003)

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observed that Post traumatic stress disorder (PTSD) may develop immediately after the trauma

or it may be brought on by a minor stress experience week, month or even year later.Flood is one of the most sever natural disaster and it can result in direct economic and

property lose, physical injuries, death and psychological injuries (Huang, 2010). Post traumatic

stress disorder (PTSD) is one of the most common psychological injuries that the flood survivorsfaced. Green (1992) examined the survivors of Buffalo creek dam collapse in 1972 and found

that 63% of the survivors were suffering From Post traumatic stress disorder (PTSD).

Natural disasters also caused Post traumatic stress disorder (PTSD) among schoolstudents as ziaddini (2009) observed that the prevalence of Post traumatic stress disorder (PTSD)

was 66.7% among high school students after the earth quick disaster in the city of Bam, Iran.

The people of Pakistan faced a devastating flood in late July 2010 following by monsoon

rain in Punjab, Sindh, Khyber Pukhtunkhwa and Balochistan regions. It destroyed the propertyand infrastructure and affected about 20 million people, with a death toll close to 2000. The

people had horrifying experiences accompanying death of families and property loses resulted in

severe traumatic responses in surviving people including school children.

The present study was designed to determine the prevalence of Post traumatic stressdisorder (PTSD) among flood affected school children in Pakistan.

METHOD

The sample of the study was comprised of 522 randomly selected students aged 10-16

years from five flood affected districts of Khyber Pukhtunkhwa. These districts include

Charssada, Lower Dir, UpperDir, Noshehra and Swat. The instrument used in the study was TheImpact of Event Scale-Revised (IES-R) to measure Post traumatic stress disorder (PTSD) among

flood affected school children in Pakistan.

The Impact of Event Scale (IES) is a short set of 15 questions evaluating experiences ofavoidance and intrusion which attempts to reflect the intensity of the post traumatic phenomena.

Developed in 1979 by Mardi Horowitz, Nancy Wilner, and William AlvarezDaniel S. Weiss and Charles R. Marmar (1997) chose to revise the scale by adding sevenadditional questions to measure another dimension of intense stress events. Both versions have

been found to be valid and reliable. The revised version of the Impact of Event Scale (IES-r) has

seven additional questions and a scoring range of 0 to 88.

On this test, scores that exceed 24 can be quite meaningful. High scores have the following

associations.

24

or more

Those with scores this high have partial PTSD or at least some of the

symptoms.

33

and above

This represents a probable diagnosis of PTSD.

37

or more

This is high enough to suppress your immune system's functioning.

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The data was collected four month after the event.

RESULTSTable 1Descriptive statistics

Mean and standard deviation of age and PTSD of flood affected school children

Variables N Mean S.D

Age 522 12.87 1.79

PTSD 522 42.48 9.35

Table 1 shows that the numbers of respondents are 522.The mean and standard deviationof age are 12.87 and 1.79 respectively. The mean and standard deviation on PTSD scale are

42.48 and 9.35.

Table 2

Total number and percentage (%) of secondary school students on the measure of the Impact of

Event Scale (IES-r)

Scoring rang of IES-r No. of students percentage (%)

Less than 24 16 3.06

24 or more 74 14.1733 or more 46 8.81

37 or more 386 73.94

Total 522 100

Table 2 shows that the total no. of respondents is 522. Out of which (16) 3.06 % did not have

Post traumatic stress disorder (PTSD), (74) 14.17% had partial Post traumatic stress disorder(PTSD), (46) 8.81 % had a probable diagnosis of PTSD and (386) 73% had high PTSD. This

shows that secondary school students were highly affected by Post traumatic stress disorder(PTSD).

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Table 3

Total number and percentage (%) of male secondary school students on the measure of theImpact of Event Scale (IES-r)


Less than 24 16 5.8424 or more 62 22.63

33 or more 42 15.33

37 or more 154 56.20

Total 274 100

Table 3 shows that the total no. of male respondents is 274. Out of which (16) 5.84 % did nothave Post traumatic stress disorder (PTSD), (62) 22.63% had partial Post traumatic stress

disorder (PTSD), (42) 15.33 % had a probable diagnosis of PTSD and (154) 56.20 had high

PTSD. This shows that male secondary school students were affected by Post traumatic stressdisorder (PTSD).

Table 4Total number and percentage (%) of female secondary school students on the measure of the

Impact of Event Scale (IES-r)


Less than 24 0 0.0

24 or more 12 4.83

33 or more 4 1.61

37 or more 232 93.54Total 248 100

Table 4 shows that the total no. of female respondents is 248. Out of which (12) 4.83% had

partial Post traumatic stress disorder (PTSD), (4) 1.61 % had a probable diagnosis of PTSD and

(232) 93.54% had high PTSD. This shows that female secondary school students were highlyaffected by Post traumatic stress disorder (PTSD).

Table 5 Total number and percentage (%) of displaced secondary school students on the

measure of the Impact of Event Scale (IES-r)


Less than 24 0 0.0

24 or more 0 0.0

33 or more 20 6.1337 or more 306 93.87

Total 326 100

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Table 5 shows that the total no. of displaced respondents is 326. Out of which (20) 6.13 % had a

probable diagnosis of PTSD and (306) 93.87% had high PTSD. This shows that displacedsecondary school students were highly affected by Post traumatic stress disorder (PTSD).

Table 6Total number and percentage (%) of non-displaced secondary school students on the measure of

the Impact of Event Scale (IES-r)


Less than 24 16 8.1624 or more 66 33.61

33 or more 30 15.31

37 or more 84 42.86

Total 196 100

Table 6 shows that the total no. of non-displaced respondents is 196. Out of which (16) 8.16 %

did not have Post traumatic stress disorder (PTSD), (66) 33.61% had partial Post traumatic stress

disorder (PTSD), (30) 15.31 % had a probable diagnosis of PTSD and (84) 42.86% had highPTSD. This shows that non-displaced secondary school students were also affected by Post

traumatic stress disorder (PTSD).

TABLE 7

Mean, S.D, t and p value of flood affected female and male students on the measure of PTSD.

Variables Female Male t p

N=248 N=274M S.D M S.D

PTSD 49.02 6.61 36.56 7.32 20.32 .007

df=520

Table 7 reflects the numbers of female and male students are 248 and 274 respectively.The mean and standard deviation of female students on the measure of PTSD scale are 49.02 and

6.61 and the mean and standard deviation of the male on the measure of PTSD scale are 36.56

and 7.32 respectively. The t and p vale of both groups are 20.32 and .007.This indicates that the difference between the means of the two groups is significant at

.01 levels. Inspection of means suggests that female students developed more PTSD as compared

to male students.

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TABLE 8Mean, S.D, t and p value of flood affected displaced and Non-displaced students on the measureof PTSD.

Variables Displaced Non-displaced t p

N=326 N=196

M S.D M S.D

PTSD 46.78 6.86 35.32 8.53 16.83 .000

df=520

Table 8 reflects the numbers of displaced and non-displaced students are 326 and 196

respectively. The mean and standard deviation of displaced students on the measure of PTSDscale are 46.78 and 6.86. The mean and standard deviation of non-displaced students on themeasure of PTSD scale are 35.32 and 8.53 respectively. The t and p vale of both groups are

16.83 and .000.

This indicates that the difference between the means of the two groups is significant at

.01 levels. Inspection of means suggests that displaced students developed more PTSD ascompared to non-displaced students.

DISCUSSIONThe present study was designed to determine the prevalence of Post traumatic stress disorder

(PTSD) among flood affected school children in Pakistan. The main findings of the study were;

secondary school students were highly affected by Post traumatic stress disorder (PTSD); Femalesecondary school students were highly affected by Post traumatic stress disorder (PTSD;

Displaced secondary school students were highly affected by Post traumatic stress disorder

(PTSD); Female students developed more PTSD as compared to male students; and displaced

students developed more PTSD as compared to non-displaced students.The main findings of the study that secondary school students were highly affected by

Post traumatic stress disorder (PTSD) was supported by Piyasil et-al (2007) study on Post

traumatic stress disorder (PTSD) in children after Tsunami disaster in Thailand: 2 years follow-up. They found that 57.3% students were suffered from Post traumatic stress disorder (PTSD)

among affected children.

The finding of the study that female secondary school students were highly affected by

Post traumatic stress disorder (PTSD) was supported by Stallard et-al (1998). They observed thatthere is 19% risk of Post traumatic stress disorder (PTSD) in boys and 55% in girls in children

involved in road traffic accidents. This finding was also supported by Breslau (1997) on hisstudy on Sex Differences in Posttraumatic Stress Disorder observed that Post traumatic stress

disorder (PTSD is more likely to develop in female than in male after exposure to traumatic

events.

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References

Breslau, Naomi. Glenn C., Davis., Patricia Andreski., Edward L. Peterson.., Lonni R.& Schultz.(1997). Sex Differences in Posttraumatic Stress Disorder. Arch Gen

Psychiatry 54(11):1044-1048.Retrieved from http://archpsyc.ama-

assn.org/cgi/content/abstract/54/11/1044Clark, Carolyn Chambers. (1997). Posttraumatic Stress Disorder: How to Support Healing. The

American journal of Nursing 97(18) : 26-33 Retrieved from

http://www.jstor.org/stable/3465317Green B L.,indy J D.,race M C., & Leonard A C. (1992)

Chronic posttraumatic stress disorder and diagnostic comorbidity in a disaster sample.The Journal of nervous and mental disease 180(12):760-766.

Peng Huang., Hongzhuan Tan., Aizhong Liu.,Shuidong Feng., & Mengshi Chen.(2010).Prediction of posttraumatic stress disorder among adults in flood district. . Retrieved from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868002/

Horowitz, M. Wilner, N. & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective

stress. Psychosomatic Medicine, 41, 209-218.Piyasil, Vinadda.,Panom Ketuman ., Ratnotai Plubrukarn., Vajiraporn Jotipanut ., Somsong

Tanprasert., Sumitra Aowjinda ., & Somchit Thaeeromanophap .(2007). Post TraumaticStress Disorder in Children after Tsunami Disaster in Thailand: 2 Years Follow-up. J

Med Assoc Thai 2007; 90 (11): 2370-6. Retrieved fromhttp://www.medassocthai.org/journal

Smith, H. (2003). Despair, resilience, and the meaning of family: Group therapy with French-speaking survivors of torture from Africa. In R. Carter & B. Wallace (Eds.),

Understanding and dealing with violence. Multicultural PerspectivesThousand Oaks, CA.pp. 291319.

Stallard, Paul., Richard Velleman., & Sarah Baldwin .(1998). Prospective Study of Posttraumatic

Stress Disorder in children Invovled on road Traffic Accidents. British Medical Journal317 (1173), 1619-1623 Retrieved from http://www.jstor.org/stable/25181287

Walsh. Neol. (1994). A psychodynamic Model of Posttraumatic Stress Disorder. An Irish

Quarterly Rewiew 83 (331) : 322-330 Retrieved from

http://www.jstor.org/stable/30091089Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J.P. Wilson & T.M.

Keane (Eds.), Assessing Psychological Trauma and PTSD (pp.399-411). New York.

Guilford.Ziaaddini, Hassan., Nouzar Nakhaee., & Kolsoom Behzadi. (2009). Prevalence and Correlates of

PTSD among High School Students After the Earthquake Disaster in the City of Bam,

Iran. American Journal of Applied Sciences 6(1): 130-132. Retrieved from

http://www.scipub.org/fulltext/ajas/ajas61130-132.pdf

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Survey Social Capital situation in Iranian Hospital

Freyedon Ahmadi

Public management Department, Payame Noor university, 19395-4697 Tehran, I.R. of IRAN

Seyyed Ali Akbar Ahmadi


Arghavan Zandieh


Abstract

Much of the literature on business development has focused on the role of community resources,

especially financial and human capital, in organizational success and survival. Several studies

also have examined the contributions of small and large businesses to the social and economicwell-being of communities. There has been much less research on the relationships between

social resources in communities and business development. This paper examines the importance

of social capital in Iranian hospital. For this aims were selected 90 people from three hospitals.The results of this research indicated the level of structural and relational social capital is high,

but the level of cognitive social capital is below of average.

Key words:

Social capital, relational capital, cognitive capital, structural capital

Introduction

Scholars such as Coleman (1990) and Putnam (1995) in an attempt to explain non-economic

factors in explaining success of certain economic processes drew on the concept of social capital.

That is why at present, besides human, financial, and economical capitals, a new reality as socialcapital is being extensively utilized in the literature of social and organization realms. Fukuyama

(1999) believes that a numberof definitions had been given with respect to social capital but they

refer to its manifestation rather than to social capital itself. He says social capital is aninstantiated informal norm that promotes co-operation between two or more individuals

(Fukuyama, 1999). Putnam (1995) also defines social capital as The characteristics of the social

organization such as networks, norms and social trust that facilitate coordination and cooperationfor mutual benefit. Social capital as a theory view has been considered by behavioral science,

economy, management and social science experts in recent two decades. Social capital is

sometimes viewed as the peoples' property, so it is related to widespread social networks and

accessible resources. Therefore social capital is considered as the group property. Social capitalhas been the subject of many surveys in recent years and its relation to political and economical

development and personal effectiveness has been considered. Studies show that without social

capital, it is hard to reach economical development by the means of other resources likefinancial, physical and natural resources.

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The Prevalence of Post Traumatic Stress Disorder (PTSD) among Flood Affected School Children in Pakistan