Study of Life Stress in Children with Psychiatric Disorders in India

By Malhotra, Savita | Hong Kong Journal of Psychiatry, September 1993 | Go to article overview
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Study of Life Stress in Children with Psychiatric Disorders in India


Malhotra, Savita, Hong Kong Journal of Psychiatry


SUMMARY

Life Events Scale for Indian Children (LESIC) was developed and standardized for use on Indian children. Life stress was measured using LESIC in 80 children with psychiatric disorders and 100 normal children. The findings revealed that the sick group encountered more serious life events as reflected in their having greater stress score in the one year preceding the onset of symptoms. Sick children also experienced greater stress in younger age (4-7 yrs), and more undesirable events as compared to normal controls. This study focuses on issues of measurement of stress. Its role in psychiatric disorders and cultural factors.

INTRODUCTION

The role of life events in the causation of psychiatric disorders was recognized long back by Adolf Meyer (1951) who suggested that even the most normal and essential events in life could contribute to psychiatric disorders Literature concerning life events and stress in childhood is sparse in contrast to that in adults. In the last decade there have been few measures of stress in childhood (Compas, 1987; Johnson, 1986). Classical life events approach of Holmes & Rahe (1967) was used in Coddington's Social Readjustment Rating Scale (Coddington, 1972 a & b, 1984). Limitations of the life events checklist approach to studs of stress in childhood have been discussed in various reviews (Goodyer, 1990 a & b, Rutter & Sandberg, 1992). mainly extrapolating from relevant literature on adults. However, Coddington's Social Readjustment Rating Scale or its modifications have been widely used in many studies (Monaghan, Robnison and Dodge 1979, Hurme 1981. Wertieb, Weigel and Feldstein 1987, Jensen et al, 1991). Till the alternative methodology of interview technique for assessing life stress is standardized and validated, studies using the checklists we likely to continue for some time.

Psychopathology in childhood has been found to be associated with many environmental factors and life events such as adverse family circumstances (Rutter, 1985 & 1989, Shaw and Emery, 1989, Goodyer, Wright Altham, 1988), maternal separation or deprivation (Bowlby, 1969 & 1980, Rutter, 1981 & 1989, Wolkind end Rutter, 1985), birth of a sibling (Dunn & Kendrick, 1982, Dunn, 1988), parental diverce (Hetherington, 1988), bereavement (Van Eerdewegh et al, 1982), physical handicap (Wasserman & Allen. 1985), urbanism) (Quinton. 1988), maternal depression (Mills at al, 1985). It has been found that these events assume etiological significance in a particular such-cultural context. Brown & Harris (1989) emphasized that the significance of these events should be interpreted in the social context of its occurence. Another way of approaching this question of cultural relativity of stressful events can be via0 studying the same event in socio-culturally different populations and to examine and compare directions and strength of their relationships to psychopathology.

No studies have been reported from India on stress and psychiatric disorders in children and there is no assessment measure developed for Indian population. Only one study in India (Rangaseami & Kamakshi, 1983) on adolescent hysterics, used Coddington's Social Readjustment Rating Scale and reported that majority (85%) of hysterics had a significant life stress before the onset of symptoms.

Present study was planned to examine the relationship between stress and psychiatric disorders in children in India in a case-control study design. Being the first systematic study in this area, it was necessary to develop a measure of stress applicable to Indian population.

MATERIAL AND METHODS

LIFE EVENTS SCALE FOR INDIAN CHILDREN

British Life Event Inventory (Monoghan, Robinson & Dodge, 1979) which was an adaptation of Coddington's SRRS (Coddington, 1972) was adapted for use on Indian papulation). The process of adaptation involved evaluation of the British Inventory by experienced professionals in terms of relevance of items and appropriate stress score, keeping in mind the Indian socio-cultural context.

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