Depression Anxiety Stress Scale Psychology Essay

The death of parents is among the most painful events that occur in life. An anticipated, 3.5% of adolescents in the United States have experienced the parental death (Social Security Administration, 2000). Literature suggests that parental death places children endangered for many negative outcomes including psychological problems (e.g., depression, anxiety, somatic complaints, PTSD), traumatic grief (e.g., a longing for deceased and lack of acceptance of loss), decreases academic success and self-worth, and greater external locus of control (e.g., Cohen, Mannarino, & Deblinger, 2006; Dowdney, 2000; Lutzke, Ayers, Sandler, & Barr, 1997).

However, across diverse types of painful event including bereavement, 50% of people have been found to exhibit resilience. (Bonano & Mancini, 2002). Dowdney concluded that when clinically referred adolescents are excluded, only a small minority of bereaved adolescents experience psychiatric evils. Others have measured that childhood bereavement alone is unlikely to lead to future psychopathology. Even among the adolescents bereaved by parental cancer and suicide, most adolescents reported less psychological pain, suggesting a significant level of resilience (Ratnarajah and Schofield, 2007).

Resilience is defined as having the considered to be made up of individual, ability to resist or ‘bounce back’ subsequent of adversity and is usually family and community factors. According to Newman (2004), the importance of resilience is not only in defending a child in unfavorable conditions, but also enabling the child to become self actualized in spite of adverse circumstances.

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It was observed that contrary to expectations, numerous adolescents rising up in sarcastic socioeconomic conditions follow healthy developmental trajectories and it is indeed a common phenomenon (Garmezy, 1974). In fact, resilience refers to a set of phenomena characterized by positive outcomes in spite of solemn fear to adaptation or growth (Masten, 2001). Garmezy, Masten, and Tellegen (1989) operationalized resilience as manifestations of aptitude in adolescents regardless of exposure to traumatic events.

Scientifically, resilience has extended beyond the area of child growth to comprise the study of risk versus resilience to stress in adult population, with meticulous concentration to resilience as a defensive factor against the growth of PTSD (Agaibi & Wilson, 2005; Bonnano, 2004; Connor, 2006; Hoge, Austin, & Pollack, 2007).

Historically, internalizing problems were termed as neuroses. These were also called over inhibited, over controlled and shy-anxious problems (Achenbach, 1982). Internalizing behavior patterns are behaviors that are directed inwardly toward the individual and represent an over-controlled and inner-directed pattern of behaviors. These behaviors include social withdrawal, depression, anxiety, somatization problems and selective mutism (Gresham & Kern, 2004).

Most pioneer studies of adults showing to potentially disturbing events were subjective and relied on small sample sizes and variable levels of sufferings. Modern trauma studies have offered more efficient but indirect facts for resilience in adults like Saigh (1988) founded adjustment among Lebanese university students before and after they had been exposed to severe and lingered aerial attack. Even though most sample demonstrated signs of acute agony instantly after the bombing, almost all had returned to normal levels of functioning within one month after the bombing. Moreover, Bryant, Moulds and Guthrie (2000) examined hospitalized survivors of motor vehicle accidents and concluded that a large no of people did not develop PTSD and showed very few signs within the first week after hospitalization.

In another research, resilience was measured in a probability sample (N = 2752) of New York Metropolitan residents during the first six months after the September 11th terrorist attack in 2001 (Bonanno, 2006). Reviews of PTSD symptoms were found to be highly reliable in this sample when obtained at 1, 4 and 6 months, it was possible to use a comparatively traditional meaning of resilience as either zero or one symptom of PTSD at any point during the first 6 months after this attack. Mild trauma/recovery was defined as two or more PTSD symptoms in the absence of PTSD diagnosis. Based on this definition, almost two-third of the sample was found to be resilient. When the sample was lessened to include only those people who had either bystander or were directly affected by it i.e. they were injured, or lost a friend or loved ones, the ratio of the sample that confirmed resilience was still more than 50%.

In another research on refugee adolescents, researchers concluded that females tended to have higher resilience and Adolescents suffering from internalizing and other behavioral problems had lower psychological resilience (Ziaian and et al., 2012).

2. Statement of the Problem

The rationale of the study is to investigate resilience and internalizing psychological problems among parentally bereaved adolescents.

Objectives

To explore the relationship between resilience and internalizing psychological problems.

To explore the gender differences for resilience and internalizing problems among parentally bereaved adolescents.

Significance of the study

The prime objective of the present study was to propose a hypothetical model explaining resilience and internalizing problems among parentally bereaved adolescents.

Most premature studies of adults uncovered to potentially traumatic events were subjective and depend on small sample sizes and different levels of pain exposure. Recent trauma studies have provided more efficient but indirect evidence for resilience in adults like in studies with adolescents exposed to peer suicide (Melhem et al., 2004) and with parentally bereaved adolescence (Melhem, Moritz, Walker, Shear & Brent, 2007) severe pain was found to be related with functional impairment, suicidal ideation, and increased depressive and PTSD symptoms.

Although such studies cater the presence or absence of stress symptoms but does not target the issue of resilience directly. So there is a need for a research that can measure the relationship between internalizing problems and resilience directly.

Research on adolescents is still relatively new in Pakistan. Only recently have studies been conducted on the lives of parentally bereaved adolescents in Pakistan however, they provide only limited data on parentally bereaved adolescents.

Through conducting research on such a model will help psychologists and social workers to understand the significance of resilience in parentally bereaved children. The present study will also highlight the issue of how to cope up with the internalizing problems among parentally bereaved children.

Delimitations of the study:

Like any experimental study, the generalization and validity of the result of the research are limited with respect to issues like sampling, measurement and alternative explanations, which need to be taken into account for researches of the field. Such limitation may influence the generalization of the results.

The sample size was limited to 200 adolescents. A large sample size may yield more fruitful findings. The sample was also not the nationally representative as it was collected only from Sargodha city which was too short to be generalized and does not guarantee the perfect generalization of the findings.

In this research social desirability will be high as self-reported measures will be used.

Only scales will be used for data collection.

Hypotheses

In order to achieve the objectives of the present study, following hypotheses will be evaluated:

Resilience will be inversely correlated to internalizing problems.

Parentally bereaved girls will experience more internalizing problems as compared to parentally bereaved boys.

Operational Definitions of Variables

Operational definitions of the study are reproduced below.

7.1 Internalizing Problems

Internalizing problems are problems that are directed inwardly toward the individual and represent an over controlled and inner-directed pattern of behaviors such as, social withdrawal, depression, dysthymia, anxiety, somatization problems, and selective mutism (Achenbach, 1982). In the present study, internalizing problems will be assessed with Urdu version of Depression Anxiety Stress Scale (Aslam, 2007).

7.2 Depression

Depression is the feeling of dysphoria, desperation, and devaluation of life, self condemnation, and lack of interest/participation, anhedonia, and apathy (Lovibond & Lovibond, 1995). In this study, it will be assessed by the Depression subscale of Depression Anxiety Stress Scale (Aslam, 2007). High scores reflect higher levels of depression.

7.3 Anxiety

Anxiety is regarded as an autonomic stimulation, skeletal muscle effects, situational anxiety, and biased experience of anxious affect (Lovibond & Lovibond ,1995). In present study, it will be assessed by the Anxiety subscale of Depression Anxiety Stress Scale (Aslam, 2007). High scores indicate higher levels of anxiety.

7.4 Stress

It is a chronic non specific arousal, difficulty relaxing, nervous arousal, and being easily agitated/upset, irritable/over-reactive and impatient (Lovibond & Lovibond, 1995). In present research, it will be measured by the Stress subscale of Depression Anxiety Stress Scale (Aslam, 2007). High scores indicate higher levels of stress.

7.5 Resilience

Resilience is generally regarded as an ability of individuals and organizations to cope effectively in the face of significant hardships or threats. This potential grows and changes over time, and is improved by defensive factors within the individual/ system and the surroundings, and contributes to the safeguarding or improvement of health (Mangham, McGrath, Reid & Stewart, 1995). In the current study, resilience of the respondents will be tapped by Urdu version of Ego Resiliency Scale (Aslam, 2007). High scores on Ego Resiliency Scale indicate high levels of resilience and low scores reflect low levels of resilience.

8. Method:

8.1 Research design:

Design of the study will be cross sectional (descriptive) research design.

8.2 Population

The population of the study will comprise of 200 adolescents from Ghosia Orphan home (General Bus Stand), and approx. 500 adolescents from Khalqia Orphan home (26 block), Sargodha.

8.3 Sample

A sample of 30 parentally bereaved adolescents will be taken from Khalqia Orphan home (26 block), Sargodha (n = 15) and Ghosia Orphan home (General Bus Stand), Sargodha (n = 15). Sample included both girls (n = 7) and boys (n = 8) respondents. Age range of the sample will be of 13-18 years. Snowball sampling technique will be used to collect the information from the participants.

8.4 Research tools

Details of the instruments to be used in the present study are given below.

Demographic Form

A demographic form will be formulated to obtain the required information such as age, sex, duration of parental death and education of every participant. The entire adolescents will be assured that the information shall be kept confidential.

Ego Resiliency Scale

The Ego Resiliency Scale (Block & Kremen, 1996) is a short inventory scale to assess (trait-based) psychological resilience. Urdu version of Ego Resiliency Scale (Aslam, 2007) consisting of 14 items will be used. Each question requires a response on 4-point scale ranging from 1, with the answer “does not apply at all”, to 4 with the answer “applies very strongly”. All the items will positively state and there will be no reverse scoring. Those who score low on this measure are expected to experience more emotional distress or problems compare to those who score high when adversity is controlled. Coefficient alpha of Ego Resiliency Scale is .81 while test-retest reliability is .67. Minimum score that an individual can obtain is 14 whereas, possible maximum score is 56.

Depression Anxiety Stress Scale

It is a self-report inventory originally developed by Lovibond and Lovibond (1995) and translated by Aslam (2007). It is a set of three self-report subscales namely depression, anxiety, and stress and number of total items is 42. Depression subscale of DASS consist of item numbers 3, 5 10, 13, 16, 17, 21, 24, 26, 31, 34, 37, 38, and 42. Anxiety subscale consists of item numbers 2, 4, 7, 9, 15, 19, 20, 23, 25, 28, 30, 36, 40, and 41. Item number 1, 6, 8, 11, 12, 14, 18, 22, 27, 29, 32, 33, 35, and 39 comprise the stress subscale of DASS. It is a 4 point scale in which “not at all” is scored as 0, “occasionally” as 1, “often” as 2, and “all the times” as 3. In present study, the translated version of Depression Anxiety Stress Scale (Aslam, 2006) will be used. Alpha reliability of Urdu version of subscale of DASS is .84 for Depression subscale, .82 for Anxiety subscale, and .87 for Stress subscale. Minimum possible score that an individual can obtain would be zero and maximum possible score is 126. Higher score indicates higher levels of internalizing problems i.e. depression, anxiety and stress.

8.5 Data collection:

For collecting data, at first administration of the organizations will be contacted and informed consent will be obtained from the concerned authorities. After that individual participants will be personally contacted in their respective organizations. The authorities and the students will be provided with the details about the nature, purpose, and importance of the study. The participants will be assured of confidentiality.

8.6 Data analysis:

In the present study, data will be evaluated using Statistical Package for Social Sciences (SPSS-18). Pearson correlation will be applied to study the relationship between variables. Alpha reliability coefficients will be computed for all study variables. Multiple Regression analysis will be applied to study relationship between resilience and internalizing problems among parentally bereaved adolescents. Finally, role of resilience and internalizing psychological problems among parentally bereaved adolescents will be studied by applying t-test and one-way ANOVA.

9 Conclusions:

The present study will explore the relationship between resilience and internalizing psychological problems among parentally bereaved adolescents. If the results are significant this shows that the resilience will be inversely related to internalizing psychological problems and the girls are more resilient than parentally bereaved boys.