Objective: To study the risk factors in psychosocial profile of blind people undergoing vocational training. using a screening test ,Personality based hardiness index and suggest recommendations if any. Study design: Cross sectional study. Participants: Blind people. Study Variables: Sex, socioeconomic status, literacy, psychiatric morbidity. Statistical analysis: Fishers Exact test, χ2 test. Results: Recently introduced technique of Personality based hardiness index was tested for its utility for screening of blind persons to detect possible psychological maladjustments and hardiness. Analysis of results of Personality based hardiness index revealed that 9% subjects were non hardy. Most of the non hardy subjects were
The overall results of the above detailed tests brought some salient risk factors that can be strongly associated with psychosocial maladjustments and hardiness in the handicapped persons. These risk factors are Lower socioeconomic class, Rural residence, Illiteracy, Sex These risk factors that emerged out of the statistical analysis of the data can be immensely useful in the planning stages of rehabilitation.
Keywords: Literacy, socioeconomic class, personality based hardiness index, rural area, males
The psychiatric research for decades was confined to mental hospitals and psychiatric clinics, and was characterized by lengthy interviews, case records, and case studies. The application of public health principles to mental disorders was tried only recently, with the aim of expanding the mental health research beyond the mental health hospital and the psychiatric clinics. It is at stage of implementation in field that the difficulties in practicing these scientific principles are experienced. Resource crunch, in respect of technical manpower, poses the main hurdle among other things, especially in a developing country like India. It is generally agreed that psychological aspects are the common victims of these circumstances. A very substantial lack of manpower trained in psychology, psychiatry, social sciences, and related fields has been the real hurdle in this respect.
The Personality based hardiness index is the measurable personality characteristics and dynamics of those who appear immune to the development of stress related disorders, and comprises a variable personality based hardiness index .The notion of hardness is derived from existential theories of psychology, which states that individuals require meaning and commitment in their life to become fulfilled and psychologically healthy. In the Intrinsic Indies existential theories, the three factors, which are considered to be important for the actualization for the fulfillment of an individual, are : commitment, control, and challenge.
Commitment: The ability to believe in the truth, importance, and interest value of when is and what one is doing, and thereby the tendency to fully involve oneself in many situations of life including work, family, interpersonal relationship, and social institutions. It is also described as the tendency to be curious about and involve oneself in whatever is happening rather than avoid doing vigorous interaction with the environment.
Control: The tendency to believe and act as if one can influence the course of events rather than feeling like the passive victim of circumstances. The persons high in control seek explanation for why something is happening not with respect to others’ action or fate but rather with an emphasis on their own responsibility.
Challenge: The belief that the change rather than stability is the normative mode of life. From a challenge’s perspective , much of the disruption associated with the occurrence of a stressful life events can be anticipated as an opportunity and incentive for personal growth rather than a simple threat to security. The challenge leads a person to be a catalyst in the environment, and to practice responding to the unexpected events. Also, they are characterized by openness and tolerance for ambiguity. This characteristic allows an individual, high on the factors, to integrate and effectively appraise the threat even in the most unexpected stressful life events. In effect, these individuals expect the unexpected. They are not thrown off guard by an anticipated turn of events.
The person high on hardiness places stressful events in a broad perspective, where they are less threatening, and also actively engages in transforming the situation at hand. Though he may be under more strain for a short period of time, yet he will be relieved of the stresses in the end. In contrast, those low on hardiness are believed to be more likely to not see the forest for the trees, and hence, be more easily overwhelmed and reluctant to interact with the change in the world around them.
Those doing research on hardiness as a factor in development of physical and psychological symptoms are clear to point out that the personality factors are not the only variables in stress illness equation. Life events, social support, physiological predispositions, and health habits also play a major role in the likelihood of developing an illness.
For this study, the third generation hardiness test has been used. This latest version of the hardiness test consists of 50 rating scale items that can be completed in a few minutes. The test has been carefully constructed both conceptually and empirically.
Therefore, the present study was carried out in two institutions, which have been carrying out vocational rehabilitation of blind persons for a long time. The research was undertaken with a view to study the risk factors in the hardiness profile of blind people utilizing the above-mentioned personality based hardiness index technique and then suggest recommendations if any.
The study was conducted in two institutions from January 1992 to January 1993.
The respective authorities of above institutions admit blind subjects having inability to count fingers at a distance of 6 meters as certified by Civil Surgeon of the concerned district.
The permission was obtained from respective authorities of above two institutions for conducting this study.
All the blinds enrolled in above two institutions at the time of the study were included.
The information regarding the types of questions was given to all blinds included in the study, and the answers were obtained by interview technique.
For the present study, the personality hardiness index followed by Kobasa and Maddi,, was used .The index consisted of 50 scale rating items.
For the present study, 47 of these 50 items were selected, as 3 of them were deemed by consulting psychiatrist to be ambiguous. The 47 selected item consisted of 14 positive and 33 negative statements. Each statement was read and explained to the subject to elicit answers. All subjects above the age of 14 years were considered for hardiness test as recommended by Kobasa and Maddi.
For the 14 positive statements scoring was done as follows:
For the choice, score 0 was given because of complete disagreement with a correct statement. For choice, score 1 and for choice, scores 2 were given, respectively. For choice, the subject was given score 3 because of complete agreement with a correct statement.
The scoring system was exactly reverse for the 33 negative statements therefore, response 0 got score 3, and response 3 got score 0. At the end, the scores obtained by a given subject for all 47 statements were totaled. A subject scoring equal to or more than 50% of the maximum possible score, that is 47×3 =141, was classified as hardy, which means well-equipped to cope up with psychological stresses. While the one whose score was less than 50% was labeled as non hardy.
The experience for scientific utilization of personality hardiness was obtained by working in the psychiatry department under the guidance of qualified psychiatrist. The Personality based hardiness index was used in the present study for screening of blind subjects to study the risk factors in the psychosocial profile of blind people.
The Hardiness score was calculated among blind subjects, and subjects were classified as hardy and non hardy. It can be observed from [Table 1] that 8.88% of study subjects were non hardy. This would mean, that 8.88% of study subjects were ill-equipped to cope up with the stressful conditions of life, and were more prone to develop psychological maladjustments. These subjects would need intervention in the form of psychological counseling for improving their hardiness for a successful psychological rehabilitation.
When hardiness results were co-related with the sex of the subjects by using the test of significance, as observed from [Table 2], there was, statistically, a significant difference between the two at 95% confidence limit.
It would appear that males are relatively less hardy than females. The observed difference in the hardiness in both the sexes could perhaps be due to the difference in levels of exposure to socioeconomic stresses and frustrations outside the protection of the home.
Ray in 1962 and Sethe in 1977 observed higher percentage of male population registered at psychiatric facilities in India.
Rudolf Pinter et al in their study of deaf observed that men were more neurotic and introvert than women.
Springer and Rosler in their study of deaf observed that deaf boys were more neurotic than girls.
It can be observed from [Table 3] that there was, statistically, a significant difference between the two groups at 95% confidence limit.
Applying Fishers exact test P=0.003424
This would mean that blind subjects in rural area were more prone to get psychological maladjustments than their urban counterparts.
All 51 urban dwellers showed presence of hardiness.
This would mean that blind subjects in rural area need more careful attention especially in the area of psychological counseling for ensuring better results of rehabilitation process. The mental morbidity revealed in various rural surveys among general population varies from 18.24 per thousand to 102.8 per thousand. The mental morbidity revealed in various urban surveys among general population, varies from 0 per thousand to 38 per thousand.,
[Table 4] shows the hardiness results as per socioeconomic status. None of the subjects from class II and class III showed non hardiness. Owing to unacceptably small values in some of the cells of the table, which would undermine the utility of χ2 test, the data for class II, class III (upper and lower middle class), class IV, and class V were pooled for statistical analysis.
When hardiness results were co-related with socioeconomic status of the subjects by using the test of significance, as observed from the table, there was, statistically, a significant difference between the two at 95% confidence limit.
χ2=4.964, D.F.=1, P<0.05
It appears that hardiness of an individual varies according to socio-economic status, as none of the blind subjects in class II and class III were non hardy, and 27.08% of those in class V showed non hardiness.
It would mean that as socio-economic status become better, hardiness increases, that is, the subjects belonging to lower socio-economic classes may have more risk of getting psychiatric maladjustments than those in the higher classes. This confirms that socio-economic status is one of the important factors in deciding the probable psychological maladjustment among blind subjects.
It is a known fact that even in case of persons without any disabilities, the adverse socio-cultural factors present in the lower socio-economic classes make the subjects more vulnerable to psychiatric morbidities. Blindness or other handicaps further complicate the picture.
Several studies made in different parts of world have shown that lower socio-economic classes have a higher rate of mental disorders.
B. Sen. et al. in their study observed that more than half of the families of social class V had psychiatric morbidity.
Tanksale in her study of blind observed a significant relationship between better self-adjustment and higher socio-economic class.
When hardiness were correlated with literacy of blind subjects, it was observed from the table that there was, statistically, a significant difference between hardiness results in the 2 groups at 95% confidence limits (applying fisher’s exact test, P=9.271×10-8). It appears that non hardiness was more in Illiterate as compared to Literates as [Table 5] reveals that only 2.19% of Literates were non hardy.
This would mean that literacy is one of the crucial risk factors that decide the occurrence of psychological maladjustment. Thus, while planning rehabilitation process, more efforts will be needed to provide Illiterate blind subjects more facilities for education that will help them avoid psychological disturbances.
Prajakta Tanksale in her study observed high association between education of blind subjects and adjustment of blind persons.
The overall results of the above detailed tests brought some salient risk factors that can be strongly associated with psychosocial maladjustments and psychiatric morbidities in the handicapped persons.
These risk factors are:
These risk factors that emerged out of the statistical analysis of the data can be immensely useful in the planning of stages of rehabilitation. Hence, they can be integrated in the planning stages of rehabilitation of blind persons.
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Conflicts of interest
There are no conflicts of interest.
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]