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| ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 19
| Issue : 2 | Page : 140-146 |
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A comparative study to assess the resilience among patients with neurotic and stress-related disorders with normal counterpart in a selected hospital Tezpur, Assam
Deepa Das1, Arunjyoti Baruah2
1 Department of Psychiatric Nursing, Charnock College of Nursing, Kolkata, West Bengal, India
2 Department of Psychiatric Nursing, LGBRIMH, Tezpur, Assam, India
| Date of Submission | 03-Jun-2021 |
| Date of Decision | 26-Apr-2022 |
| Date of Acceptance | 29-Apr-2022 |
| Date of Web Publication | 27-Dec-2022 |
Correspondence Address:
Prof. Arunjyoti Baruah
Department of Psychiatric Nursing, Charnock College of Nursing, Kolkata, West Bengal
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/iopn.iopn_47_21
Context: Health is a multidimensional concept, denoting not only an absence of disease and disability, but also feeling of happiness and welfare. Stress is among the important factors threatening mental health, and people are faced with numerous stressors in their everyday lives. Accumulation of daily stress would affect individuals' physical and mental health, and when it lasts for long term, it can lead to negative outcomes, including neurotic and stress-related disorders. However, most individuals do not develop such illnesses after experiencing stressful life events, because the person who is resilient does not develop neurotic and stress-related disorders because this resilience shield people against the development of stress-related disorder. Aim: This study was conducted to find if there is a significant difference in the scores on measures of resilience between patients with neurotic and stress-related disorders with normal counterpart. Methods: The sample comprised 60 participants, 30 with neurotic and stress-related disorder, and 30 their normal counterpart. Participants were administered Connor–Davidson Resilience Scale (CD-RISC-25), General Health Questionnaire-12, and sociodemographic pro forma. Results: Significant differences were found in the resilience score of neurotic and stress-related disorders' patients with normal counterpart (t = 18.524, P = 0.000). Conclusion: CD RISC-25 showed the mean score of resilience among neurotic and stress-related disorders' patients were found to be 34.86 ± 9.35, and the counterpart scored the mean value of 85.66 ± 11.70 where the maximum possible score was 100. Resilience of counterpart was higher than neurotic and stress-related disorders' patients, (t = 18.524, P = < 0.000).
Keywords: Counterpart, neurotic, resilience, stress-related disorders
How to cite this article:
Das D, Baruah A. A comparative study to assess the resilience among patients with neurotic and stress-related disorders with normal counterpart in a selected hospital Tezpur, Assam. Indian J Psy Nsg 2022;19:140-6 |
How to cite this URL:
Das D, Baruah A. A comparative study to assess the resilience among patients with neurotic and stress-related disorders with normal counterpart in a selected hospital Tezpur, Assam. Indian J Psy Nsg [serial online] 2022 [cited 2023 May 31];19:140-6. Available from: https://www.ijpn.in/text.asp?2022/19/2/140/365466 |
| Introduction | |  |
Resilience is a human capacity to adapt successfully to stressful events and manages to revert to a positive state.[1] Most individuals do not develop neurotic disorder, because these people are thought to be resilient.[2] Resilience has been increasingly identified as an important area of intervention for neurotic disorders' patient, yet it has received little emphasis because the main focus is given on disease and pathology. Therefore, the researcher has felt to conduct a study to compare the resilience among patients with neurotic and stress-related disorders and normal counterpart as study in this field is poorly evidenced in the current setting.
| Subjects and Methods | | |
Subject
For the present study 30 patients, who were diagnosed with neurotic and stress-related disorders by the psychiatrist in the outpatient department (OPD) of selected mental health institution were taken, and 30 samples were taken as normal counterpart. Normal counterpart were those who attended OPD of selected mental health institution with other patients and whose General Health Questionnaire-12 (GHQ-12) score was found to be below 5 out of 12 as per the inclusion criteria set in the study.
Inclusion criteria
- Age between 18 and 60 years
- Both genders.
Exclusion criteria
- Who was diagnosed with any major physical and psychiatric illness?.
Design
The descriptive research design was selected to assess resilience.
Sampling technique
The investigator used the purposive sampling technique to select the sample from the population.
Material
sociodemographic pro forma to collect the baseline data, Conner–Davidson Resilience Scale (CD-RISC-25) to assess the resilience level of patient diagnosed with neurotic and stress-related disorders. The reliability of the scale (CD-RISC) is 0.89; GHQ-12 was used to assess the mental health status of normal counterpart. Cronbach's alpha value of GHQ-12 is 0.90.
Statistical analysis used
Both descriptive and inferential statistics was used for the data. Frequency and percentage were used to analyze sociodemographic characteristics. Chi-square test was applied to find associations between demographic and clinical variables and resilience scores of the neurotic and stress-related disorders' patients and normal counterpart. t-test was used to compare the resilience of neurotic and stress-related disorders' patients with normal counterpart.
Data collection procedure
Interview was done by the investigator for data collection using structured scales for assessing the resilience; written permission was obtained from the concerned authorities before the collection of information. Data collection was completed in the month of January to May 2019. The data were collected from the patient diagnosed with neurotic and stress-related disorders and normal counterpart who fulfilled the criteria for the study in the outpatient setting of selected mental health institution. The participants were informed about the objectives of the study, and written informed consents were taken before the data collection. A peaceful environment was maintained for data collection, and privacy was provided while collecting information. Questionnaire was explained by the researcher herself, and participants were also asked for further assistance if they required which the researcher could within her professional responsibility and limit. Sociodemographic information of patients diagnosed by psychiatrist in the OPD of selected mental health institution as neurotic and stress-related disorders and normal counterpart, who accompanied the different patients in the OPD of selected mental health institution are collected beforehand and subsequently structured tools for assessing resilience and GHQ-12 for counterpart were administered. More or less 40–45 min was used up with each participant for the entire data collection. Assurance is given to the participants about the confidentiality of their information's for ethical consideration. The researcher collected 2–3 samples every day in the outpatient setting of the institute.
| Results | | |
Descriptive and inferential statistics were used to analyze and interpret the data. SPSS version 20, IBM, java, Malaysia version was used for the statistical analysis.
As per [Table 1], finding of the study showed that among the neurotic and stress-related disorders' patients, the mean age was 34.93 ± 9.74. Majority i.e. 56.6% (17) were above 31 years of age, 90% (27) were female, 96.6% (29) were married, 86.6% (26) were belong from Islam religion, 50% (15) were illiterate, and 83.3% (25) were homemaker. Majority i.e. 93.3% (28) were live in village and monthly income of majority 63.33% (19) was below Rs. 10,000. Similarly, 53.3% (16) were in the age group of below 30 years, 96.6% (29) were female, 76.6% (23) were married, 70% (21) were belonging to Islam religion. Majority 33.3% (10) were attained high school, 66.6% (20) were homemaker, 73.33% (22) were live in village, and 66.6 (20) monthly income was between Rs. 10,000 and 20,000. | Table 1: Distribution of frequency and parentage of patients with neurotic and stress-related disorder and their counterpart (n=60)
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[Table 2] shows that the mean score of the resilience of neurotic and stress-related disorders' patients was found to be 34.86 ± 9.35 and the counterpart scored the mean value of 85.66 ± 11.70 where the maximum possible score was 100. | Table 2: Mean and standard deviation of resilience of patients with neurotic and stress-related disorder and their counterpart (n=60)
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[Table 3] shows that there is a significant differences was found in resilience scores of neurotic and stress-related disorders' patients with normal counterpart (t = 18.524, P = 0.000). | Table 3: Comparison of resilience of patients with neurotic and stress-related disorder with normal counterpart (n=60)
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The Chi-square test shows that there is no significant association found between the resilience and selected sociodemographic variables of neurotic and stress-related disorder patients [Table 4]. For the variable with cell calculus <5 and having 2 × 2 contingency table, Fisher's exact test was computed and considered. | Table 4: Association between demographic variables and resilience scores of the neurotic and stress-related disorder patients (n=60)
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[Table 5] shows that a significant association was found between resilience and religion (χ2 = 12.857, df = 1, P = 0.001) of the normal counterpart, whereas no significant association was found between resilience and other selected demographic variables. | Table 5: Association between demographic variables and resilience scores of counterparts (n=30)
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| Discussion | | |
Health is a multidimensional concept, denoting not only an absence of disease and disability, but also feeling of happiness and welfare. Stress is among the important factors threatening mental health and the accumulation of daily stress would affect individuals' physical and mental health. Therefore, more attention is paid to the positive aspect of health so that people can use their strength as a protective shield.[3] such as resilience which means ability to recover or spring back, or the process of adaption to significant stress factors against mental disorders.[2] Although resilience has been increasingly identified as important area of both research and clinical intervention for neurotic and stress-related disorders' patient, yet it has received little emphasis because the main focus is given on disease and pathology because of which there is the constant failure over the past few decades to reduce the high prevalence of stress-related disorders.[4] Therefore, the present study was carried out to assess and to compare the resilience of patients with neurotic and stress-related disorders with normal counterparts. The sample size was 60, out of which 30 patients with neurotic and stress-related disorders, and 30 participants were normal counterparts who fulfilled the inclusion criteria.
In patients with neurotic and stress-related disorders, the mean age was 34.93, whereas in normal counterparts, the mean age was 33.73. The consistency of the above finding is also maintained with the study of Pietrzak et al.[5] on “Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operation Enduring Freedom and Iraqi Freedom: the role of resilience, unit support, and postdeployment social support” where the mean age of the total sample was 34.9 ± 4 years.
In patients with neurotic and stress-related disorders majority 90% (27) were female also it was found among normal counterparts, majority 96.6% (29) were female too. The consistency of the above finding is also maintained with the study of Marx et al.[6] on “An Examination of Differences in Psychological Resilience between Social Anxiety Disorder and Posttraumatic Stress in the Context of Early Childhood Trauma” where majority of the subjects were female (55.9%). According to the study “PTSD Gender Differences in PTSD: Susceptibility and Resilience” conducted by Hu et al.,[7] suggest that the higher rate of PTSD among women cannot be attributed to a greater overall risk of trauma. Coping style for dealing with trauma has been proven to play a critical role in PTSD development. The different coping styles between men and women may be one of the explanations for gender differences in PTSD. Men and women are known to have different coping styles. Women are more likely to exhibit an emotional reaction to stressors (emotion-focused), and are believed to spend more time seeking support and discussing problems with friends or family. Unlike women, men are more likely to use direct problem-focused coping strategies to deny or avoid stressor.
In patients with neurotic and stress-related disorders, majority 50% (15) were illiterate, whereas among normal counterparts, majority 33.3% (10) were attained till high school. The consistency of the present study is also maintained with the study of Yngve.[8] on “Resilience against social anxiety – The role of social networks in social anxiety disorder” that there was a significant difference in education where the control group had attained higher levels of education than the clinical group.
In patients with neurotic and stress-related disorder, majority 93.3% (28) were live in village whereas among normal counterpart 73.33% (22) were live in village. The consistency of the above finding is also maintained with the study of the “National Mental Health Survey of Assam 2015–2016” by LGBRIMH, Tezpur.[9] That compared to urban nonmetro (0.39%) areas, persons in the rural (0.84%) areas were twice as likely to have experience of neurotic and stress-related disorders.
In patient with neurotic and stress-related disorders, majority 63.3% (19) monthly income was below Rs. 10,000, whereas in normal counterparts, majority 66.6% (20) monthly income was between Rs. 10,000 and 20,000. The consistency of the above finding is also maintained with the study of Ahmad and Bokharey[10] on “Resilience and coping strategies in the patients with conversion disorder and general medical condition” that most of the participants in both the groups belonged to lower socioeconomic status and the mean monthly income ranged from Rs. 16,788 to Rs. 27,202. According to the Gender and Mental Health in Assam: A Study on Magnitude, causes, and impact of mental illness among women,[11] the stress related to managing expenses within a limited income, reveals how the women experienced difficulty in providing for food, educational expenses, and health-related expenses. These factors create a sense of frustration and dejection, more particularly among women who feel responsible for taking care of family members. These stressors often disturb the mental health of the women.
Comparison between patient with neurotic and stress-related disorders with normal counterpart on variables showed significant findings, viz, resilience (t = 18 524, P = 0.000). From this study, it was found that the resilience of normal counterpart was higher than resilience of neurotic and stress-related disorder patients. It was found in the study “Resilience linked to personality dimensions, alexithymia and affective symptoms in motor functional neurological disorders” by Jalilianhasanpour et al.[12] that patients with Functional Neurological Disease (FND) reported lower CD-RISC scores (P < 0.001; mean score 63.2 ± 16.5) compared to controls (mean score 78.7 ± 12.1); 24 of 50 patients with FND were within one standard deviation of the mean score observed in the control group. It was also found in the study “An examination of differences in psychological resilience between social anxiety disorder and posttraumatic stress disorder (PTSD) in the context of early childhood trauma” by Marx et al.[6] that there are significant differences in resilience between social anxiety disorder and PTSD groups with childhood trauma and control group where both disorders groups had significantly lower levels of resilience than healthy control. None of the Chi-square values is found to be significant with selected sociodemographic for neurotic and stress-related disorder patients though significant association was found between resilience and religion (χ2 = 12.857, df = 1, P = 0.001) of normal counterpart.
| Conclusion | | |
Various researchers had shown that the resilience and its importance in mental health despite the study on resilience worldwide, few comparative studies were encountered. No study was found to assess resilience for all neurotic disorders together. Hence the study was conducted by the researcher's interest to gain some insight into these aspects. After conducting the study it can be concluded that there is significant difference in resilience between neurotic patients and their counterpart. The study opened the understanding of the wide and varied role of nurses in these aspects with implications to nursing practice, education, administration, and research.
Ethical policy and institutional review board statement
Ethical clearance from institutional ethical committee was obtained, permission was obtained from concerned authority of LGBRIMH, Tezpur to conduct the study, consent was taken from all the participants, confidentiality and anonymity of the subjects and data were maintained.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 11. | Indian Council of Medical Research, Department of Health Research (Ministry of Family and Health Welfare). Project on Gender and Mental Health in Assam: A Study on Magnitude, Causes and Impact of Mental illness on Women; 2015. Available from: https://indiascienceandtechnology.gov.in. [Last accessed on 2019 Feb 21]. |
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
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