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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 19  |  Issue : 2  |  Page : 123-128

Comparing strengths, difficulties, and loneliness between socioeconomically deprived and advantaged children


1 Post graduate in Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India
2 Associate Professor, Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India
3 Professor, HOD, Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India
4 Professor, Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India

Date of Web Publication31-Dec-2018

Correspondence Address:
Dr. Raghuram Macharapu
Department of Psychiatry, Mamata Medical College, Khammam, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AMH.AMH_28_18

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  Abstract 


Aims and Objectives: The present study is an attempt to study strengths-difficulties, and experiences of loneliness in below poverty line (BPL) and above poverty line (APL) children and compared the same between two groups.
Materials and Methods: The total sample consisted of 120 participants (age range 10–13 years), 60 BPL and 60 APL children. Each group further consisted of 25 females and 35 males. The samples were drawn using convenience sampling method. Strengths and difficulties questionnaire (SDQ) and loneliness and social dissatisfaction scale were the tools used.
Results: In BPL children, peer problems were found to be the highest (i.e. 25% in abnormal and 55% in borderline range). Significant difference was found between BPL and APL children on emotional symptoms (P = 0.003), peer problems (P = 0.02), and prosocial behavior (P = 0.03), on SDQ, and experiences of loneliness (P = 0.04) on loneliness and social dissatisfaction questionnaire. The significant negative correlation was found between loneliness score and emotional symptoms score (P = 0.03), loneliness score and hyperactivity score (P = 0.002), and between loneliness score and peer problems score (P = 0.001). The significant positive correlation was found between experiences of loneliness score and prosocial behavior score (P = 0.03).
Conclusions: In BPL children, peer problems were found to be the highest. BPL children have more emotional symptoms, peer problems, and feeling more lonely compared to APL children. APL children have low prosocial behavior. Children with more emotional symptoms, peer problems, and hyperactivity are feeling lonely. Children with low prosocial behavior are feeling lonely.

Keywords: Below poverty line children, loneliness, strengths-difficulties


How to cite this article:
Kumar M V, Macharapu R, Mallepalli PK, Babu RS. Comparing strengths, difficulties, and loneliness between socioeconomically deprived and advantaged children. Arch Ment Health 2018;19:123-8

How to cite this URL:
Kumar M V, Macharapu R, Mallepalli PK, Babu RS. Comparing strengths, difficulties, and loneliness between socioeconomically deprived and advantaged children. Arch Ment Health [serial online] 2018 [cited 2019 Jan 22];19:123-8. Available from: http://www.amhonline.org/text.asp?2018/19/2/123/248883




  Introduction Top


Psychiatric disorders of childhood result from the relationship between genetic and environmental factors. Children living in below poverty line (BPL) families are three times more likely to have a mental illness than children in socioeconomically advantaged family.[1] Children's cognitive skills and educational achievement are most strongly affected by poverty and social disadvantage.[2] The relationship between poverty and childhood disorders seems to be stronger in childhood than in adolescence. Several other researchers have reported the risk for lower achievement, behavioral problems, dropping out of school, health problems, anxiety, depression, and other negative outcomes among children in families facing persistent economic stress.[3],[4],[5] Children from low-income families appear to have higher levels of depression and antisocial behavior.[6]

Poverty negatively impacts on children's development through its effects on the parental emotional state, parenting practices, and their effects on the home environment.[2] Families under economic stress are unlikely to monitor their children's activities, which in turn is associated with poorer school performance and social adjustment.[7] The changes in the family due to economic strain are linked to externalizing behaviors (marked by defiance, impulsivity, hyperactivity, aggression, and antisocial features) in boys and internalizing behaviors (evidenced by withdrawal, dysphoria, and anxiety) in girls.[8] It is evident that the child who experiences poverty may also experience other life adversities.[9]

Loneliness can be a terrible experience and can often contribute to a range of psychological difficulties. Most likely, every person experiences loneliness at some time during his or her life, at least in a transient form. Loneliness has been defined as the “unpleasant experience that occurs when a person's network of social relations is deficient in some important way.” Loneliness depends on person's appraisal, and this appraisal is influenced by a wide variety of factors such as mood, sex, age, cultural norms, social comparison, etc.[10]

Stable pattern of loneliness poses a severe threat to an individual's mental health and psychosocial functioning.[11] This is represented by the link between psychosocial maladjustment and loneliness when it is assessed by conventional scales.[12] For example, loneliness has been found to be associated with depression, alcoholism, obesity, and suicide in adults.[13] Loneliness in children has been found to be associated with being rejected by peers, being victimized, aggression, shyness, and disruptive behavior.[14],[15]

Many families living in poverty are socially excluded because they are poor. They also face discrimination and stigma. This can lead to feelings of loneliness among these children. This lack of inclusion can be experienced in many different ways and has a negative impact on health as well as their sense of belonging.[16] The consequences unfold over the lifespan.[17]

Keeping in view the impact of poverty on child mental health, the present study is an attempt to systematically study the emotional, behavioral difficulties and experience of loneliness among children affected by poverty in the Indian context, using well-validated scales, SDQ, and loneliness and social dissatisfaction questionnaire (LSDQ).

Aims and objectives

The aims and objectives of this study were

  • To study the strengths-difficulties among children living in BPL and above poverty line (APL) families
  • To study the experiences of loneliness and social dissatisfaction among children living in BPL families and APL families
  • To compare the strengths-difficulties and experiences of loneliness-social dissatisfaction among children living in BPL families and APL families
  • To study the gender differences in experiences of loneliness and strengths and difficulties
  • To study the relationship between strengths-difficulties and experiences of loneliness.



  Materials and Methods Top


Place of study

In Khammam city, majority of children belonging to BPL families study in government schools while those belonging to APL families study in private schools; therefore, three government and three private schools were selected from Khammam, Telangana using convenient sampling method.

Study period

This study was undertaken from August 2017 to December 2017.

Study sample

The study sample consisted of 120 children – 60 children living in BPL families and 60 children living in APL families. Out of the total sample, 70 were male and 50 female, within the age range of 10–13 years. After taking permission from higher authorities in these schools, the researcher carried out informal visits to become familiar with the participants. This was followed by taking written informed consent from class teachers, parents as well as from participants to participate in the study. Participant's status of BPL was assured by taking information from teachers as well as by checking participant's BPL cards.

Study design

This study was a cross-sectional study.

Inclusion criteria

All the students, who fit into BPL and APL category, are willing to participate in the study.

Exclusion criteria

Students who not willing to participate, and who had psychiatric illness were excluded from the study.

Materials

Defining BPL: monthly per capita consumption expenditure below Rs. 356.35 for rural areas and Rs. 538.60 for urban areas (61st round of the National Sample Survey) Defining APL: monthly per capita consumption expenditure above Rs. 356.35 for rural areas and Rs. 538.60 for urban areas (61st round of the National Sample Survey).

Selection criteria for below poverty line families

Below poverty line families have BPL cards issued by the government.

Sociodemographic record sheet

Sociodemographic record sheet was used which included name, age, gender, parental occupation, and monthly income of the family.

Loneliness and Social Dissatisfaction Questionnaire

The 24-item loneliness and social dissatisfaction questionnaire was used in this study. The 16 primary items focus on student's feelings of loneliness (e.g. “I'm lonely”), feelings of social adequacy very inadequacy (e.g., “I'm good at working with other children”), or subjective estimations of peer state (e.g., “I have lots of friends”). The other eight items focus on children's hobbies or preferred activities (e.g., “I like to paint and draw”; “I watch TV a lot”). These eight “filler” items are included to help children feel more open and relaxed about indicating their attitudes about various topics (items 2, 5, 7, 13, 15, 19, and 23).[12],[14],[15] Based on mean scores of students rated as having most significant loneliness and social acceptance issues. If Loneliness and Social Dissatisfaction Questionnaire mean score is 16–28 (fail), mean score 29–40 (marginal), mean score 41–52 (pass), and mean score above 52 (pass).

Strength and Difficulties Questionnaire (self-report version)

The strengths and difficulties questionnaire is an internationally well-validated screening tool for child's emotional and behavioral difficulties.[18] The SDQ contains 25 items and five clinical subscales for prosocial behavior, hyperactivity, emotional, conduct, and peer problems.

Statistical analysis

Data obtained were analyzed using the Statistical Package for the Social Sciences, Version 20 (IBM Corp., IBM SPSS Statistics for Windows, Armonk, NY, USA).[19] The Student's t-test and Pearson's correlation were used.


  Results Top


[Table 1] shows the percentages of BPL children falling in abnormal and borderline and normal range on the SDQ. Peer problems were found to be the highest, i.e. 25% in abnormal and 55% in borderline range followed by conduct problem 20% in abnormal and 21.6% in borderline range, emotional symptoms 20% in abnormal and 6.6% in borderline range, and hyperactivity 11.6% in abnormal and 26.6% in borderline range. On prosocial behavior scale, 15% were found to be in abnormal and 11.6% in borderline range.
Table 1: Percentages of below poverty line children falling in abnormal, borderline, and normal range on strengths and difficulties (n=60)

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[Table 2] shows the significant difference between BPL and APL children on prosocial behavior (P = 0.03), emotional symptoms (P = 0.003), peer problems (P = 0.02), and total strengths and difficulties (P = 0.003) on SDQ and experiences of loneliness (P = 0.04) on LSDQ.
Table 2: Independent t-test results of strengths-difficulties and loneliness experiences for below poverty line and above poverty line children

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[Table 3] showing that BPL boys mean loneliness and social dissatisfaction score is 54.88 and among BPL girls mean score is 58.66. This difference was statistically not significant. Which means BPL boys feeling more lonely compared to BPL girls.
Table 3: Independent t-test results on loneliness experiences-social dissatisfaction between below poverty line boys and below poverty line girls

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[Table 4] showing that BPL boys mean SDQ score is 14.91 and among BPL girls mean score is 16.44. This difference was statistically not significant. which means BPL girls facing more difficulties compared to BPL boys.
Table 4: Independent t-test results on strengths and difficulties questionnaire between below poverty line boys and below poverty line girls

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[Table 5] Shows the significant difference between males and females on prosocial behavior and shows the insignificant difference between males and females in all the dimensions of the SDQ and LSDQ.
Table 5: Independent t-test results of gender differences on strengths-difficulties and loneliness experiences

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[Table 6] shows the significant negative correlation between loneliness score and emotional symptoms score (P = 0.03), between loneliness core and hyperactivity score (P = 0.002), and between loneliness score and peer problems score (P = 0.001) and shows significant positive correlation between experiences of loneliness score and prosocial behavior score (P = 0.03).
Table 6: Correlation between loneliness experiences score and strengths-difficulties score

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  Discussion Top


In developing countries like India with the rapid social and economic changes that are occurring, there is rising inequality between the rich and the poor, and resulting in a higher incidence of anxiety and clinical depression in the disadvantaged population. In the present study, the findings indicate that BPL children have more emotional symptoms, peer problems, and experiences of loneliness compared to children living in APL families.

Among BPL children, peer problems were found to be the most prevalent, followed by conduct problems, emotional symptoms, and hyperactivity on the SDQ. A large number of BPL children were also found to be high on prosocial behavior on SDQ.

Significant differences were found between BPL and APL children on the SDQ. BPL children were found to be high on emotional symptoms and peer problems compared to children living in APL. APL children were found to be low on prosocial behavior compared to BPL children. These findings are consistent with some earlier studies reporting children from low-income families had higher levels of depression and antisocial behavior.[6] Children living in poverty have been found to have higher rates of aggression, such as starting fights with their peers or family members and greater risk of emotional problems such as breaking the rules, rashness, and trouble getting along with peers.[20],[21],[22],[23],[24],[25],[26] Children in poverty have also been found to display fewer positive behaviors than their nonimpoverished peers.[27],[28]

It is thought that poverty contributes to less favorable family environment and poor quality parenting. It diminishes the ability of parents to provide supportive and consistent behavior, which negatively influences the well-being of the child. The risk factors that additively influence a child's psychological adjustment include parents' unemployment and low educational status, larger family size, poor maternal mental health, parental divorce, and inconsistent parental discipline.[8]

In the present study, there were no significant differences among male and female BPL children on SDQ and LSDQ. These findings are inconsistent with the previous research where externalizing problems were reported more in boys whereas girls were reported as more friendly and helpful than boys.[29],[30] Self-reporting by the children in the present study rather than parent or teacher reporting may account for this inconsistency. Further research in this area needs to use multiple sources of information including parents and teachers along with self-reporting.

Significantly more experiences of loneliness-social dissatisfaction were found among BPL children as compared to APL children. These findings are consistent with the existing research where economic hardship directly affected adolescent's feelings of loneliness and depression.[31] LSDQ score (as measured on LSDQ scale) was significantly negatively correlated with peer problems score, emotional symptoms score (as measured on the SDQ) which means children with more emotional symptoms, peer problems, and hyperactivity are feeling more lonely. LSDQ score (as measured on LSDQ scale) was significantly positively correlated with prosocial score (as measured on the SDQ) which itself implies that children with low prosocial behavior are feeling lonely.

The experiences of loneliness in children living in poverty are thought to be mediated by stigma, social isolation, exclusion and the shame, and humiliation of poverty.[32] Many families living in poverty are socially excluded because they are poor and face discrimination and stigma. This has a negative impact on the health of poor children. Poverty results in lack of opportunities in general, lack of opportunities to practice social skills, lack of opportunities to participate in an extracurricular activity, and general increase in levels of frustration over negative situations in which the child has no control.[16]


  Conclusions Top


In the present study, we observed that

  • Among BPL children, peer problems were found to be the most prevalent, followed by conduct problems, emotional symptoms, and hyperactivity
  • BPL children were found to be high on emotional symptoms and peer problems compared to APL children. APL children were found to be low on prosocial behavior compared to BPL children
  • Significantly more experiences of loneliness-social dissatisfaction were found among BPL children as compared to APL children
  • Experience of loneliness-social dissatisfaction in children was positively correlated with peer problems and emotional symptoms
  • The significant negative correlation was found between loneliness experience and prosocial behavior
  • As the majority of BPL children in our study have screened positive for emotional and behavioral problems, further research focusing on these aspects is needed for validation of these findings. This can help the state government to develop policies and programs that address problems of BPL children.


Limitations

This study has few limitations. It used self-reported measures rather than also incorporating parent and teacher reporting. Besides, SDQ is only a screening tool, and therefore, future research in this area needs to use more detailed assessment tools for the complete picture of emotional and behavioral problems to emerge. Small sample size, use of convenient sampling, and narrow age range are some of the other limitations of the present study that needs to be taken into consideration before planning further research in this area.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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