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Friday 18 September 2020
Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences
Lupine Publishers | Inclusive Educational Environment as a Condition for Successful Socialization of Students with Disabilities
Introduction
Today; many indifferent people concerned
about the issue: how in the twentieth century I century feels Russian invalid;
the extent to which it met the specific needs of what is; by and large; his
philosophy of life in society. The answer to this question depends on the
degree of maturity of an inclusive society; public policy with respect to
persons with disabilities. And on the other hand; the question can and should
be raised; but what can ablebodied; educated disabled person give to society?
This is a topical issue; primarily because in our country there has been a
tendency to reduce labor resources. The working-age population in Russia will
be reduced by more than 2 million by 2020. Therefore; the employment of
able-bodied people with disabilities is precisely that reserve that will fill
up the shortage of labor resources. We must admit the fact that; despite the
efforts made to integrate people with disabilities into society; they still
remain a special group; very poorly included in social processes and very
limited in rights; not only because of their psychophysical characteristics;
but also due to a number of barriers to the realization of basic human needs.
So; the employment rate among disabled people of working age; according to the
Ministry of Labor; is 25%; which is 2.5 times lower than the same indicator for
Russians without restrictions on health. “Chronic” unemployment among people
with disabilities of different nosologies reaches 77%. By 2020; the employment
rate among people with disabilities should double and reach 50%. Now only every
second student with a disability is subsequently employed-by 2020 this provider
must grow to 90% [1-9] However; to achieve such indicators; it is necessary;
first of all; to increase the effectiveness of career guidance for children
with disabilities; the accessibility and quality of general professional and
higher education. H ADO to take into account the fact that the number of
children with disabilities up to 18 years in Russia from year to year - this
year compared to last increased by almost 19 thousand. With oday general
education system rapidly changing; increasingly adapting to training for
children with disabilities. These changes; creating new opportunities for
learning and socialization for children with disabilities; will in the future
lead to an increase in their level of need for higher education. Therefore;
universities should be prepared in advance for an increase in the number of
applicants and students with disabilities. International experience offers
models of vocational training for people with disabilities; both in an
inclusive (or integrated) form; and in specialized centers equipped with
special equipment; training technologies and conditions for people with
disabilities to stay. Today; inclusion as a way of organizing the education of
children with disabilities is recognized by the whole world community as the
most humane.
Inclusion has become one of the leading strategies in Russian educational
policy. The importance of creating an inclusive educational environment is
recognized by socio- pedagogical practice; reinforced by the domestic
regulatory framework; and becoming the norm. It is educational inclusion that
meets the ideology as much as possible; which eliminates any form of
discrimination against the disabled and creates the necessary conditions for
their successful socialization. In modern psychological and pedagogical science
and practice; the concept of “inclusive educational environment” is widely used
when discussing the educational conditions of children with disabilities.
Inclusive educational environment (hereinafter - IOS) is a special type of
educational environment that involves solving the problem of education of
children with disabilities by adapting the educational space to the needs of
each child; including reforming the educational process; methodological
flexibility and variability; a favorable psychological climate; and providing
students with disabilities supporting services [1]. This releases some levels
inclusive air azovatelnoy environment [10].
The first level is also an inclusive
general educational environment. E the level of implementation of inclusive
general education purposes in a particular school with its terms; the objective
factors of the regional environment of its location; as well as subjective
factors; the characteristics of real subjects’ education. In the studies of
[1-6] presents the leading characteristics of IOS in mass educational
institutions. The second level is the inclusive environment of the educational
organization of secondary vocational and higher education. E is a specially
organized space that promotes the most comfortable receiving professional
formation I ; taking into account the special educational needs and psycho-
physical characteristics of students with disabilities . Moreover; this concept
is interpreted widely. It includes not only the situation of the educational
institution; but also “... the inner circle; the circle of communication of the
disabled person: this is the family and those who surround him; who are next to
him in the process of learning; during leisure hours” [3]. And finally; the
third level is the inclusive educational environment of a particular person (a
student with a disability; his typical peer; teacher) as a subject of inclusive
higher education. It is necessary; because the development of this environment
is aimed at achieving educational goals and results. Naturally; the personal
environment of each participant in the inclusive educational process should be self-organizing
at the level of this person; but methodologically managed by the university.
Therefore; the level of the educational environment of a university is a
combination of specific conditions and individuality of students. The holistic
educational environment of a university under inclusive education appears as a
supersystem for many unique; personality-adapted; personally significant social
and educational developmental environments of each and everyone [1]. In recent
years; experts have increasingly begun to pay attention to the design features
of an inclusive educational environment [ 3,7-9]. The purpose of designing is
to create a conceptual model of the educational environment; reflecting its
essential properties and requirements for it in accordance with the educational
specialization; the principles of the pedagogical system; the specifics of its
implementation and subject teaching.
Each educational institution of higher
education (university; academy; institute) creates its own IOS and; therefore;
creates its own abstract and universal image (model of this university) for
this environment. So; the purpose of the IOS project of the Moscow State
University of Economics and Economics is to develop and test the current IOS
model; which ensures the accessibility and improvement of the quality of higher
education for people with disabilities with social security ; their
socialization and integration into society through systemic state support for
the learning process for people with disabilities. One of the main goals of the
IOS formation is the development and adaptation of educational and
informational educational resources for higher education programs to the needs
of users (students with disabilities); the creation of a system of
programmatic; normative and informational support for the processes of
university education; compensation and rehabilitation ( habilitation ) of
students disabled people; the development of various forms of alternative
education; effective psychological and pedagogical support of the educational
process ; providing spy the physiological health of all participants in the
inclusive educational process [4].
Implementation of the project will make
it possible to justify and design a model of training teachers in additional
professional education for work in the conditions of IOS of the university; to
develop and test diagnostic tools to determine the level of formation of
teachers’ professional readiness for the formation of IOS in the university. In
addition; the implementation of the university’s IOS project will be important
to ensure the coherence of the actions of participants in the inclusive
educational process; social partners; and the development of a system of
psychological ; medical; pedagogical; informational; scientific; methodological
and sociocultural support for students; teachers and staff involved in the
formation of an adequate IOS ; increase the level of tolerance towards people
with disabilities; their social adaptation and integration in ordinary groups
of students. And the inclusive educational environment of a university is a
pedagogical system that has a specific structure that includes a number of
system components.
Spatial Subject Component
It characterizes the material
capabilities of the university; such as: affordable (barrier-free )
architectural and spatial organization; provision of modern technical means and
systems that meet the educational needs of students with disabilities and
disabilities of various nosological groups. By law; a student with a disability
has the right to apply for an adapted educational environment. By accepting
such a student; the university takes responsibility; and the conditions must
comply with its health restrictions. Implementation of the relevant regulatory
standards for space accessibility; technical equipment and the arrangement of a
“ barrier-free environment” for those universities that plan to accept disabled
people for training is required. Building on our university’s territory an
environment accessible for educating people with NODA was one of the first
tasks that were solved when creating special educational conditions. On the
instructions of the Ministry of Education and Science of Russia in 2012; our
university; together with the Moscow State University of Civil Engineering;
developed guidelines for ensuring the accessibility of buildings and structures
of educational institutions of secondary prof. and higher education for persons
with disabilities of various nosological groups.
Monitoring of the status of inclusive
higher education conducted by the RMTC shows that the vast majority of
universities are not ready for the inclusion of disabled people either morally;
methodologically; or technically [2,3]. Moreover; the lack of infrastructure
for the needs of people with disabilities is one of the most acute problems
limiting the access of people with disabilities to higher education.
Universities with effective technologies for teaching students with
disabilities and staff with relevant professional competencies are concentrated
mainly in 10-12 subjects of the Central; Volga and North-West federal
districts. This encourages some applicants with disabilities to apply to such
universities. However; admission to them for people from remote regions is
associated with a number of difficulties that not every potential student with
disabilities is able to overcome.
Of course; ensuring the physical
accessibility of the educational environment requires effort- organizational;
financial. And not every university is seriously engaged in this. Moreover; if
in former times; when there were no official strict requirements for the
accessible environment of an educational institution; children with
disabilities studied at a comprehensive school; they were accepted to
universities; now disabled students are simply denied admission to the
admission campaign; allegedly due to the lack of special conditions. So;
according to the monitoring of the Ministry of Education and Science ; within
the framework of the admission campaign of the last three years; people with
disabilities submit approximately 10 to 12 thousand applications for admission
to higher education programs ; and only every second applicant with
disabilities receives it.
Content Methodological
Component
Includes curriculum and teaching and
methodical the activities of students and teachers in the conditions of
inclusive education ( goal ; differentiation; individualization and variation
in the organization and content of the educational process ; teaching style and
character control; flexible educational methods and technologies the ) [4].
There is a widespread belief that most students with disabilities are not able
to fully master the content of academic disciplines and receive a quality
professional education. Indeed; they experience difficulties in mastering the
educational program at the same pace; on the same educational material and in
the same sequence as other students. And these circumstances must be considered
when organizing an inclusive educational process [5]. However; university
practice shows that even with a technically equipped audience; teachers who do
not have the skills to work with students with disabilities prefer to give the
material the old fashioned way; ignoring the special educational needs of students
with disabilities . Often; the teacher is satisfied with the empty “ sitting
out “ of a disabled student at lectures; instead of an adequate presentation of
the material; he tries to pay off with positive grades in the set-off. Or; on
the contrary; it is not uncommon for a student with disabilities to impose
unrealistic requirements for completing control tasks by misunderstanding . It
is therefore important is finding teachers competences in methods of work in
terms of inclusive higher education.
To create an adapted educational
environment; according to [6,7] it is necessary: to apply experimental;
stimulating interest and activity methods of development of students; apply
more practical teaching methods; including business games; case technologies;
apply methods of phased assimilation of new material; make students understand
that they are responsible for completing assignments; provide them with greater
freedom of choice; pay more attention to the emotional needs and interests of
everyone; use unifying types of productive activities that contribute to the
unity of students in an inclusive educational environment [2] . At the same
time; it is necessary to proceed from the individual needs of each; using
individualized types of activities; involve parents of students with
disabilities in collaboration ; coordinate an individual educational route with
them; rely only on the positive achievements of the learning outcomes . One of
the productive mechanisms for ensuring accessibility and quality of education
for people with disabilities and disabilities is distance learning; the
possibilities of which are systematically increasing: the number of
universities is increasing, and the quality of distance learning technologies
is improving. According to the results of expert evaluations; no less than 80%
of universities have access to educational portals for students; where they can
master the training material needed to prepare for classes. Training using
distance learning technologies is carried out in the implementation of
full-time; part-time and part time forms of training.
This training offers a range of
educational services provided to persons with disabilities and disability with
the help of specialized information - educational environment; based on the
medium of exchange of educational information at a distance. The choice of
interactive teaching aids that provide operational interaction with the
teacher; with other students; as well as with teaching material; helps to
increase the effectiveness and quality of distance learning for students with
disabilities and disabilities. The content-methodological component of the IOS
of the university is interconnected with the means of information and
communication technologies (ICT) and contains a system of information and
educational resources (IOR) ; including a system of electronic educational
resources (ESM). In 2016 designed and in March 2017 launched in test mode; the
Internet portal of information support of inclusive higher education (https: //
inklyuzivnoeobrazovanie born in f) ; a maximum of adapting the first for use by
persons with disabilities when using the PC and various mobile devices. The
portal contains and annually updates information on the state of ensuring the
availability of conditions for the education of disabled people in
universities. Currently; information is provided on 716 universities and 408
branches. It is possible to search for a university by given parameters
(region; desired specialty; type of nosology of the applicant; and so on).
Having specified a specific nosology; a disabled person can see a list of
universities where the most favorable conditions for students with this disease
are created; and also see the Atlas of the most popular professions. For
students with disabilities; it is possible to take an online career guidance
test and get advice on choosing the direction of preparation and admission to
universities. In addition; there is access to a library of teaching materials
and open courses tailored to nosology; and graduates are provided with
information on employment opportunities.
The modern educational process at the
university is high-tech in terms of using technical and informational teaching
aids; which for a student with health restrictions can act both as a barrier
and as a resource. On the one hand; complex laboratory work; including the use
of technical devices; mandatory for many specialties and areas of training; can
be difficult or dangerous for a student with visual; hearing; and motor
impairments. On the other hand; modern computer and information technologies
make it possible to provide information in a form accessible to students with
sensory impairments (electronic magnifiers for the visually impaired and voice
programs for the blind; sound amplifying equipment and multimedia for hearing
impairments). Computer simulators allow students with motor disabilities in a
simulation mode to perform experimental procedures inaccessible to them. A
variety of ESM cannot and should not fully replace live communication with the
teacher and other students during various forms of classroom activities; but
can significantly help a student with disabilities. In this regard; providing
an inclusive educational process with technical means of receiving and
transmitting information in forms that meet the special educational needs of
students with disorders of various nosology; as well as the development and
application of appropriate pedagogical technologies; is an effective way to
increase the accessibility of higher education for people with disabilities
[8,4] .
The content-methodical component of the
IOS of the university accumulates methodological resources; classified
according to the subject and subjects of study; including those having
electronic presentation. However; it is possible; for reasons of specific
expediency; the allocation of a specialized resource component of the IOS that
integrates all the methodological and educational information resources. The
need for such a component is also caused by the fact that not all universities
have experience in teaching and organizational and pedagogical support of
disabled people of various nosological groups. In order to increase the
effectiveness of the system of supporting the activities of universities for
the education of persons with disabilities; 3 resource educational and
methodological centers were created in 2016; and in October 2017; the RMTC
network was expanded by creating another 13 RMCs based on educational
institutions under the jurisdiction of the Russian Ministry of Education and
Science ; including Moscow State University of Economics and Economics. In the
higher education system; ROMCs act as a resource that other universities can
use to increase the accessibility and quality of education for people with
disabilities. The program for introducing inclusive education through the RMTC
network is planned until 2020. For the most part; the centers are based in
universities with departments of defect logical education; as well as in
universities that have approved AEHE . In RUMTS launched retraining courses for
the teaching staff of universities. On the one hand; the picture is rather
optimistic the university community has moved in the right direction; on the
other; the specialists of the RMTC believe; some of the universities undergo
retraining to close the gap before accreditation.
Communicative and
organizational component
Is a space of interpersonal interaction
in a direct or subjectmediated form and ways of interaction between subjects of
an inclusive educational process; a favorable psychological climate in
inclusive groups; management of team activities of specialists providing
inclusive practice at a university. Higher education; in fact; ensures that
students enter a wide variety of social interactions into the special
sociocultural environment of the university; which creates and expands the
basis for adaptation. Developing social skills; collectivism; organizational
skills; the ability to establish contacts and collaborate with different
people. A worldview and civic position are being formed.
The practical experience of MSGEU shows that the introduction of an inclusive
approach to teaching people with disabilities today faces not only difficulties
in organizing an accessible environment (physical accessibility to university
facilities; special teaching aids; and special equipment). The most difficult
to solve are problems of a socio-psychological nature; including the prevailing
stereotypes of education; the lack of readiness of participants in the
educational process (teachers; students; parents) to accept new principles of
education; the lack of comprehensive psychological and pedagogical knowledge
and technology; special monitoring studies regarding the experience of
inclusive higher education [10].
The socio-psychological situation in the
educational institution is an important aspect of an inclusive educational
environment. Here we are talking about the nature of the relationship that a
student with a disability develops with teachers; other students; supervisors;
all staff of the educational organization. In fact ; there are good reasons for
relational barriers with an inclusive approach in modern conditions. So; when
presenting the same requirements to all students; students with disabilities
often need to spend more time to master the material they have gone through;
make more effort than a “healthy” student. During the lecture; students with
disabilities ask more clarifying questions; and the pace of writing material is
much lower. As a result; “healthy” students have to expect a continuation of
the lecture; which causes irritation in individuals; a conflict may arise in
the group. Moreover; facts are known when people with disabilities that are not
externally expressed acted on the side of discrimination against persons with
disabilities [9]. As psychologists note; this attitude is usually associated
with one’s own disagreement with one’s real state of health It is also worth
noting that the conflict can also occur between the “disabled” - “disabled”
groups; and “healthy” students can support one or the other. According to our
observations; conflicting parties are formed on issues of active and passive
relations. So; students who study continuously in an inclusive approach within
the walls of the university; more easily adapt to new conditions; establish
contact with their peers. In addition to educational activities; they are
engaged in scientific and social life; and show their leadership qualities.
Students with disabilities who previously studied at a specialized educational
institution or received a general education at home; the socialization process
is difficult; time-consuming; there are communication barriers. A negative
attitude arises between groups: students with an active position consider
others unsure of themselves; students with a passive position consider the
other group as “upstarts”; directly showing this with their behavior. In our
opinion; despite such a negative attitude in groups; conflict can be considered
as a way to resolve contradictions. The identification and resolution of
conflicts as a whole is useful both for these social groups; and for society as
a whole. Paying attention to conflict resolution; an individual; group or
society as a whole achieve more effective results; of course; if they follow
certain rules aimed at the civilized regulation of conflicts and management of
their development [5].
Conclusion
The most important aspect of the
communicative and organizational component of the IOS is the management of
inclusive practice at the university. It is well known that the education and
socialization of a person with disabilities is a complex problem even in a
special educational institution. Inclusion of the educational process makes
even greater demands on the interprofessional and interagency interaction of
specialists. The managers in the field of vocational education; combining the
knowledge of a wide range of pedagogical technologies of higher education with
special defect logical training; are practically absent. To create a truly
inclusive university; it is necessary to cultivate such professionals of a new
formation. It is obvious that the country’s universities will inevitably have
to solve a wide variety of tasks in the formation of an adapted educational
environment - methodological; technical; regulatory and accreditation. But;
first of all; participants in the educational process need to learn inclusive
interaction-full-scale entry into equal relations. By this distribution of
roles or di students or ordinary students or teachers are often not prepared.
It is such a conscious “inclusion” that needs to be learned first.
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Thursday 17 September 2020
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Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences
Lupine Publishers | Well-being at a glance:with special focus on Geriatric population
Introduction
The various models on wellbeing define
wellbeing as a multidimensional construct integrating mental and physical
health regarding health promotion by preventing disease. WHO also holds a
holistic view of health comprising of physical mental and social wellbeing.
Researches nowadays are more alert towards public health model rather than the
medical model proposed during earlier times. The advent of positive psychology
has led to a paradigm shift in health management strategies from pathogenic
orientation which lays more emphasis on treatment and cure for illness to
maltogenic approach that focuses on prevention of illness and health promotion.
At an elementary level, wellbeing can be defined as how people perceive and
evaluate the actions and activities in their life, the positive outcome that
stands significant for individuals. The factors that can significantly affect
the state of an individual’s wellbeing are presence and the degree of positive
relationship, self actualization, resilience, positive emotions contentment and
purpose in life. Researches reveal global judgment of life satisfaction and
feelings ranging between joy to depression to be included under wellbeing
[1-6].
Numerous cross sectional
and longitudinal researches have revealed that wellbeing is associated
positively with the following variables [5,7]:
a) Self-perceived health
b) Longevity
c) Healthy behaviors
d) Mental and physical illness
e) Social connectedness
f) Productivity
g) Factors in the physical and social environment
Research studies also state higher levels
of wellbeing are associated with decreased risk of physical ailments like
cardiovascular risk, injury and other types of illnesses; it improves immune
functioning leading to quick recovery from ailments thus increasing the longevity.
Further it is also related positively to job productivity and social
contributions. The positive affect component of wellbeing is associated with
extraversion and negative affect component to neuroticism [8-10].
Aspects of Wellbeing
The Concepts Identified
are the Following
a) Attitude of an individual towards his
own self
b) Self actualization
c) Integration
d) Autonomy
e) Perception of reality
f) Environmental mastery
Seeman’s model is based on the behavioral
subsystems of all human systems. It is based on the concept of organismic
integration where organismic would refer to a pervasive process that
comprehends all the subsystem such as biochemical, physiological, perceptual
cognitive and interpersonal dimensions of behavior. The model proposed, looks
like (Table 1). The horizontal dimension of the model emphasizes the point that
wellbeing is a longitudinal development terms so as to include the concept of
health as an ongoing process. Crompton’s model finally proposes that
psychological wellbeing can best be assumed by a tripartite model that includes
subjective wellbeing, personal growth and religiosity. Research conducted by
Crompton (2001) found that as people strive to gain greater psychological
wellness they may seek interpersonal relationship to enhance self esteem,
search for existentialism for self actualization. He further concluded that the
conflict people experience in search of their happiness and good life may be
related to a relative stable sense of identity. Correlates and determinants of
individual wellbeing: Wellbeing is dependent upon good health, positive social
relations and the basic/ primary needs of the individual, so as to quote the
definition of health by W.H.O. “The physical, mental and social health of the
individual”. Individual wellbeing is determined by factors like autonomy,
environmental mastery, life satisfaction, self acceptance, positive regard with
others, and purpose in life and happiness. As individual correlates are based
on the environment, might vary from one individual to the other. Personality
and genes at the individual level are related to wellbeing. Researchers have
shown that positive emotions are heritable to some degree suggesting that there
may be some set points for emotions like happiness and sadness to be felt or
experienced. Although it is not solely the genetic effects that would determine
positive emotions, environmental factors would also play a role significantly.
Genetic factors and personality factors would interact closely to influence the
individual wellbeing of individuals. Age and gender as correlates of wellbeing
show that men and women would almost have the similar levels of wellbeing,
however with age [8] there has been found a U shaped distribution wherein,
wellbeing will be more among the younger and older population than the middle
aged adults [1]. In terms of relationships, positive relations turn up to be
one of the strongest correlates of wellbeing, having a positive effect
altogether [10-12].
Some Reviews on Well
Being Based on Report Prepared by CDC
a) Employed women would show higher
levels of wellbeing and also used fewer professional services to cope with
stress than non employed ones, data from NHANES (1971-1975) revealed [13].
b) The other review from NHIS and quality of wellbeing scale (2001) found that
males and females between the age group of 20-39 showed significantly better
sense of wellbeing than the ones aged 40 years and older [7].
c) Data from BRFSS revealed that 8.6% of adults in US reported of never or
rarely receiving emotional and social support [12].
Statistics on Wellbeing
Report presented on ageing statistics by World Health Organization shows that India’s current elderly population is 60 million, which is projected to increase to 227 million in 2050 which shows an increase of 280 percent from the current situation. Similarly, glancing at China’s current elderly population i.e. 65 and above, from 110 million shall likely reach to 330 million by 2050 (Figure 2). In a study conducted by global AGEing and adult health (SAGE) six major health risk factors viz. physical inactivity, current tobacco use, heavy alcohol consumption, high risk waisthip ratio, hypertension and obesity have been identified. The study reported that three of these six health risk factors rises with age however the patterns and percentage would vary by country. The pattern and percentage has been depicted in Figure 2 below. One of the goals of further researches in this direction might be to study and find out the outcome of such health conditions on the well being of the country’s population. Number of disabilities seems to increase among the developing nation as the number of older people tends to increase. Health services in the developing nations needs improvement in their health services in order to understand the health risks faced by older people and accordingly plan for prevention and intervention. Further studies conducted in this direction show the health status score of males and females from six different countries. In the figure below (Figures 3 & 4), it has been depicted that health status score declines with age, as expected. The graph shows the score for males is higher than females. However females tend to live longer than males on an average but have poorer health status. The health score in the figure ranges from 0 (worst health) to 100 (best health).
Conclusion
India has acquired the label of “an
ageing nation” with 7.7% of its population being more than 60 years. In India,
the elderly population suffers from dual health issues i.e. either communicable
or non communicable diseases. According to the Government of India statistics,
cardiovascular diseases account for one third of elderly mortality. Respiratory
disorders account for 10% mortality. As a concept, wellbeing can be defined as
to how people evaluate their lives. Psychological well being as a construct
comprises of positive affective state like happiness on one end and optimal
functioning on the other end [14]. Thus accordingly, psychological wellbeing
can be observed as a combination of feeling happy and functioning effectively.
Studies and researches conducted further have reported that people who are high
on psychological wellbeing report of feeling happy capable and good
availability of social support and higher degrees of life satisfaction. The
authors in a study concluded positive emotions as a potential promoting agent
for population longevity and health [15]. Apart from the psychological factors
it is also dependent upon physical health conditions that can be mediated by
brain activation patterns neuro chemical effects and also genetic factors. The
focus of any future research can be to increase the life expectancy rate of the
elderly population and accordingly explore the ways of ensuring good quality of
life with increasing age. With a special focus on the developing nations of the
world, better medical aid and services should be provided by the community
based health care centers and hospitals. The aim of these health care centers
should be to plan interventions and improve the overall health conditions of
the elderly population.
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Thursday 10 September 2020
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Lupine Publishers | A Review on Gender Differences in Schizophrenia in Indian Settings
Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences
Abstract
The present article is a scientific review aimed to explore the various gender differences, which are seen in individuals with schizophrenia. Cultural difference is seen as one of the factors playing a major role in the gender differences of people with schizophrenia. The present article presents a comprehensive review of the research done in the past in the area of schizophrenia, thereby presenting a significant summary of the previous research findings. This article focusses on the researches on gender differences in Schizophrenia in Indian context as well as worldwide. It suggests that there are various factors, which have not been further explored, and there is a scope for research in the Indian context, thereby helping to fill in the gaps in the literature related to the factors involved in contributing to the gender differences in Schizophrenia.
Keywords: Schizophrenia; Gender Differences; Indian context; Worldwide
Introduction
Schizophrenia is one of the widely studied disorders across the globe. It is the most widely researched topic by scholars worldwide. It is a chronic and disabling mental illness affecting millions of people worldwide [1-5]. The annual prevalence of Schizophrenia worldwide is 0.2-0.4/1000 [6]. The prevalence of Schizophrenia in India is 3/1000 [7]. The annual incidence rates obtained were 4.4 and 3.8 per 10,000 for rural and urban areas, respectively. There are many gender differences observed in the individuals with Schizophrenia. Men tend to show more Negative symptoms as compared to women who display more of Affective symptoms [8]. Gender differences in terms of prognosis is noted, where women have better outcomes in terms of clinical course and occupational and social functioning [9-11]. Disability being one area where gender differences are evidently seen, men face disability in occupational functioning [12] whereas women in the marital functioning [13]. The cumulative lifetime risk is the same in both the genders [14].
Prevalance and Incidence
Sex differences in the incidence and prevalence of Schizophrenia may be dependent on the stringency of diagnostic criteria applied. When the diagnostic criteria are broader, there sex differences are less significant [15].
Age of Onset
Majority of studies done in this area suggests that men have an earlier age at their 1st hospitalisation as compared to woman [16,17]. They further noted that these differences in the age of 1st hospitalisation have ranged from 2-6 years. Another research suggests that there has been a general shift in the age of onset between both genders, with women being at a higher rate to have a later onset of symptoms regardless of when hospitalisation first occurred [18]. Castle and [3,8] did a prospective study where they go the average onset of males, which was 31.2, was almost 10 years younger than the average onset age for females, which was 41.1. In addition, when family ratings of then1st appearance of Schizophrenic symptoms was used, it was clearly seen that men show an earlier onset of schizophrenic symptoms than women [7,10]. This difference in the age could also be affected by the familial values versus non-familial status. Albus and [5] conducted a study to see the differences in the age of onset related to familial and nonfamilial status and found that there is no difference in onset age in familial cases of schizophrenia (38 Male-male pairs and 29 femalefemale pairs). It was also evidently seen that the age of onset of earlier for males in non-familial cases. It is widely seen that females have a much later onset of Schizophrenia. Researchers suggest that the females also have a better course of illness than males. They suggest that these two phenomena are related to one another, I.e., worse subtype of illness occurs earlier and hence results in later onset in women results in a less aggressive illness thereby resulting into a better outcome. These views are encouraged by epidemiological literature to s great extent [6].
Premorbid Functioning
Andia [3] did a research on the sex differences in the premorbid functioning in individual with schizophrenia. It was found that females had a higher level of functioning which majorly included greater educational attainment. It was also evidently found that females had a greater likelihood of getting married prior to their onset of illness. There is a positive correlation between premorbid functioning and prognosis. Better the premorbid functioning, better is the prognosis for illness. Shtasel, Gur & Heinberg [14] found gender differences in premorbid functioning being worse in men than women. McGlashan and Bardenstein [5,9]
did a research related to gender differences and found that females had better premorbid functioning and marital adjustment. Symptomatologic characteristics: Gender differences are vividly seen in symptoms and its exhibition. Females are more likely to present with comorbid depression or even anxiety disorders as opposed to males who are more likely to receive a diagnosis for substance abuse or alcohol abuse and difficulties in impulse control during the first psychiatric admission. When the symptoms are expressed, it is seen that men tend to experience more affective flattening and negative symptoms at the time of their 1st episode as compared to females [4]. These results were also supported by the study done by Rachel Willhite in California. In addition, males were found to have more difficulties related to emotions and were found to be impaired on emotional and social withdrawal, blunted affect, poor rapport. Females on the other hand were seen to have severe somatic symptoms.
Course and Outcome
Alice & Chue [2] did a study to explore the gender perspective in course of schizophrenia and found that the course was more favourable in women with less smoking and substance abuse. It was also seen that women presented higher rates oh remission, less days of hospitalisation and better response to typical anti psychotics than men. However, research has contrast view related to gender differences in hospitalisation. Haro and his colleagues [1] found that women presented higher risk of hospitalisation than men. Another study done by Usual and colleagues in 2001 reported that number of previous hospitalisation were similar to both men and women. These 3 contradictory results pave way for further investigation in this regard.
Types of Research Done in India
Prevalence & Incidence
The prevalence of schizophrenia in India is observed to be lower as compared to that in the western countries [16]. In addition to this, it was also seen that the prevalence rate in “least developed” countries was significantly lower as compared to emerging and developed countries. One of the factors which might affect this difference would be “under reporting” (Avasthi [5]). Considering the important aspect of the incidence and prevalence rate across gender, various kinds of results have been noted by differences researchers. Rode [3] did a study on 196 individuals having schizophrenia, of which 55.61% were males and 44.39% were females. It is interesting to note these sex differences and understand the factors related to it. This area of research remains least explored in Indian context and is in need of further research.
Age of Onset
Similar to the research from western countries, it was seen that the gender differences do exist in the age of onset of schizophrenia in Indian population too Murthy [8] found that the males had an earlier onset of the illness as compared to that of females. The males were seen to develop it 5 years earlier than the females [12]. But another study done by Gangadhar and colleagues found contradictory results. It was seen that there was no difference in the onset age between the genders. Although, it was further seen that the proportion of females was higher in group if under 20 years of age. Janakiramiah [11] said that this could be due the over representation of younger ages. Murthy and colleagues in 1998 did a study and found no sex differences in the age of onset. These studies contradict in results thereby paving a way for further research. It is important to find that if the difference in the onset age is really a true onset age or age at case finding. Many factors could affect it and they play a major role. It can be highly possible that the early hospitalisation in men is due to quicker response to symptoms by society rather than early manifestation. It is also possible that the females are cared at home prior to diagnosis which postpones hospitalisation.
Premorbid Functioning
Stusser [9] reported various types of premorbid abnormalities in individuals with schizophrenia. These abnormalities are exaggerated in intellectual and social areas. Foerster [13] added to these results that such abnormalities I’m the premorbid functioning are seen more in men as compared to women who develop schizophrenia. Other studies also supported the findings where in it was seen that males have higher premorbid abnormalities than females Childers [11]. Retrospective studies reported children seeking mental health services and those at high risk suggest similar results. These premorbid deficits also result in an early onset of illness especially in Male gender. According to the neurodevelopmental model of schizophrenia, the premorbid functioning has abnormal development in early years. Crow [10] confirmed this view adding gender differences related to it. Men have an irritable, disagreeable premorbid functioning. They also tend to be defiant of authority, whereas women tend to be secure and shy and participate less in groups [1,6].
Clinical Representation
Gender also influences the way the symptoms are expressed. Seeman [1] did a research and found that females are seen to have more affective symptoms and fewer negative symptoms. They also tend to get a diagnosis of schizoaffective disorder. Roberta & Handel [4] found that females with schizophrenia tend to be more hostile as compared to males. They also are physically active and dominating, with more sexual delusions. They tend to be more emotional than men. McGlashan & Bardenstein [6] did a study and results were consistent with earlier findings that women experience affective symptoms and less negative symptoms. They also said that females exhibit more or anxiety and paranoid symptoms. The meaning of symptoms seems differ across genders and manifest in different ways. Symptoms of withdrawal and dependency reflect as depression syndrome in women whereas negative symptoms in men.
Course and Outcome
Thara [1] did a longitudinal study of 25 years in madras and found that there were no differences in genders in the course and outcome of schizophrenia. These results contradict the results from western countries. Although, there have been studies which support that women have favourable outcomes than men. Dutta & Kapur [7] did a research related to course and outcome of schizophrenia and the gender differences in it. They looked at the prognostic factors and found a negative correlation between chances of improvement and duration of illness. Shorted the duration of illness (less than one year), higher are the chances of improvement. Other factors playing important role in improvement are no family history of mental illness, acute onset and younger age. It was also seen that gender and previous history of mental illness had no prognostic significance.
Cultural Influences
“Culture” plays a very important role in the entire journey of schizophrenia especially in the Indian context. Various studies focus on the culture and its influence on overall functioning of individuals with schizophrenia. Loganathan and Murthy did a research on gender differences and doing marriage, job and children as most important factors being affected. Women had a ear if rejection and were not comfortable disclosing about their illness to their husbands. They used concealing as a strategy. Females also preferred to stay unmarried. It was seen that separation was a common event occurring when told about their illness. Women who expecting were forced to abort their child, and of given birth, were separated from child. On the other hand, men with schizophrenia, faced a lot of frustration in securing jobs. They were highly stigmatised. It was therefore seen that women were separated or divorced while more men remained single.
Lacunae in Researches Today
The “culture” as a factor which broadly influences the expression of symptoms across genders needs to be investigated further. This investigation may help to identify the unexplored link between the illness and related factors. In the Indian context, religious influences need to be investigated further. To determine various causal mechanisms across the genders, longitudinal studies need to be done.
Studies Required in Indian Setting
The prevalence and incidence of schizophrenia is seen more in men in India. But the reasons for this higher proportion in one gender remains unexplored. Ignorance and underreporting could be some factors that can be studied in Indian context. Factors involved in favourable outcomes for women in Indian context can be studied further Another area which needs to be explored are the religious influences on the overall course of schizophrenia. Studies related to practising spirituality and outcomes of schizophrenia can be done.
Conclusion
The evidences noted throughout the paper point towards general susceptibility across genders for schizophrenia. Despite of contrary results in various studies, most of the work consistently show that males are more prone towards early onset, have negative symptoms and less favourable outcome towards Schizophrenia in both, Indian as well as western context. However, research done in India has been without much structure and organisation. Wellcoordinated studies are needed to arrive at clear, structured and organised reports of the gender differences in India. In addition, the results can also be used effectively in planning for gender-sensitive mental health services in India.
https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000158.pdf
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Monday 7 September 2020
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Lupine Publishers | Attachment without Love: Treating the Failing Student
Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences
Opinion
When you talk about letting go as a weak melting that you apply to a joinings, and that knowing that you can join would take you out from acting on it to a living achievements, where you are not closer to ignorance, and that word is so unspoiled that it is sad. Whenever a student arrives at my office with failing grade and some happiness due to falling in love again, I know immediately it was a bad thing to have that attaching, because you agree that when ignoring people talk about these failure and connections, one never knows when person can do bad (le mal) or good (le bonb), large by large !, one can wonder “... what a terrible connection” or a “stop, they won’t do it”. And that’s when at the end of my analysis of my thoughts, you mention to the student that he lives an unfortunate time, and you turn to me to hear with the most credible ears ever ever, and you say “but how do I act? It is the best moment of your life “, and you would not like to say that a moment of joy is the worst ball with which we can hear a situation, if you are weak enough despite the times to come, it is to miss that warm and fuzzy wave that you They allows us to obtain that surrender that we would do otherwise. Sacrebleu, it is the goal to obtain that power that all students have, and of which even the professors lack, the goal is to have open love, like Woodstock where the bands play on and flowers bloom. A failing grade can open you to it. You will be unable to do what I don’t want, and to decide what a long way you have to go. To reach the state. That is the way to shrink, to ignore outcomes, to make you weak, for your sins, since what fails to distinguish you is your way of prevaricating; and the cowardly brother of the decision is attaching. We do not understand the attachment as grabbing on, grabbing on, letting go, letting go, not being bolted down, knowing and not being worth the licorice that did not occur, is facing up and avoiding to that loose detaching. Do you want to lack the power? It’s false, you have to be a student or a professor, you cannot leave your partner, no. You must ignore and be bad, no, but you cannot come with your backpack of books, not knowing to go later to miss an thought that we like, that is helpful and negotiable: go to the Isle of Dogs or the leisure is nonnegotiable, it is better to go to Mehico or Amazonia, it is to abstain from all parties, study hard, but it is negotiable fidelity, love in its various forms, the random chance of not overcoming leisure , called “del”, or be the professor with good habits of unwellness. Only you do not choose, only you do not choose, we all choose, we all choose, and cannot assume the outcomes, since in our state we are not accustomed to being victorious, to retain our conscience, to say that you are le mal and I am le bon, and so on and so fifth, but You always take irresponsibility, and those thoughts will always make you shrink. Do you want to be a false student, or an incomplete professor? Don’t make decisions, be irresponsible, don’t take on the outcomes and you will miss the old twilight., and fail no more.
https://lupinepublishers.com/psychology-behavioral-science-journal/fulltext/attachment-without-love-treating-the-failing-student.ID.000142.php
https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000142.pdf
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Thursday 3 September 2020
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Lupine Publishers | Prevention Methods of Posttraumatic Stress Disorder (PTST) in Cancer Survivors
Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences
Introduction
It is quite appropriate to say, people are less likely to look for diagnostic ways of cancer because of the fear of having cancer. In addition, many people have phobias of cancer treatment methods (such as surgery, chemotherapy, and radiotherapy) [1,2]. The fact remains that, many people are unwittingly exposed to the posttraumatic stress disorder (PTST) because of severe stress [3]. Nevertheless, many researchers do not believe to the psychology complications of cancer, but psychological distress during and after cancer treatment increased concerns about sexuality, intimacy, and physical well-being. These disorders can occur after the stressor agent such as cancer [4]. It is widely supposed that PTSD is psychological disease and separate from physiological system. Whereas, PTSD can have physiological consequences such as elevated blood pressure, cholesterol, and cortisol levels [4]. However, disabling subsyndromal PTSD symptoms is not known for each individual, but the consequences of this disorder make it more important to treat it [4,5]. Distress and anxiety and less optimal quality of life are caused by PTSD in cancer survivor. It would be better to say that PTSD has a direct effect on the quality of cancer treatment. As detailed, patient’s spirit has a great impact on the positive response of cancer to chemical drugs and radiation doses during treatment. Also, treatment conditions can get worse PTSD. So that, the treatment environment, the attitude of the treatment technicians plays an important role in the recovery and doesn’t involve them to PTSD. Passing on now to treatment methods of PTSD, we should try to suppress PTSD and comorbid symptoms by utilize treatment methods. Variety of psychotherapy (such as eye movement desensitization and reprocessing and cognitive restructuring method) and pharmacotherapy (such as prazosin, anticonvulsants and risperidone) that have been practiced on patients who suffer from PTSD symptoms induced by cancer that we will discuss below. Prazosin Utilize in PTSD is effective, particularly in reducing nightmares and improving sleep. PTSD is often associated with alcohol misuse, prazosin can reduce alcohol dependence [6]. Anticonvulsants have some beneficial attributes in treatment PTSD, particularly where irritability and a startle response are prominent [7]. Risperidone is associated with improvement in overall PTSD symptoms and specific sleep variables [8]. Some resources presented that benzodiazepines (BZDs) are treatment drugs for PTSD [9], But to be honest BZDs should be considered relatively contraindicated for patients with PTSD. Because it caused to worse psychotherapy outcomes, aggression, depression, and substance use [10]. Eye movement desensitization and reprocessing (EMDR) is faster and more effective psychotherapy method than other treatments. This method is a complex treatment that incorporates many different interventions, including imaginal exposure and free association [11]. Cognitive restructuring method included socratic questioning, guided discovery, the devil’s advocate technique and determining the pros and cons of the validity of the assumption. Also, it has vital role for the effectiveness of the intervention [12]. Patients follow up after treatment is one of the most important in radiotherapy. Important considerate to the PTSD symptoms besides clinical examination after cancer treatment can help improved patient cancer. However, the emergence of PTSD can have a direct effect on the cancer treatment benefits. Thereby PTSD can pose a big challenge for cancer treatment researchers. The importance of this issue could provide the basis for a new collaboration between psychologists and oncologists to treat cancer with high therapeutic benefit without side effects.
https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000156.pdf
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