The prevalence of post traumatic stress disorder (ptsd) among flood affected school

ijcrb.webs.com JUNE 2011
INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2

The Prevalence of Post Traumatic Stress Disorder (PTSD) among Flood Affected School

Children in Pakistan

Nasir Ahmad

PhD scholar (Education) Foundation University Islamabad, Pakistan

Dr.Tayyab Alam Bukhari

Chairman Department of Education, Foundation University Islamabad, Pakistan

Nargis Munir

M.Sc (Clinical Psychology) FFH Rawalpindi, Pakistan

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Abstract

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The present study was designed to determine the prevalence of Post traumatic stress disorder
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(PTSD) among flood affected school children in Pakistan. The sample of the study was
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comprised of 522 randomly selected students aged 10-16 years from five flood affected districts
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of Khyber Pukhtunkhwa. The instrument used in the study was The Impact of Event Scale-
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Revised (IES-R) to measure Post traumatic stress disorder (PTSD) among flood affected school
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children in Pakistan.. The main findings of the study were; secondary school students were
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highly affected by Post traumatic stress disorder (PTSD); Female secondary school students were
highly affected by Post traumatic stress disorder (PTSD; Displaced secondary school students
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were highly affected by Post traumatic stress disorder (PTSD); female students developed more
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PTSD as compared to male students; and displaced students developed more PTSD as compared
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to non-displaced students.
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Key words: Post traumatic stress disorder (PTSD), Flood, The Impact of Event Scale-Revised
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(IES-R)
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INTRODUCTION
Natural disaster affected the lives of many people all over the world. The affectess of such
disasters faces different calamities in term of deaths, physical injuries, property lose and
psychological injuries. Post traumatic stress disorder (PTSD) is one of the most common
psychological injuries that the victims of natural disasters faced. Post traumatic stress disorder
(PTSD) may be described as characteristic set of symptoms resulting from exposure to traumatic
stressors. DSM-IV described Post traumatic stress disorder (PTSD) as exposure to a traumatic
event in which person has responded with intense fear, helplessness or horror. (Clark, 1999)
Walsh (1994) observed that “Post traumatic stress disorder (PTSD) is usually provoked
by a traumatic events that is outside the rang of usual human experiences such as bereavement,
chronic illness, business losses or marital conflicts.”
The events that caused Post traumatic stress disorder (PTSD) are war, see or experience
physical violence and natural disaster like earth quick, hurricane and flood. Smith (2003)

COPY RIGHT © 2011 Institute of Interdisciplinary Business Research 445


observed that Post traumatic stress disorder (PTSD) may develop immediately after the trauma
or it may be brought on by a minor stress experience week, month or even year later.
Flood is one of the most sever natural disaster and it “can result in direct economic and
property lose, physical injuries, death and psychological injuries” (Huang, 2010). Post traumatic
stress disorder (PTSD) is one of the most common psychological injuries that the flood survivors
faced. Green (1992) examined the survivors of Buffalo creek dam collapse in 1972 and found
that 63% of the survivors were suffering From Post traumatic stress disorder (PTSD).
Natural disasters also caused Post traumatic stress disorder (PTSD) among school
students as ziaddini (2009) observed that the prevalence of Post traumatic stress disorder (PTSD)
was 66.7% among high school students after the earth quick disaster in the city of Bam, Iran.
The people of Pakistan faced a devastating flood in late July 2010 following by monsoon
rain in Punjab, Sindh, Khyber Pukhtunkhwa and Balochistan regions. It destroyed the property
and infrastructure and affected about 20 million people, with a death toll close to 2000. The
people had horrifying experiences accompanying death of families and property loses resulted in

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severe traumatic responses in surviving people including school children.

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The present study was designed to determine the prevalence of Post traumatic stress

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disorder (PTSD) among flood affected school children in Pakistan.

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METHOD er
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The sample of the study was comprised of 522 randomly selected students aged 10-16
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years from five flood affected districts of Khyber Pukhtunkhwa. These districts include
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Charssada, Lower Dir, Upper Dir, Noshehra and Swat. The instrument used in the study was The
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Impact of Event Scale-Revised (IES-R) to measure Post traumatic stress disorder (PTSD) among
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flood affected school children in Pakistan.
The Impact of Event Scale (IES) is a short set of 15 questions evaluating experiences of
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avoidance and intrusion which attempts to reflect the intensity of the post traumatic phenomena.
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Developed in 1979 by Mardi Horowitz, Nancy Wilner, and William Alvarez
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Daniel S. Weiss and Charles R. Marmar (1997) chose to revise the scale by adding seven
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additional questions to measure another dimension of intense stress events. Both versions have
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been found to be valid and reliable. The revised version of the Impact of Event Scale (IES-r) has
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seven additional questions and a scoring range of 0 to 88.

On this test, scores that exceed 24 can be quite meaningful. High scores have the following
associations.

24 Those with scores this high have partial PTSD or at least some of the
symptoms.
or more
33 This represents a probable diagnosis of PTSD.

and above
37 This is high enough to suppress your immune system's functioning.

or more



The data was collected four month after the event.

RESULTS
Table 1
Descriptive statistics
Mean and standard deviation of age and PTSD of flood affected school children
Variables N Mean S.D

Age 522 12.87 1.79

PTSD 522 42.48 9.35

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Table 1 shows that the numbers of respondents are 522.The mean and standard deviation
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of age are 12.87 and 1.79 respectively. The mean and standard deviation on PTSD scale are
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42.48 and 9.35.
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Table 2
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Total number and percentage (%) of secondary school students on the measure of the Impact of
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Event Scale (IES-r)
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Scoring rang of IES-r No. of students percentage (%)
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Less than 24 16 3.06
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24 or more 74 14.17
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33 or more 46 8.81
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37 or more 386 73.94
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Total 522 100

Table 2 shows that the total no. of respondents is 522. Out of which (16) 3.06 % did not have
Post traumatic stress disorder (PTSD), (74) 14.17% had partial Post traumatic stress disorder
(PTSD), (46) 8.81 % had a probable diagnosis of PTSD and (386) 73% had high PTSD. This
shows that secondary school students were highly affected by Post traumatic stress disorder
(PTSD).



Table 3
Total number and percentage (%) of male secondary school students on the measure of the
Impact of Event Scale (IES-r)
24 or more 62 22.63
33 or more 42 15.33
37 or more 154 56.20
Total 274 100

Table 3 shows that the total no. of male respondents is 274. Out of which (16) 5.84 % did not
have Post traumatic stress disorder (PTSD), (62) 22.63% had partial Post traumatic stress

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disorder (PTSD), (42) 15.33 % had a probable diagnosis of PTSD and (154) 56.20 had high

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PTSD. This shows that male secondary school students were affected by Post traumatic stress

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disorder (PTSD).

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Table 4 er
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Total number and percentage (%) of female secondary school students on the measure of the
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Impact of Event Scale (IES-r)
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Less than 24 0 0.0
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24 or more 12 4.83
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33 or more 4 1.61
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37 or more 232 93.54
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Total 248 100
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Table 4 shows that the total no. of female respondents is 248. Out of which (12) 4.83% had
partial Post traumatic stress disorder (PTSD), (4) 1.61 % had a probable diagnosis of PTSD and
(232) 93.54% had high PTSD. This shows that female secondary school students were highly
affected by Post traumatic stress disorder (PTSD).

Table 5 Total number and percentage (%) of displaced secondary school students on the
measure of the Impact of Event Scale (IES-r)
Less than 24 0 0.0
24 or more 0 0.0
33 or more 20 6.13
37 or more 306 93.87
Total 326 100



Table 5 shows that the total no. of displaced respondents is 326. Out of which (20) 6.13 % had a
probable diagnosis of PTSD and (306) 93.87% had high PTSD. This shows that displaced
secondary school students were highly affected by Post traumatic stress disorder (PTSD).

Table 6
Total number and percentage (%) of non-displaced secondary school students on the measure of
the Impact of Event Scale (IES-r)
24 or more 66 33.61
33 or more 30 15.31
37 or more 84 42.86
Total 196 100

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Table 6 shows that the total no. of non-displaced respondents is 196. Out of which (16) 8.16 %

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did not have Post traumatic stress disorder (PTSD), (66) 33.61% had partial Post traumatic stress
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disorder (PTSD), (30) 15.31 % had a probable diagnosis of PTSD and (84) 42.86% had high
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PTSD. This shows that non-displaced secondary school students were also affected by Post
traumatic stress disorder (PTSD).
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TABLE 7
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Mean, S.D, t and p value of flood affected female and male students on the measure of PTSD.
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Variables Female Male t p
N=248 N=274
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M S.D M S.D
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PTSD 49.02 6.61 36.56 7.32 20.32 .007
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df=520
Table 7 reflects the numbers of female and male students are 248 and 274 respectively.
The mean and standard deviation of female students on the measure of PTSD scale are 49.02 and
6.61 and the mean and standard deviation of the male on the measure of PTSD scale are 36.56
and 7.32 respectively. The t and p vale of both groups are 20.32 and .007.
This indicates that the difference between the means of the two groups is significant at
.01 levels. Inspection of means suggests that female students developed more PTSD as compared
to male students.



TABLE 8
Mean, S.D, t and p value of flood affected displaced and Non-displaced students on the measure
of PTSD.

Variables Displaced Non-displaced t p
N=326 N=196
M S.D M S.D

PTSD 46.78 6.86 35.32 8.53 16.83 .000

df=520

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Table 8 reflects the numbers of displaced and non-displaced students are 326 and 196

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respectively. The mean and standard deviation of displaced students on the measure of PTSD
scale are 46.78 and 6.86. The mean and standard deviation of non-displaced students on the

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measure of PTSD scale are 35.32 and 8.53 respectively. The t and p vale of both groups are
16.83 and .000. er
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This indicates that the difference between the means of the two groups is significant at
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.01 levels. Inspection of means suggests that displaced students developed more PTSD as
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compared to non-displaced students.
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DISCUSSION
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The present study was designed to determine the prevalence of Post traumatic stress disorder
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(PTSD) among flood affected school children in Pakistan. The main findings of the study were;
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secondary school students were highly affected by Post traumatic stress disorder (PTSD); Female
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secondary school students were highly affected by Post traumatic stress disorder (PTSD;
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Displaced secondary school students were highly affected by Post traumatic stress disorder
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(PTSD); Female students developed more PTSD as compared to male students; and displaced
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students developed more PTSD as compared to non-displaced students.
The main findings of the study that secondary school students were highly affected by
Post traumatic stress disorder (PTSD) was supported by Piyasil et-al (2007) study on Post
traumatic stress disorder (PTSD) in children after Tsunami disaster in Thailand: 2 years follow-
up. They found that 57.3% students were suffered from Post traumatic stress disorder (PTSD)
among affected children.
The finding of the study that female secondary school students were highly affected by
Post traumatic stress disorder (PTSD) was supported by Stallard et-al (1998). They observed that
there is 19% risk of Post traumatic stress disorder (PTSD) in boys and 55% in girls in children
involved in road traffic accidents. This finding was also supported by Breslau (1997) on his
study on Sex Differences in Posttraumatic Stress Disorder observed that Post traumatic stress
disorder (PTSD is more likely to develop in female than in male after exposure to traumatic
events.



References
Breslau, Naomi. Glenn C., Davis., Patricia Andreski., Edward L. Peterson.., Lonni R.& Schultz.
(1997). Sex Differences in Posttraumatic Stress Disorder. Arch Gen
Psychiatry 54(11):1044-1048.Retrieved from http://archpsyc.ama-
assn.org/cgi/content/abstract/54/11/1044
Clark, Carolyn Chambers. (1997). Posttraumatic Stress Disorder: How to Support Healing. The
American journal of Nursing 97 (18) : 26-33 Retrieved from
http://www.jstor.org/stable/3465317
Green B L.,indy J D.,race M C., & Leonard A C. (1992)
Chronic posttraumatic stress disorder and diagnostic comorbidity in a disaster sample.
The Journal of nervous and mental disease 180(12):760-766.
Peng Huang., Hongzhuan Tan., Aizhong Liu.,Shuidong Feng., & Mengshi Chen.(2010).
Prediction of posttraumatic stress disorder among adults in flood district. . Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868002/

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Horowitz, M. Wilner, N. & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective

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stress. Psychosomatic Medicine, 41, 209-218.

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Piyasil, Vinadda.,Panom Ketuman ., Ratnotai Plubrukarn., Vajiraporn Jotipanut ., Somsong

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Tanprasert., Sumitra Aowjinda ., & Somchit Thaeeromanophap .(2007). Post Traumatic
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Stress Disorder in Children after Tsunami Disaster in Thailand: 2 Years Follow-up. J
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Med Assoc Thai 2007; 90 (11): 2370-6. Retrieved from
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http://www.medassocthai.org/journal
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Smith, H. (2003). Despair, resilience, and the meaning of family: Group therapy with French-
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speaking survivors of torture from Africa. In R. Carter & B. Wallace (Eds.),
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Understanding and dealing with violence. Multicultural Perspectives
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Thousand Oaks, CA. pp. 291–319.
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Stallard, Paul., Richard Velleman., & Sarah Baldwin .(1998). Prospective Study of Posttraumatic
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Stress Disorder in children Invovled on road Traffic Accidents. British Medical Journal
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317 (1173), 1619-1623 Retrieved from http://www.jstor.org/stable/25181287
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Walsh. Neol. (1994). A psychodynamic Model of Posttraumatic Stress Disorder. An Irish
Quarterly Rewiew 83 (331) : 322-330 Retrieved from
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http://www.jstor.org/stable/30091089
Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J.P. Wilson & T.M.
Keane (Eds.), Assessing Psychological Trauma and PTSD (pp.399-411). New York.
Guilford.
Ziaaddini, Hassan., Nouzar Nakhaee., & Kolsoom Behzadi. (2009). Prevalence and Correlates of
PTSD among High School Students After the Earthquake Disaster in the City of Bam,
Iran. American Journal of Applied Sciences 6 (1): 130-132. Retrieved from
http://www.scipub.org/fulltext/ajas/ajas61130-132.pdf



Survey Social Capital situation in Iranian Hospital
Freyedon Ahmadi
Public management Department, Payame Noor university, 19395-4697 Tehran, I.R. of IRAN
Seyyed Ali Akbar Ahmadi
Arghavan Zandieh

Abstract
Much of the literature on business development has focused on the role of community resources,
especially financial and human capital, in organizational success and survival. Several studies

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also have examined the contributions of small and large businesses to the social and economic

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well-being of communities. There has been much less research on the relationships between

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social resources in communities and business development. This paper examines the importance
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of social capital in Iranian hospital. For this aims were selected 90 people from three hospitals.
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The results of this research indicated the level of structural and relational social capital is high,
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but the level of cognitive social capital is below of average.
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Key words:
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Social capital, relational capital, cognitive capital, structural capital
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Introduction
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Scholars such as Coleman (1990) and Putnam (1995) in an attempt to explain non-economic
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factors in explaining success of certain economic processes drew on the concept of social capital.
That is why at present, besides human, financial, and economical capitals, a new reality as social
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capital is being extensively utilized in the literature of social and organization realms. Fukuyama
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(1999) believes that a number of definitions had been given with respect to social capital but they
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refer to its manifestation rather than to social capital itself. He says “social capital is an
instantiated informal norm that promotes co-operation between two or more individuals”
(Fukuyama, 1999). Putnam (1995) also defines social capital as “The characteristics of the social
organization such as networks, norms and social trust that facilitate coordination and cooperation
for mutual benefit”. Social capital as a theory view has been considered by behavioral science,
economy, management and social science experts in recent two decades. Social capital is
sometimes viewed as the peoples' property, so it is related to widespread social networks and
accessible resources. Therefore social capital is considered as the group property. Social capital
has been the subject of many surveys in recent years and its relation to political and economical
development and personal effectiveness has been considered. Studies show that without social
capital, it is hard to reach economical development by the means of other resources like
financial, physical and natural resources.


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