International Journal of Mental Health & PsychiatryISSN: 2471-4372

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Research Article, Int J Ment Health Psychiatry Vol: 2 Issue: 2

Comparative Study between Family Income and Hopelessness

Ujala Zubair1*, Ahmad Faraz2, Zarafshan Zubair3
1Sindh Medical College, Karachi, Pakistan
2Karachi Medical and Dental College, Karachi, Pakistan
3Dow Medical College, Karachi, Pakistan
Corresponding author : Dr. Ujala Zubair
Sindh Medical College, Karachi, Pakistan
E-mail: [email protected]
Received: December 18, 2015 Accepted: April 04, 2016 Published: April 08, 2016
Citation: Zubair U, Faraz A, Zubair Z (2016) Comparative Study between Family Income and Hopelessness. Int J Ment Health Psychiatry 2:2. doi:10.4172/2471-4372.1000119

Abstract

Introduction: Hopelessness can be defined as a condition in which a person experiences negative expectations about future associated with symptoms such as motivational deficit, sadness and lack of concentration ultimately resulting in depression and suicide.

There have been associations of hopelessness with various factors such as depression, suicide etc. Low socio-economic status also imparts a negative impact on an individual’s psychology. Therefore, we came forward with the idea to figure out the association of hopelessness with family income in our society. It has been observed that there are direct as well as indirect effects of socio-economic conditions on mental health, setting up vicious cycle between poverty and mental disorders. This study demonstrates the vandalization of low socioeconomic status on the mental wellbeing of the individuals of underdeveloped countries.

Objective: To assess hopelessness among population of Karachi from different socio-economic status using Beck’s hopelessness scale.

Method: This is a cross-sectional study done in Karachi. We used SPSS-20 to analyze our research proposal. Data was collected from individuals aged 20-50. They were asked to fill Beck’s Hopelessness Scale.

Results: Of 295 individuals there were 44% males of which 55.3% were married and 44.6% were unmarried. Of 56% females 48%.1% females were married and 52.9% females were unmarried. 0-3 was scored by 67.2% individuals, 4-8 by 28.4% individuals, 9-14 by 4% individuals. One way ANOVA was applied to family income and BHS score, then p-value was found to be <0.05. Of those who scored between 0-3, 47% belonged to low socio-economic status, 48.8% to middle socio-economic status, 4% to high socio-economic status. Of people who scored between 4-8, 41.6 % belonged to low socio-economic status, 48.6% to middle socio-economic status, 9.7% to high socio-economic status. Of those who scored between 9 to 14, 25% belonged to low socio-economic status, 66% to middle socio-economic status, 8.3% to high socio-economic status.

Conclusion: This study provides the impact that there is positive association between low socio-economic status and hopelessness. Thus it shows that societies where there are economic crises are liable to more mental disorders, therefore this study highlights the need of proper initiatives towards the quality of life especially in the under developed parts of the world ,to avert the casual of psychiatric illness due to low social economic status & encourage further research in this discipline.

Keywords: Family income; Mental health; Hopelessness; Beck’s hopelessness scale; Socio-economic status

Keywords

Family income; Mental health; Hopelessness; Beck’s hopelessness scale; Socio-economic status

Introduction

Family income has a deep impact on one’s physical, mental and social well-being, although it plays a pivotal role in the grooming of the mind state of the individual. Family income affects the assets one can have. It affects food, housing, life style, quality of education and health care facilities, article review shows that low family income is found to be associated with food insufficiency, insecurity, lack of social support, lack of education which then further limits job opportunities [1]. Majority of individuals with low family income experience stressful life events either in childhood, adolescence or adulthood which have a great negative impact on them which then leads to development of psychiatric disorders [2]. Hopelessness, depression and suicidality are more common in people with low socio-economic status [3,4], when it comes to low social status , individuals specially of under developed countries lack access to basic health care facilities [5].
Studies have shown that illiteracy is a major risk factor for common mental disorders [6]. Iliteracy is a result of poor socio-economic status. Higher education is found to have positive influence on brain development which protects it from pathologic processes that lead to cognitive impairment [7]. Low family income relates with depression in parents which eventually has an immense affect on parenting. It has been found to be linked with lack of communication between parents and children which causes impairment of mental health of children.
Psychological impact of living in poverty is mediated by shame, stigma and humiliation [8]. One core outcome of belonging to low socio-economic status is hopelessness. This cannot be said that it only affects people with low socio-economic status but people with low socio-economic status are said to be at higher risk. Hopelessness can be defined as a condition in which a person experiences negative expectations about future and considers himself unable to help those negative events which are thought to happen in future. Some signs and symptoms of hopelessness include motivational deficit, sadness, and concentration difficulties. Increased hopelessness can lead to depression and suicidality [9]. Suicidality includes three types of behaviors: suicidal ideations, self-reported attempted suicide and completed suicide. Hopelessness is predictive of all of them [10].
Hopelessness makes a person limited, rigid and controlled. It can be present alone or in combination with depression. However, hopelessness is considered a more important risk factor than depression for evaluating suicidal risk [11].
In clinical practice, suicide prevention is a complex task and requires multiple techniques and interactions with the survivor. Late predicition of suicidality is difficult to treat and prevent. Clinicians should be provided with a tool to assess suicidality from its initial stage to its severe stage, as it makes vast difference in the management plan.
Also the tool has to be user friendly to make screening and diagnosis easier and better [12].
In developing countries, socio-economic factor related hopelessness is more in females as they are the one who bear more of the load related to poverty. Additional factors which support this hypothesis are less access to school, fewer job opportunities and limitation to participate in outdoor activities. These factors close the doors for females to solve their socio-economic problems by themselves which further exacerbates hopelessness and depression.

Objective

The objective of this study is to assess the relationship between hopelessness &family income in a destitute society where dwellers are unprivileged with the basic health care facilities eventually mortality rate increases every now & then.

Methods

This is a cross-sectional study done in Karachi. Data was collected from 295 individuals aged 11 to 40 doing convenient sampling from attendants of patients admitted in JPMC during the period of November 2014 to January 2015 A well-built questionnaire was dictated to them and they were asked to choose the most fitting option to them. They were also asked about their family members and their family income which includes the sum of income of all those living in the same house and earning and contributing to the family.
Among many scales designed by Dr. Aaron T. Beck, one is Beck’s hopelessness scale (BHS) Beck scales are used for assessment of depressive severity, hopelessness and suicidality. Many prior studies were held to assess for reliability and validity of Beck’s hopelessness scale. These studies show high internal consistency and good validity of this scale [13]. This scale also provides clinically meaningful information regarding patient’s mental health.
Beck described hopelessness with three dimensions: Cognitive dimension includes negative thoughts about future like dark or uncertain future. Affective dimension includes negative feelings about future including lack of hope, enthusiasm or faith. Motivational dimension includes negative thoughts and feelings about one’s ability to change or improve the future [13,14] BHS is the most widely used hopelessness tool in psychology. It is highly sensitive to suicide risk. It measures general pessimism about the future. It can also be used to measurement of hopelessness over the course of treatment [15].

Results

Of 295 individuals 44% were males and 56% were females. 44.6% males were unmarried while 55.3% males were married. 41.8% females were unmarried while 58.1% were married. Individuals aged between 11-20 were 51 (17.3%), 21-40 were 196 (66.4%), and 41-60 were 44 (15%) (Figure 1).
Figure 1: Ages of individuals.
106 individuals had family members between 1 to 5, 136 had between 6 to 10 and 53 had family members above 11 (Figure 2).
Figure 2: Family members of individuals compared with their family income (p<0.005).
The alpha co-efficient of this version of BHS was found to be 0.80 amongst our population.
When T-test was applied between gender and BHS scores, p-value was found to be <0.05 (0.028). Of individuals whose BHS score was calculated to be between 0 to 3 (70% percent were males, 67.5% were females), score 4 to 8 (27.6% males, 29.1% females), score 9 to 14 (5.3% males, 3% females) (Figure 3).
Figure 3: Socio-economic status compared with BHS scores.
One way ANOVA was applied to family income and BHS score, then p-value was found to be <0.05 (0.002). Of those who scored between 0-3 47% individuals (n =81) belonged to low socio-economic status, 48.8% individuals (n=84) belonged to middle socio-economic status, 4% individuals (n=7) belonged to high socio-economic status. Of people who scored between 4-8, 41.6 % individuals (n=30) belonged to low socio-economic status, 48.6% individuals (n=35) to middle socio-economic status, 9.7% individuals (n=7) to high socioeconomic status. Of those who scored between 9 to 14, 25% individuals (n=3) belonged to low socio-economic status, 66% individuals (n=8) to middle socio-economic status, 8.3% individuals (n=1) belonged to high socio-economic status (Figure 3) (Table 1 and 2).
Table 1: Descriptive Statistics of BHS.
Table 2: Correlations of BHS score with other variables.

Discussion

So far, effects of low family income on one’s mental health couldn’t be neglected. It has been found that individuals with low income and poor socio-economic status are excessively prone to clinical depression which roads to suicidal ideations ruining one’s life [16]. Wouldn’t this be better to prevent ruining of mental health by low socio-economic status at much earlier stage and maintain sound mental health. For this reason government should pay little attention towards this situation. Countries with greater income inequalilty have shown less progress in economy therefore this issue should be paid great attention [17]. According to one study held in 1996 in United States , income equality was associated with greater death rates (p<0.005), greater rate of crimes (p<0.005) and also greater number of low birth weight infants (p<0.005) [18]. No difference was found among these associations of income inequality with mortality in whites versus Africans (p<0.005) [18].
Improving economical status, providing more job opportunities and improving educational status can have a very positive influence on mental health.

Conclusion

Income inequality has so vast an effect on mental health that it could not be neglected. Our study proves this fact. Hopelessness is a better indicator of suicidality than depression. However hopelessness itself can lead to depression and then suicidality. If we pay attention towards this aspect, we can bring many positive changes for mental health of our people. Increasing rates of mental disorders in our society needs immediate attention to be paid.

Limitations of Study

For this study data was collected from attendants of patients in Jinnah Postgraduate Medical Center, which is a government tertiary care hospital providing free health care facilities to individuals. This attracts more of the population from low socio-economic status and this could add biasness to the study.

Keypoints

• Differences in socio-economic status have very deep impact on our mental health. Such vast impact that it cannot be ignored at any risk or else it may lead to an era with high rate of mental disorders.
• Government should work on making job opportunities better for people so that these disorders could be prevented.
• Females should be offered equality regarding job and education as they are very much vulnerable to psychiatric disorders.

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