STUDY OF DIFFERENCE BETWEEN MEN AND WOMEN IN THE PREVALENCE OF PSYCHOLOGICAL MORBIDITY USING GHQ.

Submitted by KOYELI SAHA [Reg. no: 07PUA21007] 2007-2010.

UNDER THE GUIDANCE OF

Mr. HAYASH TEENOTH Lecturer, Department of Psychology Acharya Institute of Graduate Studies Bangalore.

Submitted in partial fulfillment for the award of bachelors degree in arts 2010

Certificate
This is to certify that this project work entitled Study of difference between men and women in the prevalence of psychological morbidity is carried out by Ms. KOYELI SAHA, pursuing VI semester BA at Acharya Institute of graduate studies, Bangalore, in partial fulfillment of Bachelors degree in Arts.

DATE: PLACE:

Mr. George Varied Thekkan Head of the department Dept. of Psychology AIGS Bangalore.

Batch in charge Hayash Teenoth Lecturer, Dept. of Psychology AIGS Bangalore.

Name: KOYELI SAHA Register number: 07PUA21007

Contents
1. Introduction 2. Review of Literature 3. Research Methodology
4.

39 10 - 15 16 17

Discussion and Analysis:

Individual discussions for women Individual discussions for men Group discussion for women Group discussion for men Comparison between data of the two groups

19 - 24 25 - 29 30 - 31 32 33 34 35 35 36 37

5. Conclusion 6. Bibliography 7. Appendix

Introduction

General Health Questionnaire

Developed in the 1970s, by David Goldberg, the General Health Questionnaire is a method to quantify the risk of developing psychiatric disorders. This instrument targets two areas the inability to carry out normal functions and the appearance of distress to assess well-being in a person. The GHQ is used to detect psychiatric disorder in the general population and within community or non-psychiatric clinical settings such as primary care or general medical outpatients. It assesses the respondents current state and asks if that differs from his or her usual state. It is therefore sensitive to short-term psychiatric disorders but not to longstanding attributes of the respondent. The format of the full GHQ is a 60-item test with a four-point scale for each response. The test exits in several forms: GHQ-30 (30 items), GHQ-28 (28-items), GHQ-12 (12 items). The GHQ is simple to administer, easy to complete and score and widely used in many studies of (occupational) well-being. The GHQ can be scored in a variety of ways which is useful in providing multiple outcome measures. A further advantage of the GHQ is that it is widely used in occupational research, which allows simple comparisons with results obtained in other studies. In using this tool with postgraduate students conducting research in many areas of occupational health, the GHQ rarely fails to provide reliable and effective measures of well-being that usually correlate very highly with other measures of working environments or organizations.

Validity and Reliability

The reported Cronbach alpha coefficient for the GHQ is a range of 0.82 to 0.86. The instrument is considered as reliable and has been translated into 38 different languages. When correlated with the global quality of life scale, the GHQ showed negative correlation. This demonstrates the inverse relationship with an increase in distress leading to a decrease in quality of life.

Unique technical features of the GHQ-28:It is often of more interest to be able to examine a profile of scores rather than a single score, making this version of the GHQ particularly useful. It contains 28 items that, through factor analysis, have been divided into four sub-scales. The GHQ-28 is the most wellknown and popular version of the GHQ. This scaled version of the GHQ has been developed on the basis of the results of principal components analysis. The four sub-scales, each containing seven items, are as follows:

A somatic symptoms (items 1-7) B anxiety/insomnia (items 8-14) C social dysfunction (items 15-21) D severe depression (items 22-28)

There are no thresholds for individual sub-scales. Individual sub-scales are used for providing individual diagnostic or profile information. For identifying case-ness with GHQ-28, the total of the sub-scales is used.

Scoring of GHQ:All items have a 4 point scoring system that ranges from a 'better/healthier than normal' option, through a 'same as usual' and a 'worse/more than usual' to a 'much worse/more than usual' option. The exact wording will depend upon the particular nature of the item. There are four possible methods of scoring the questionnaire:

GHQ scoring (0-0-1-1). This method is advocated by the test author. Likert scoring (0-1-2-3) Modified Likert scoring (0-0-1-2) C-GHQ scoring (0-0-1-1) for positive items, where agreement indicates health, and 0-1-1-1 for negative items, where agreement indicates illness).

For both GHQ and Likert scoring, the wording of the items mean that they can all be scored in the same direction (no need to reverse score), so the higher the score, the more severe the condition. The Likert scoring method will produce a wider and smoother score distribution if a researcher wishes to assess severity and the C-GHQ method is more normally distributed than the GHQ scoring method. Modified Likert is inferior to simple Likert and may therefore be discarded. C-GHQ scoring is a relatively specialized method and is useful only when it is important not to miss cases with long-standing disorders. The GHQ-28 is a scaled version, yielding four sub-scores, each based on seven items and a total score.

Thresholds for GHQ:Thresholds are only relevant for screening use of the GHQ, i.e. for identifying case-ness. In general, it is best if the user specifies their required threshold value, based on past clinical use or research evidence relevant to their assessment circumstances. The following gives some threshold values that can be entered as default options. N.B. For people who are physically ill, a higher threshold than the default one will probably be needed for optimal discrimination between cases and non-cases. Suggested Default Thresholds Suggested default threshold using: GHQ GHQ Scoring Likert GHQ12 1/2 (max score 12) 11/12 (max score 36) GHQ28 4/5* (max score 28) 23/24 (max score 84) GHQ30 4/5 (max score 30) --- (max score 90) GHQ60 11/12 (max score 60) --- (max score 180) * advocated in 1978 GHQ Manual; 1997 WHO study (see reference above) had an average threshold, across all centres and languages, of 5/6 and reports a threshold of 6/7 for a Manchester, UK sample. Turner & Lee advocate a cut-off of 12/13 as almost always indicating a positive psychiatric condition in the PTSD context (see Easton, J.A. and Turner, S.W. (1991) Detention of British citizens as hostages in the Gulf health, psychological, and family consequences. British Medical Journal, 303, 1231-1234). The standard procedure for scoring missing data in GHQ is to count omitted items as low scores. This applies to all four versions of the GHQ.

Sub-tests of GHQ:The GHQ contains 4 sub-tests: 1. Somatic symptoms Headaches. These are fairly common in people with depression. If he/she already had migraine headaches, they may seem worse. Back pain. If you already suffer with back pain, it may be worse if you become depressed. Muscle aches and joint pain. Chest pain: it's very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But depression can contribute to the discomfort associated with chest pain. Digestive problems: feeling queasy or nauseous; diarrhea or chronic constipation.

Exhaustion and fatigue: feeling tired or worn out no matter how much you sleep. Getting out of the bed in the morning may seem very hard, even impossible. Sleeping problems: can't sleep well anymore; waking up too early or not able to fall asleep after going to bed. Others might sleep much more than normal. Change in appetite or weight: loss of appetite and loss weight; craving certain foods -- like carbohydrates. Dizziness or lightheadedness.

2. Anxiety and InsomniaAnxiety: everyone experiences anxiety to some degree as a normal part of their lives. It is actually a good thing in some situations as it prepares us to face danger by giving us more energy and making us more alert. Anxiety becomes an illness when the feeling is constant or is regularly triggered by events that wouldn't normal induce a feeling of anxiety. There are in fact 5 recognized anxiety disorders, these are:

Panic Disorder Obsessive-Compulsive Disorder Post-Traumatic Stress Disorder Generalized Anxiety Disorder Phobias (including Social Phobia, also called Social Anxiety Disorder).

One of the most common psychological disorders resulting from constant anxiety is GAD. The essential characteristic of Generalized Anxiety Disorder (GAD) is excessive uncontrollable worry about everyday things. This constant worry affects daily functioning and can cause physical symptoms. Sufferers may worry excessively about issues like deadlines or appointments but they can also worry about everyday things that shouldn't cause such strong feelings. Essentially, the feelings are out of proportion with the triggering event. The focus of worry can also shift rapidly from one thing to another. The feeling of anxiety can be constant so that whatever the sufferer thinks about, they associate with the feelings and assume that to be the cause, however mundane the actual thing may be. The major symptoms of Generalized Anxiety Disorder are:

Excessive worrying Excessive fear Inability to cope Muscle tension Sweating Nausea Gastrointestinal discomfort or diarrhea Cold clammy hands Difficulty swallowing; Jumpiness

Insomnia: Insomnia is a condition that is characterized by the sufferers inability to get adequate restorative sleep. This can be due to any number of the following:

Difficulty falling asleep Waking up frequently during the night with difficulty returning to sleep Waking up too early in the morning Unrefreshing sleep

A lack of sleep can lead to a number of symptoms during the day. These can include:

Fatigue Lack of energy Difficulty concentrating Irritability Poor coordination

Insomnia is commonly caused by both depression and anxiety (or may be present alone) and can exacerbate the symptoms of those disorders, creating a vicious circle. Many other factors can also cause insomnia; these include things like environmental factors (noise, temperature etc), change of sleeping environment, stress and physical illnesses/pain (such as the aches and pains experienced with Environmental Illnesses). 3. Social dysfunctionSocial dysfunction is an umbrella term used to describe a variety of emotional problems largely experienced in social situations. It is also one of the diagnostic criteria of psychological disorders like schizophrenia, autism, and some forms of anxiety disorders and personality disorders. Social dysfunction includes problems such as: Behavior inappropriate to circumstances Lack of affective contact Detachment from social life Problems in making and keeping friends Problems in getting along with others in social settings Trouble in concentrating Serious difficulty in coping with day-to-day stress Shyness, unreasonably strong fears, and excessive sweating in social settings. Deviance from the rules and expectations of ones own social context. Inability to satisfy social demands and to perform social roles appropriately.

4. Severe depressionDepression: Everyone feels depressed at some time in their life for any number of reasons. An event like the end of a relationship gives everyone feelings of sadness and loss, but these feelings subside over time and you feel normal again. In the case of clinical depression, the feelings are generally more intense or of much longer duration, or both. Along with feelings of sadness that someone with depression experiences, it also causes a number of physical symptoms, the most obvious being fatigue. As fatigue is probably the most prominent symptom of Environmental Illnesses as well, if you have both then the problem is magnified. The major symptoms of Major Depression are:

Loss of energy and interest Diminished ability to enjoy oneself Decreased -- or increased -- sleeping or appetite Difficulty in concentrating; indecisiveness; slowed or fuzzy thinking Exaggerated feelings of sadness, hopelessness, or anxiety Feelings of worthlessness Recurring thoughts about death and suicide.

If a person has been experiencing most of these symptoms for a period lasting longer than a few weeks, especially if there is no reason to feel down, he/she is probably suffering from depression. Another form of depression, that commonly affects environmental illness sufferers, is known as Seasonal Affective Disorder (SAD). This disorder can take the form of either major depression or bipolar depression, but only occurs during certain times of the year, usually through the winter months (winter depression). This is thought to be due to lack of sunlight exposure during the winter and tends to be more common the further north you live.

10

Review Of Literature

11

REVIEW: 1 GHQ-28 as an aid to detect mental disorders in neurological inpatients

Abstract
Lykouras L, Adrachta D, Kalfakis N, Oulis P, Voulgari A, Christodoulou GN, Papageorgiou C, Stefanis C. GHQ-28 as an aid to detect mental disorders in neurological inpatients. The prevalence of mental disorders (DSM-IIIR criteria) among 107 neurological inpatients was estimated, as well as the extent to which disorders were detected by neurologists. The validity of the scaled version of the General Health Questionnaire (GHQ-28) was evaluated using Receiver Operating Characteristic (ROC) analysis and DSM-IIIR as external criteria. Of the 107 patients who submitted to a structured psychiatric interview (SCID-R), 56 (52.3%) showed evidence of a mental disorder. Major depressive episode (n= 16), generalized anxiety disorders (n = 13) and dysthymia (n = 12) were the most frequent diagnoses. The neurologists recognized only 13/107 cases (12.1%). Significantly more women than men exhibited some form of mental disorder. The validation of GHQ-28 in the series of 107 neurological inpatients indicated that the best trade-off between sensitivity and specificity was the cut-off score of 5/6. The high occurrence of mental disorder, in association with the low rate of detection by the neurologists, points to the need for special attention to be paid to this problem by staff and experts.

REVIEW: 2
12

Job Insecurity and Psychological Well-being: Review of the Literature and Exploration of Some Unresolved Issues
Author: Hans De Witte
Abstract
Research on the psychological consequences of job insecurity is reviewed, showing that job insecurity reduces psychological well-being and job satisfaction, and increases psychosomatic complaints and physical strains. Next, three additional research questions are addressed, since these questions did not receive much attention in previous research. First, does the impact of job insecurity on workers differ according to their professional position, gender, and age? Second, how important is job insecurity compared to other stressors on the work floor? Third, how important is job insecurity compared to the impact of unemployment? To analyze these issues, data were used from a Belgian plant, part of a European multinational company in the metalworking industry (N = 336). The results of this exploratory study showed that job insecurity was associated with lower well-being (score on the GHQ-12), after controlling for background variables, such as gender and age. A significant interaction with gender occurred, indicating that gender moderated the association between job insecurity and well-being. Job insecurity was not related to psychological well-being among women. Among men, a significant increase in distress was noted among those who felt insecure, but not among the secure. Interaction terms for occupational position and age were not statistically significant. Job insecurity turned out to be one of the most distressful aspects of the work situation. The GHQ-scores of the insecure respondents were not different from those of a representative sample of short-term unemployed, suggesting both experiences to be equally harmful. The consequences of these findings for future research are discussed.

REVIEW: 3

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Risk Factors Associated With the Transition from Acute to Chronic Occupational Back Pain
Fransen, Marlene PhD; Woodward, Mark PhD; Norton, Robyn PhD; Coggan, Carolyn PhD; Dawe, Martin BA; Sheridan, Nicolette MPH

Abstract
Study Design. A prospective cohort study was conducted on workers claiming earningsrelated compensation for low back pain. Information obtained at the time of the initial claim was linked to compensation status (still claiming or not claiming) 3 months later. Objective: To identify individual, psychosocial, and workplace risk factors associated with the transition from acute to chronic occupational back pain. Summary of Background Data: Despite the magnitude of the economic and social costs associated with chronic occupational back pain, few prospective studies have investigated risk factors identifiable in the acute stage. Methods: At the time of the initial compensation claim, a self-administered questionnaire was used to gather information on a wide range of risk factors. Then 3 months later, chronicity was determined from claimants' computerized records. Results: The findings showed that 3 months after the initial assessment, 204 of the recruited 854 claimants (23.9%) still were receiving compensation payments. A combined multiple regression model of individual, psychosocial, and workplace risk factors demonstrated that severe leg pain (odds ratio [OR], 1.9), obesity (OR, 1.7), all three Oswestry Disability Index categories above minimal disability (OR, 3.1-4), a General Health Questionnaire score of at least 6 (OR, 1.9), unavailability of light duties on return to work (OR, 1.7), and a job requirement of lifting for three fourths of the day or more all were significant, independent determinants of chronicity (P < 0.05). Conclusions: Simple self-report measures of individual, psychosocial, and workplace factors administered when earnings-related compensation for back pain is claimed initially can identify individuals with increased odds for development of chronic occupational disability.

REVIEW: 4
14

Unemployment and suicidal behavior: A review of the literature

Stephen Platt MRC Unit for Epidemiological Studies in Psychiatry, University Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, Scotland

Abstract
In order to provide a framework for reviewing the voluminous literature on unemployment and suicidal behavior, the author distinguishes between two categories of deliberately selfharmful act: those with fatal outcome (suicide) and those with non-fatal outcome (Parasuicide); and differentiates four major types of quantitative research report: individual cross-sectional; aggregatecross-sectional; individual-longitudinal; and aggregatelongitudinal. Methodological issues and empirical research findings are discussed separately for each type of study and each category of deliberate self-harm. Cross-sectional individual studies reveal that significantly more parasuicides and suicides are unemployed than would be expected among general population samples. Likewise, parasuicide and suicide rates among the unemployed are always considerably higher than among the employed. Aggregatecross-sectional studies provide no evidence of a consistent relationship between unemployment and completed suicide, but a significant geographical association between unemployment and parasuicide was found. Results from all but one of the individual longitudinal studies point to significantly more unemployment, job instability and occupational problems among suicides compared to non-suicides. The aggregate longitudinal analyses reveal a significant positive association between unemployment and suicide in the United States of America and some European countries. The negative relationship in Great Britain during the 1960s and early 1970s has been shown to result from a unique decline in suicide rates due to the unavailability of the most common method of suicide. However, despite the firm evidence of an association between unemployment and suicidal behavior, the nature of this association remains highly problematic. On the basis of the available data, the author suggests that macro-economic conditions, although not directly influencing the suicide rate, may nevertheless constitute an important antecedent variable in the causal chain leading to self-harmful behavior. Further empirical research based on a longitudinal design is recommended as a matter of urgency so that a more definitive assessment of the etiological significance of unemployment in parasuicide may be made.

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REVIEW: 5 The Effect of Mild to Moderate Dementia on the Geriatric Depression Scale and on the General Health Questionnaire
T. G. O'RIORDAN, J. P. HAYES, D. O'NEILL, R. SHELLEY, J. B. WALSH and D. COAKLEY The Geriatric Depression Scale (GDS) and two versions of the General Health Questionnaire (GHQ 28 and corrected GHQ 28) were administered to 111 patients admitted to an acute geriatric medical unit. Depression and dementia were diagnosed by semistructured interview using DSM III criteria. There was no statistically significant difference in the three scales between cognitively normal depressed patients and demented depressed patients. The three scales were sensitive indicators of depressive illness (> 90o), but the GHQ28 and CGHQ28 needed adjustment of their community-based threshold values.

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Research Methodology

Problem: To assess presence of psychological morbidity in men and women.

17

Hypothesis: There will be no difference between men and women in the prevalence of
psychological morbidity.

Plan: Administer the GHQ and find out the total score of the subjects and interpret with
reference to the norms. Then compare the results of the two groups.

Research design: Single subject design Sample: Ten men and ten women between 25 - 30 age groups. Materials:
1. General Health Questionnaire (GHQ) 2. Manual and scoring key 3. Writing materials

Instructions:
I would like to know if you had any medical complaint and how your health has been in general over the past few weeks. Reply to the questions simply by putting a tick mark before the answers which you think most applies to you. Remember that I want to know about present and recent complaints, and not those that you had in the past. It is important that you try to answer all the questions.

Analysis of data:
1. A score of zero is given to the first two answers and a score of one is given to the remaining two answers. 2. The number of items identified by the subject is found out. Add the raw scores in all the four dimensions. 3. Individuals with a total score of 5 and above are considered to be possible cases of psychological morbidity.

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Discussion AND ANALYSIS

Individual discussion for women:19

1. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score G.K 0 0 0 0 0

The experiment was conducted on G.K, 25 yrs. Female, postgraduate student. The table shows that the subject has scored 0 in each of the sub-scales of GHQ. Therefore the subjects total score is also 0. Since this score is below 5, it indicates that the subject cannot be considered a possible case of psychological morbidity. She is not suffering from any kind of psychological distress. Conclusion: The subject is not psychologically morbid. 2. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score S.N 1 1 1 0 3

The experiment was conducted on SN, 25 yrs. Female, postgraduate student. The subject has scored 1 in somatic symptoms, 1 in anxiety insomnia, 1 in social dysfunction, and 0 in severe depression. The subjects total score is 3. Since this score is below 5, it indicates that the subject cannot be considered as a possible case of psychological morbidity. The subject has shown some problems though, like not feeling perfectly well and in good health, feeling of everything getting on top of her, and not managing to keep herself busy and occupied (much less than usual). Conclusion: The subject is not psychologically morbid. 3. Table showing the number of problems identified by the subject in the four subscales.

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Name S.R

Somatic symptoms 4

Anxiety insomnia 7

Social dysfunction 6

Severe depression 0

Total score 17

The experiment was conducted on S.R, 26 yrs, working woman. The subject has scored 4 in somatic symptoms, 7 in anxiety insomnia, 6 in social dysfunction, and 0 in severe depression. The subjects total score is 17. Since this score is much above 5, it indicates that the subject can be considered a possible case of psychological morbidity. In the area of somatic symptoms the subject has indicated problems like not feeling perfectly well and in good health, feeling of pain and tightness/pressure in the head, and having frequent hot/cold spells. In the area of anxiety insomnia the subject has indicated problems like losing much sleep over worry, having difficulty in staying asleep, feeling constantly under strain, and getting edgy and bad tempered, feeling scared and panicky for no good reason, and feeling nervous and strung up all the time. In the area of social dysfunction the subject has indicated problems like taking longer time over doing things, not feeling satisfied with the way she has carried out the task, feeling less useful in playing a part in things, felt less capable of making decisions, and not being able to enjoy normal day-to-day activities. In the area of severe depression the subject has not indicated any problems. Conclusion: The subject might be psychologically morbid.

21

4. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score C.R 0 0 1 0 1

The experiment was conducted on C.R, 25 yrs, female, undergraduate student. The subject has scored 0 in each of the sub-scales somatic symptoms, anxiety insomnia, and severe depression. The subject has scored 1 in the area of social dysfunction. She has indicated the problem of feeling less satisfied than usual with the way she carried out her tasks. The subject has a total score of 1, which indicates that the subject cannot be considered as a possible case of psychological morbidity. Conclusion: The subject is not psychologically morbid.

5. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score G.C 0 3 2 0 5

The experiment was conducted on G.C, 26 yrs, working woman. The subject has scored 0 in somatic symptoms, 3 in anxiety insomnia, 2 in social dysfunction, and 0 in severe depression. The subjects total score is 5 which indicates that the subject can be considered as a possible case of psychological morbidity. She has indicated problems like losing much sleep over worry, having difficulty in staying asleep, getting scared and panicky for no good reason, feeling of not doing things well, and feeling much less satisfied with the way she carried out her tasks. Conclusion: The subject can be considered as a possible case of psychological morbidity. 6. Table showing the number of problems identified by the subject in the four subscales. 22

Name S.V

Somatic symptoms 4

Anxiety insomnia 2

Social dysfunction 0

Severe depression 0

Total score 6

The experiment was conducted on S.V, 28 yrs, working woman. The subject has scored 4 in somatic symptoms, 2 in anxiety insomnia, 0 in social dysfunction and severe depression. The subjects total score is 6 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like not feeling perfectly well and in good health, feeling rundown and out of sorts, pain and tightness/pressure in the head, having difficulty in staying asleep, and feeling constantly under strain. Conclusion: The subject can be considered as a possible case of psychological morbidity.

7. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score K.M 3 4 0 0 7

The experiment was conducted on K.M, 26 yrs, female, and exe.postgraduate student. The subject has scored 3 in somatic symptoms, 4 in anxiety insomnia, 0 in social dysfunction and severe depression. The subjects total score is 7 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling pain and tightness/pressure in the head, having frequent hot or cold spells, losing much sleep over worry, having difficulty in staying asleep, feeling constantly under strain, and getting scared and panicky for no good reason. Conclusion: The subject can be considered as a possible case of psychological morbidity.

23

8. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score S.D 0 0 0 0 0

The experiment was conducted on S.D, 26 yrs, working woman. The table shows that the subject has scored 0 in each of the sub-scales of GHQ. Therefore the subjects total score is also 0. Since this score is below 5, it indicates that the subject cannot be considered a possible case of psychological morbidity. She is not suffering from any kind of psychological distress. Conclusion: The subject is not psychologically morbid. 9. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score M.K 4 3 1 0 8

The experiment was conducted on M.K, 26 yrs, female, and exe.postgraduate student. The subject has scored 4 in somatic symptoms, 3 in anxiety insomnia, 1 in social dysfunction, and 0 in severe depression. The subjects total score is 8 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling pain and tightness/pressure in the head, having frequent hot or cold spells, having difficulty in staying asleep, feeling constantly under strain, getting scared and panicky for no good reason, and taking longer time over the things she does. Conclusion: The subject can be considered as a possible case of psychological morbidity.

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10. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score H.M.R 0 3 2 1 6

The experiment was conducted on H.M.R, 25 yrs, female, undergraduate student. The subject has scored 0 in somatic symptoms, 3 in anxiety insomnia, 2 in social dysfunction, and 1 in severe depression. The subjects total score is 6 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like losing much sleep over worry, having difficulty in staying asleep, getting scared and panicky for no good reason, feeling of not doing things well, feeling much less satisfied with the way she carried out her tasks, and giving thought to the possibility of committing suicide. Conclusion: The subject can be considered as a possible case of psychological morbidity.

25

Individual discussion for men:1. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score M.K 2 3 1 0 6

The experiment was conducted on M.K, 25 yrs, working male. The subject has scored 2 in somatic symptoms, 3 in anxiety insomnia, 1 in social dysfunction, and 0 in severe depression. The subjects total score is 6 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling pain and tightness/pressure in the head, losing much sleep over worry, feeling constantly under strain, getting edgy and bad tempered, and feeling less satisfied with the way you have carried out your task. Conclusion: The subject can be considered as a possible case of psychological morbidity. 2. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score B.S 1 3 0 0 4

The experiment was conducted on B.S, 25 yrs, working male. The subject has scored 1 in somatic symptoms, 3 in anxiety insomnia, 0 in social dysfunction and severe depression. The subjects total score is 4 which indicates that the subject cannot be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling pain in the head, feeling constantly under strain, feeling of everything getting on top of him, and feeling nervous and strung up all the time. Conclusion: The subject cannot be considered as a possible case of psychological morbidity.

26

3. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score R.V 4 2 2 1 9

The experiment was conducted on R.V, 25 yrs, male, postgraduate student. The subject has scored 4 in somatic symptoms, 2 in anxiety insomnia, 2 in social dysfunction, and 1 in severe depression. The subjects total score is 9 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling pain and tightness/pressure in the head, losing much sleep over worry, getting edgy and bad tempered, feeling of not doing things well and being less satisfied with the he carried out his tasks, and not being able to do anything due to bad nerves. Conclusion: The subject can be considered as a possible case of psychological morbidity. 4. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score R.K 2 1 1 0 4

The experiment was conducted on R.K, 25 yrs, male, undergraduate student. The subject has scored 2 in somatic symptoms, 1 in anxiety insomnia, 1 in social dysfunction, and 0 in severe depression. The subjects total score is 4 which indicates that the subject cannot be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling in need of a good tonic, having frequent hot or cold spells, been getting edgy and bad tempered, and feeling less satisfied with the way he carried out his tasks. Conclusion: The subject cannot be considered as a possible case of psychological morbidity.

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5. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score V.S 1 0 0 1 2

The experiment was conducted on B.S, 25 yrs, working male. The subject has scored 1 in somatic symptoms, 0 in anxiety insomnia and social dysfunction, and 1 in severe depression. The subjects total score is 2 which indicates that the subject cannot be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling rundown and out of sorts, and giving thought to the possibility of committing suicide. Conclusion: The subject cannot be considered as a possible case of psychological morbidity.

6. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score A.A 0 0 0 1 1

The experiment was conducted on A.A, 25 yrs, working male. The subject has scored 0 in somatic symptoms, anxiety insomnia, and social dysfunction, and 1 in severe depression. The subjects total score is 1 which indicates that the subject cannot be considered as a possible case of psychological morbidity. The subject has indicated that the thought of committing suicide has crossed his mind. Conclusion: The subject cannot be considered as a possible case of psychological morbidity.

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7. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score P.M 2 2 2 1 7

The experiment was conducted on B.S, 25 yrs, male, undergraduate student. The subject has scored 2 in somatic symptoms, 2 in anxiety insomnia, 2 in social dysfunction, and 1 in severe depression. The subjects total score is 7 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like not feeling perfectly well and in good health, having frequent hot or cold spells, losing much sleep over worry feeling constantly under strain, taking longer time over to do things, less able to enjoy his normal day-to-day activities, and wishing himself dead and away from it all. Conclusion: The subject can be considered as a possible case of psychological morbidity. 8. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score A.S 2 3 2 3 10

The experiment was conducted on B.S, 25 yrs, male, graduate. The subject has scored 2 in somatic symptoms, 3 in anxiety insomnia, 2 in social dysfunction, and 3 in severe depression. The subjects total score is 10 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling pain and tightness/pressure in the head, having difficulty in staying asleep, getting scared and panicky for no good reason, feeling nervous and strung up all the time, feeling of not being able to do things well, feeling less capable of making decisions about things, thinking himself as a worthless person, wishing himself dead and away from it all, and thinking about committing suicide. Conclusion: The subject can be considered as a possible case of psychological morbidity. 29

9. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score A.K 2 3 1 0 6

The experiment was conducted on A.K, 25 yrs, male, undergraduate student. The subject has scored 2 in somatic symptoms, 3 in anxiety insomnia, 1 in social dysfunction, and 0 in severe depression. The subjects total score is 6 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like not feeling perfectly well and in good health, feeling constantly under strain, finding everything getting on top of him, and feeling less capable of making decisions about things. Conclusion: The subject can be considered as a possible case of psychological morbidity. 10. Table showing the number of problems identified by the subject in the four subscales. Somatic Anxiety Social Severe Total Name symptoms insomnia dysfunction depression score S.S 1 3 0 1 5

The experiment was conducted on S.S, 25 yrs, working male. The subject has scored 1 in somatic symptoms, 3 in anxiety insomnia, 0 in social dysfunction, and 1 in severe depression. The subjects total score is 5 which indicates that the subject can be considered as a possible case of psychological morbidity. The subject has indicated problems like feeling of tightness/pressure in the head, losing much sleep over worry, having difficulty in staying asleep, feeling constantly under strain, and thought of committing suicide. Conclusion: The subject cannot be considered as a possible case of psychological morbidity.

30

Group discussion for women:Table showing the number of problems identified by the group in the four sub-scales: Sl. Name No. 1. G.K Somatic symptoms 0 Anxiety insomnia 0 Social dysfunction 0 Severe depression 0 Total score

2.

S.N

3.

S.R

17

4.

C.R

5.

G.C

6.

S.V

7.

K.M

8.

S.D

9. 10.

M.K H.R

4 0

3 3

1 2

0 1

8 6

TOTAL

16

23

13

53

MEAN

1.6

2.3

1.3

0.1

5.3

31

Group data for women

6 5 4 3 2 1 0 0.1 mean scores Subtests of GHQ 1.6 2.3 1.3 I II III IV total score 5.3

The above table and graph shows the scores of the group of women in the GHQ. The group has scored a mean of: 1.6 in subtest I: Somatic Symptoms; 2.3 in subtest II: Anxiety Insomnia; 1.3 in subtest III: Social Dysfunction; and 0.1 in subtest IV: Severe Depression.

The group has a mean total score of 5.3. This indicates that the group exhibits a fair amount of psychological distress. The group has shown the most number of problems in the area of anxiety the least in the area of severe depression. Individual differences exist among the members of the group.

32

Group discussion for men:Table showing the number of problems identified by the group in the four sub-scales: Sl. Name No. 1. M.K Somatic symptoms 2 Anxiety insomnia 3 Social dysfunction 1 Severe depression 0 Total score

2.

B.S

3.

R.V

4.

R.K

5.

V.S

6.

A.A

7.

P.M

8.

A.S

10

9. 10.

A.K S.S

2 1

3 3

1 0

0 1

6 5

TOTAL

17

20

55

MEAN

1.7

2.0

0.9

0.8

5.5

33

Group data for men

6 5 4 3 2 1 0 1.7 2 0.9 0.8 I II III IV total score 5.5

mean scores Subtests of GHQ

The above table and graph shows the scores of the group of men in the GHQ. The group has scored a mean of: 1.7 in subtest I: Somatic Symptoms; 2.0 in subtest II: Anxiety Insomnia; 0.9 in subtest III: Social Dysfunction; and 0.8 in subtest IV: Severe Depression.

The group has a mean total score of 5.5. This indicates that the group exhibits a fair amount of psychological distress. The group has shown the most number of problems in the area of anxiety the least in the area of severe depression. Individual differences exist among the members of the group.

34

Comparison between men and women in the prevalence of psychological morbidity:

Graph showing the trends in psychological distress in men and women

6 5 mean scores 4 3 2 1 0
II III IV I ls co re

men women

sub-scales of GHQ

The above graph shows the differences between men and women in the prevalence of psychological morbidity. Both men and women have shown the presence of a considerable amount of psychological distress. The mean total scores are therefore quite close i.e. 5.5(men) and 5.3(women). Psychological morbidity has been found to be slightly more prevalent in men. In sub-scale I: Somatic symptoms, both men and women have scored low and almost equal i.e. 1.7(men) and 1.6(women). Men have shown a slightly greater amount of somatic symptoms. In sub-scale II: Anxiety Insomnia, women have shown a greater amount of symptoms than men i.e. 2.0(men) and 2.3(women). In sub-scale III: Social dysfunction, women have shown a much greater amount of symptoms than men i.e. 0.9(men) and 1.3(women).

to ta

35

In sub-scale IV: Severe Depression, men have shown a much greater amount of symptoms than women i.e. 0.8(men) and 0.1(women).

Among women, psychological morbidity has been found to be more in working women and women studying in executive degrees. It is quite less in undergraduate and postgraduate students. Among men, psychological morbidity has been found to be almost equally distributed among undergraduate, postgraduate, working, and unemployed men. Depressive tendencies, however, is more in unemployed men.

Conclusion:
The above data and graphs have rejected the null hypothesis that there is no difference between men and women in the prevalence of psychological morbidity.

36

Bibliography:

Science Direct Statistical Solutions WebMD GL Assessment InformaWorld Amazon.com HealthyPlace.com Oxford Journals, Oxford University Press

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Appendix

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