ADJUSTMENT AND SELF-CONCEPT OF DISSOCIATIVE DISORDER PATIENTS
Purposive samples of 102 (n = 13 males, n = 89 females) diagnosed cases of dissociative disorder by consultant psychiatrist at the out- door and in-door services of the Department of Psychiatry and Mental Health , TUTH were included in the study. The objectives of the study were to assess the self-concept, adjustment pattern, and neurotic reactions among the patients of dissociative disorder. For this purpose, Self-concept Questionnaire (SCQ) (Saraswat, 1984), Bell Adjustment Inventory (Mohsin et al., 1969) and Neurosis Measurement Scale (NMS) (Uniyal et al., 1989) were used. The mean age of patients was 18.29 years. Majority of the sample were Hindu, Brahmin and Chhetri; mostly they were school students studied up to grade10. The majority of sample were found to be having poor adjustment (n = 93; 91.17%), at home and in health (n = 100; 98.03%), social (n = 97; 95.09%) and in emotional areas respectively. Majority of sample were found to be below 80th percentile, which indicates poor adjustment. Home, health, social, and emotional adjustment areas were found to be highly significantly correlated with each other. Similarly, home, health, social and emotional adjustment were found to be significantly positively correlated with anxiety, conversion, obsessive and depressive reaction. There was highly significant correlation within different items of neurotic reaction (anxiety, dissociative, conversion, phobic, obsessive, and depressive reaction). 92 (90.19%) were non-neurotic and only 10 (9.8%) were found to be neurotics. 69 (67.64%) of them were having above average and 29 (28.43%) of them were having average level of self-concept. The correlation between adjustment and neuroticism was found to be significantly positively correlated. However, the correlation of adjustment and neuroticism with self-concept was found to be significantly negatively correlated.
It can be concluded that female teenaged school girls of Brahmin and Chhetri caste of Hindu religion, are more vulnerable to dissociative disorder than male and other age groups. They were found to be having poor adjustment, without neuroticism and with average and above average self-concept. Among the three hypotheses, the first hypothesis: “There will be poor adjustment among the patients of dissociative disorder was proven, therefore accepted. However, the second hypothesis: “There will be high neurotic trend of dissociative patients,” and the third hypothesis: “There will be poor self-concept among the patients of dissociative disorder,” could not be proven thus, both these hypotheses were rejected. The study does not represent the total population of Nepal because the sample was taken purposively within the limited approach in the T.U. T.H. facilities between outdoors and in-patients within limited resources. So the finding can not be generalized to represent the Nepalese population. Even though, there is limited work on self-concept and adjustment among the dissociative patients in Nepal. Result showed the adjustment problem was prominent among the dissociative disorder rather than neurotic reaction and self-concept. Therefore, treatment strategy should focus on the specific areas of adjustment problem for dissociative disordered patients. This study will help for the better management among the patients of dissociative disorder.
Author: Rajan K.C.