Stress, Coping and Mental Health of Arsenic Victims in Bangladesh

Abstract

The research, strived to study the psychological impact of arsenic toxicity m Bangladesh. It investigated the perceived stress, coping strategies and mental health of the arsenic victims. A total of 394 randomly selected participants (200 arsenic affected and 194 non-affected), employing probability proportional to size (PPS) method, were used as samples. A Perceived Stress Questionnaire was developed to measure the stress. Mental health was measured by the Bengali version of General Health Questionnaire. Ways of Coping Questionnaire, Mastery Scale and Life Orientation Test were adapted in Bengali. To explore the stressful experience and mental health status of arsenicosis patients 2x2x3 analyses of variance were used with 2 levels of arsenic toxicity (affected and non-affected) 2 levels of gender (female and male), 3 levels of income (low, lower middle and middle income). Arsenic affected participants were more stressed and poorer in mental health than non-affected ones. Overall gender difference was significant for perceived stress, but not for mental health. Females were more stressed than males. In case of affected participants alone the gender difference was significant for both perceived stress and mental health. Affected females had high stress and poorer mental health compared to affected males. When interaction was looked into, it was found that perceived stress and mental health did not vary as a function of arsenic toxicity, gender and income. However, correlation revealed that increase in age, prolonged duration of arsenicosis elevated stress and deteriorated mental health. On the other hand, high income, high mastery and high optimism decreased the stress level and enhanced the mental health of the victims. Also, elevated stress deteriorated mental health or vice-versa. Regression analysis showed various socio-environmental and psychological factors as predictors of perceived stress and mental health. Both perceived stress and mental health were explained by these two factors. However, perceived stress was explained more by socio-environmental factors, whereas mental health was explained more by psychological ones. Further, stepwise regression confirmed that arsenic toxicity was the best predictor of perceived stress as well as mental health. Out of 3 psychological factors, perceived stress was identified as the best predictor of mental health. Multivariate anova found arsenic affected participants significantly different from non-affected participants in using overall 8 ways of coping (confrontive coping, distancing, self-control, accepting responsibility, escape avoidance, planful problem solving and positive reappraisal). Moreover, compared to non-affected participants, affected participants used significantly less of only 5 strategies - confrontive coping, distancing, self-control, accepting responsibility and planful problem solving. Order of use of the 8 different ways of coping was determined. A two-by-two (2x2) multivariate analysis of variance showed that planful problem solving, positive reappraisal and escape avoidance coping varied as a function of gender and arsenic toxicity. When arsenic toxicity was involved, use of planful problem solving was lower and positive reappraisal and escape avoidance were higher for the affected males, whereas use of all 3 strategies were lower for the affected females. Finally, based on the overall findings a stress-coping-mental health model was developed.