Skip to main content
Top
Published in: Child and Adolescent Psychiatry and Mental Health 1/2015

Open Access 01-12-2015 | Research article

Perceived behavioral problems of school aged children in rural Nepal: a qualitative study

Authors: Ramesh P. Adhikari, Nawaraj Upadhaya, Dristy Gurung, Nagendra P. Luitel, Matthew D. Burkey, Brandon A. Kohrt, Mark J.D. Jordans

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2015

Login to get access

Abstract

Background

Studies on child behavioral problems from low and middle income countries are scarce, even more so in Nepal. This paper explores parents’, family members’ and teachers’ perceptions of child behavioral problems, strategies used and recommendations to deal with this problem.

Method

In this study, 72 free list interviews and 30 Key Informant Interviews (KII) were conducted with community members of Chitwan district in Nepal.

Result

The result suggest that addictive behavior, not paying attention to studies, getting angry over small issues, fighting back, disobedience, and stealing were the most commonly identified behavioral related problems of children, with these problems seen as interrelated and interdependent. Results indicate that community members view the family, community and school environments as being the causes of child behavioral problems, with serious impacts upon children’s personal growth, family harmony and social cohesion. The strategies reported by parents and teachers to manage child behavioral problems were talking, listening, consoling, advising and physical punishment (used as a last resort).

Conclusions

As perceived by children and other community dwellers, children in rural Nepalese communities have several behavioral related problems. The findings suggest that multi-level community-based interventions targeting peers, parents, teachers and community leaders could be a feasible approach to address the identified problems.
Literature
1.
go back to reference Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378:1515–25.PubMedCrossRef Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378:1515–25.PubMedCrossRef
2.
go back to reference Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2013;380(9859):2197–223.CrossRef Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2013;380(9859):2197–223.CrossRef
3.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Walters EE. Lifetime prevalence and age‐of‐onset distributions of DSM‐IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.PubMedCrossRef Kessler RC, Berglund P, Demler O, Jin R, Walters EE. Lifetime prevalence and age‐of‐onset distributions of DSM‐IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.PubMedCrossRef
4.
go back to reference WHO. Preventing suicide a global imperative. Geneva, Switzerland: World Health Organization; 2014. WHO. Preventing suicide a global imperative. Geneva, Switzerland: World Health Organization; 2014.
5.
go back to reference Bongers IL, Koot HM, Ende J, Verhulst FC. Developmental trajectories of externalizing behaviors in childhood and adolescence. Child Dev. 2004;75(5):1523–37.PubMedCrossRef Bongers IL, Koot HM, Ende J, Verhulst FC. Developmental trajectories of externalizing behaviors in childhood and adolescence. Child Dev. 2004;75(5):1523–37.PubMedCrossRef
6.
go back to reference Alisauskas A, Simkiene G. Teachers’ experiences in educating pupils having behavioural and / or emotional problems. Spec Educ. 2013;1(28):62–72. Alisauskas A, Simkiene G. Teachers’ experiences in educating pupils having behavioural and / or emotional problems. Spec Educ. 2013;1(28):62–72.
7.
go back to reference Erskine HE, Ferrari AJ, Polanczyk GV, Moffitt TE, Murray CJL, Vos T, et al. The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010. J Child Psychol Psychiatry. 2014;55(4):328–36.PubMedCrossRef Erskine HE, Ferrari AJ, Polanczyk GV, Moffitt TE, Murray CJL, Vos T, et al. The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010. J Child Psychol Psychiatry. 2014;55(4):328–36.PubMedCrossRef
8.
go back to reference Atilola O, Balhara YPS, Stevanovic D, Avicenna M, Kandemir H. Self-reported mental health problems among adolescents in developing countries: results from an international pilot sample. J Dev Behav Pediatr. 2013;34:129–37.PubMedCrossRef Atilola O, Balhara YPS, Stevanovic D, Avicenna M, Kandemir H. Self-reported mental health problems among adolescents in developing countries: results from an international pilot sample. J Dev Behav Pediatr. 2013;34:129–37.PubMedCrossRef
9.
go back to reference Murray J, Anselmi A, Gallo EAG, Fleitlich-Bilyk B, Bordin IA. Epidemiology of childhood conduct problems in Brazil: systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1527–38.PubMedCentralPubMedCrossRef Murray J, Anselmi A, Gallo EAG, Fleitlich-Bilyk B, Bordin IA. Epidemiology of childhood conduct problems in Brazil: systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1527–38.PubMedCentralPubMedCrossRef
10.
go back to reference Prior M, Virasinghe S, Smart D. Behavioural problems in Sri Lankan schoolchildren Associations with socio-economic status, age, gender, academic progress, ethnicity and religion. Soc Psychiatry Psychiatr Epidemiol. 2005;40:654–62.PubMedCrossRef Prior M, Virasinghe S, Smart D. Behavioural problems in Sri Lankan schoolchildren Associations with socio-economic status, age, gender, academic progress, ethnicity and religion. Soc Psychiatry Psychiatr Epidemiol. 2005;40:654–62.PubMedCrossRef
11.
go back to reference Syed EU, Hussein SA, Haidry S. Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan – multi informant survey. Indian J Pediatr. 2009;76:623–7.PubMedCrossRef Syed EU, Hussein SA, Haidry S. Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan – multi informant survey. Indian J Pediatr. 2009;76:623–7.PubMedCrossRef
12.
go back to reference Pathak R, Sharma RC, Parvan UC, Gupta BP, Ojha RK, Goel NK. Behavioural and emotional problems in school going adolescents. Australasian Med J. 2011;4(1):15–21.CrossRef Pathak R, Sharma RC, Parvan UC, Gupta BP, Ojha RK, Goel NK. Behavioural and emotional problems in school going adolescents. Australasian Med J. 2011;4(1):15–21.CrossRef
13.
go back to reference Patel V, Flisher AJ, Nikapota A, Malhotra S. Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry. 2008;49(3):313–34.PubMedCrossRef Patel V, Flisher AJ, Nikapota A, Malhotra S. Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry. 2008;49(3):313–34.PubMedCrossRef
14.
go back to reference Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359–64.PubMedCentralPubMedCrossRef Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359–64.PubMedCentralPubMedCrossRef
15.
go back to reference Fergusson DM, Horwood LJ, Ridder EM. Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood. J Child Psychol Psychiatry. 2005;46(8):837–49.PubMedCrossRef Fergusson DM, Horwood LJ, Ridder EM. Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood. J Child Psychol Psychiatry. 2005;46(8):837–49.PubMedCrossRef
16.
go back to reference Moffitt TE, Arseneault L, Jaffee SR, Kim-Cohen J, Koenen KC, Odgers CL, et al. Research review: DSM-V conduct disorder: research needs for an evidence base. J Child Psychol Psychiatry. 2008;49(1):3–33.PubMedCentralPubMedCrossRef Moffitt TE, Arseneault L, Jaffee SR, Kim-Cohen J, Koenen KC, Odgers CL, et al. Research review: DSM-V conduct disorder: research needs for an evidence base. J Child Psychol Psychiatry. 2008;49(1):3–33.PubMedCentralPubMedCrossRef
17.
go back to reference UNDP. Human development report 2014, UN plaza. New York, USA: United Nations Development Programme (UNDP); 2014. UNDP. Human development report 2014, UN plaza. New York, USA: United Nations Development Programme (UNDP); 2014.
18.
go back to reference CBS. National population and housing census 2011. Kathmandu, Nepal: Central Bureau of Statistics; 2012. CBS. National population and housing census 2011. Kathmandu, Nepal: Central Bureau of Statistics; 2012.
19.
go back to reference NHRC. Status of child rights in Nepal annual report 2008. Harihar Bhawan Lalitpur Nepal: National Human Rights Commission; 2008. NHRC. Status of child rights in Nepal annual report 2008. Harihar Bhawan Lalitpur Nepal: National Human Rights Commission; 2008.
20.
go back to reference UNOHCHR. Nepal conflict report 2012, An analysis of conflict-related violations of international human rights law and international humanitarian law between February 1996 and 21 November 2006. Geneva: United Nations Office of the High Commissioner for Human Rights; 2012. UNOHCHR. Nepal conflict report 2012, An analysis of conflict-related violations of international human rights law and international humanitarian law between February 1996 and 21 November 2006. Geneva: United Nations Office of the High Commissioner for Human Rights; 2012.
21.
go back to reference Kohrt BA, Jordans MJD, Tol WA, Perera E, Karki R, Koirala S, et al. Social ecology of child soldiers: child, family, and community determinants of mental health, psychosocial well-being, and reintegration in Nepal. Transcult Psychiatry. 2010;47(5):727–53.PubMedCrossRef Kohrt BA, Jordans MJD, Tol WA, Perera E, Karki R, Koirala S, et al. Social ecology of child soldiers: child, family, and community determinants of mental health, psychosocial well-being, and reintegration in Nepal. Transcult Psychiatry. 2010;47(5):727–53.PubMedCrossRef
22.
go back to reference Chhabra GS, Sodhi MK. Impact of family conflict on the psychosocial behaviour in male adolescents. J Nepal Paediatr Soc. 2012;32(2):124–31.CrossRef Chhabra GS, Sodhi MK. Impact of family conflict on the psychosocial behaviour in male adolescents. J Nepal Paediatr Soc. 2012;32(2):124–31.CrossRef
23.
go back to reference Tol WA, Jordans MJ, Regmi S, Sharma B. Cultural challanges to psychosocial counseling in Nepal. Transcult Psychiatry. 2005;42:317–33.PubMedCrossRef Tol WA, Jordans MJ, Regmi S, Sharma B. Cultural challanges to psychosocial counseling in Nepal. Transcult Psychiatry. 2005;42:317–33.PubMedCrossRef
24.
go back to reference Hruschka DJ, Kohrt BA, Worthman CM. Estimating between- and within-individual variation in cortisol levels using multilevel models. Psychoneuroendocrinology. 2005;30:398–714.CrossRef Hruschka DJ, Kohrt BA, Worthman CM. Estimating between- and within-individual variation in cortisol levels using multilevel models. Psychoneuroendocrinology. 2005;30:398–714.CrossRef
25.
go back to reference Regmi SK, Khalid A, Nepal MK, Pokhrel AK. A study of socio-demographic characteristics and diagnostic profile in psychiatric outpatients of TUTH. Nepalese J Psychiatry. 1999;1:26–33. Regmi SK, Khalid A, Nepal MK, Pokhrel AK. A study of socio-demographic characteristics and diagnostic profile in psychiatric outpatients of TUTH. Nepalese J Psychiatry. 1999;1:26–33.
26.
go back to reference Atilola O. Cross-cultural child and adolescent psychiatry research in developing countries. Global Ment Health. 2015;2. Atilola O. Cross-cultural child and adolescent psychiatry research in developing countries. Global Ment Health. 2015;2.
27.
go back to reference Bolton P. Local perceptions of the mental health effects of the Rwandan genocide. J Nerv Ment Dis. 2001;189(4):243–8.PubMedCrossRef Bolton P. Local perceptions of the mental health effects of the Rwandan genocide. J Nerv Ment Dis. 2001;189(4):243–8.PubMedCrossRef
29.
go back to reference Ojha SP, Jasmin M, Chapagain M, Tulachan P. Educational and Behavioural Problems among Sheltered Homeless Children. J Nepal Med Assoc. 2013;52(191):457–61. Ojha SP, Jasmin M, Chapagain M, Tulachan P. Educational and Behavioural Problems among Sheltered Homeless Children. J Nepal Med Assoc. 2013;52(191):457–61.
30.
go back to reference Vijayalakshmi K, Kumar CV, Rajamanickm H, Cherian A. Child rearing practices and psychological problems of children. Nurs Midwife Res J. 2007;3(2):49–56. Vijayalakshmi K, Kumar CV, Rajamanickm H, Cherian A. Child rearing practices and psychological problems of children. Nurs Midwife Res J. 2007;3(2):49–56.
31.
go back to reference Karki YB. Sex preference and the value of sons and daughters in Nepal. Stud Fam Plan. 1988;19(3):169–78.CrossRef Karki YB. Sex preference and the value of sons and daughters in Nepal. Stud Fam Plan. 1988;19(3):169–78.CrossRef
32.
go back to reference Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: a global public-health challenge. Lancet. 2007;369:1302–13013.PubMedCrossRef Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: a global public-health challenge. Lancet. 2007;369:1302–13013.PubMedCrossRef
33.
go back to reference Harland P, Reijneveld SA, Brugman E, Verloove-Vanhorick SP, Verhulst FC. Family factors and life events as risk factors for behavioural and emotional problems in children. Eur Child Adolesc Psychiatry. 2002;11(4):176–84.PubMedCrossRef Harland P, Reijneveld SA, Brugman E, Verloove-Vanhorick SP, Verhulst FC. Family factors and life events as risk factors for behavioural and emotional problems in children. Eur Child Adolesc Psychiatry. 2002;11(4):176–84.PubMedCrossRef
34.
go back to reference Reed RV, Fazel M, Jones L, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet. 2011;379:250–65.PubMedCrossRef Reed RV, Fazel M, Jones L, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet. 2011;379:250–65.PubMedCrossRef
35.
go back to reference Arman S, Keypour M, Maracy MR, Attari A. Epidemiological study of youth mental health using strengths and difficulties questionnaire (SDQ). Iranian Red Cresc Med J. 2012;14(6):371–5. Arman S, Keypour M, Maracy MR, Attari A. Epidemiological study of youth mental health using strengths and difficulties questionnaire (SDQ). Iranian Red Cresc Med J. 2012;14(6):371–5.
36.
go back to reference Mesman J, Stoel R, Bakermans-Kranenburg MJ, van IJzendoorn MH, Juffer F, Koot HM, et al. Predicting growth curves of early childhood externalizing problems: differential susceptibility of children with difficult temperament. J Abnorm Child Psychol. 2009;37:625–36.PubMedCrossRef Mesman J, Stoel R, Bakermans-Kranenburg MJ, van IJzendoorn MH, Juffer F, Koot HM, et al. Predicting growth curves of early childhood externalizing problems: differential susceptibility of children with difficult temperament. J Abnorm Child Psychol. 2009;37:625–36.PubMedCrossRef
37.
go back to reference Bordin IA. Epidemiology of childhood conduct problems in Brazil: systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1527–38.PubMedCentralPubMedCrossRef Bordin IA. Epidemiology of childhood conduct problems in Brazil: systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1527–38.PubMedCentralPubMedCrossRef
38.
go back to reference Bharati S, Takao H. Schooling: knowledge, perception and practices of parents. J Educ Res. 2010;2:44–51. Bharati S, Takao H. Schooling: knowledge, perception and practices of parents. J Educ Res. 2010;2:44–51.
39.
go back to reference CVICT. Violence against children in Nepal series 2, A study of the system of school discipline in Nepal. Kathmandu, Nepal: Center for Victims of Torture (CVICT) and UNICEF Nepal; 2004. CVICT. Violence against children in Nepal series 2, A study of the system of school discipline in Nepal. Kathmandu, Nepal: Center for Victims of Torture (CVICT) and UNICEF Nepal; 2004.
40.
go back to reference Engle PL, Fernald LCH, Alderman H, Behrman J, O’Gara C, Yousafzai A, et al. Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. Lancet. 2011;378:1339–53.PubMedCrossRef Engle PL, Fernald LCH, Alderman H, Behrman J, O’Gara C, Yousafzai A, et al. Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. Lancet. 2011;378:1339–53.PubMedCrossRef
41.
go back to reference Kazdin AE. Premature termination from treatment among children referred for antisocial behavior. J Clin Child Psychol. 1993;31:2–16.CrossRef Kazdin AE. Premature termination from treatment among children referred for antisocial behavior. J Clin Child Psychol. 1993;31:2–16.CrossRef
42.
go back to reference Upadhaya N. “Distress, a door to happiness?” the meaning and etiology of everyday adolescent distress, in a Nepalese government high school university of Amsterdam. 2011. Upadhaya N. “Distress, a door to happiness?” the meaning and etiology of everyday adolescent distress, in a Nepalese government high school university of Amsterdam. 2011.
43.
go back to reference Hiscock H, Bayer JK, Lycett K, Ukoumunne OC, Shaw D, Gold L, et al. Preventing mental health problems in children: the Families in Mind population-based cluster randomised controlled trial. BMC Public Health. 2012;12(420):1–9. Hiscock H, Bayer JK, Lycett K, Ukoumunne OC, Shaw D, Gold L, et al. Preventing mental health problems in children: the Families in Mind population-based cluster randomised controlled trial. BMC Public Health. 2012;12(420):1–9.
Metadata
Title
Perceived behavioral problems of school aged children in rural Nepal: a qualitative study
Authors
Ramesh P. Adhikari
Nawaraj Upadhaya
Dristy Gurung
Nagendra P. Luitel
Matthew D. Burkey
Brandon A. Kohrt
Mark J.D. Jordans
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2015
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-015-0061-8

Other articles of this Issue 1/2015

Child and Adolescent Psychiatry and Mental Health 1/2015 Go to the issue