عنوان

Ecocultural Perspectives on Problematic Child Behavior:

TLpq2375515414

انگلیسی

Ecocultural Perspectives on Problematic Child Behavior:

[Thesis]

Elaraby, Sarah

An Exploratory Qualitative Study in the Context of Urban Poverty in Egypt

Ensminger, Margaret

The Johns Hopkins University

2019

157

Ph.D.

The Johns Hopkins University

2019

Background: Disruptive behavioral problems (DBPs) are the most commonly identified mental health issues in children and have long-term health, social, and economic consequences. Community violence, lack of basic infrastructure, and inaccessibility to services in the context of urban poverty aggravate DBPs and their consequences. Most research around child behavior occurs in high-income countries and relies on a biomedical understanding of decontextualized disorders. Definitions and meaning ascribed to DBPs, however, vary by culture and context. In Egypt, child DBPs are a major reason for care-seeking. Like many developing countries, Egypt has an extremely low coverage of child psychiatric services, and limited research exists around the contextual influences on DBPs. This study addresses this gap in knowledge by examining how mothers in urban slums in Egypt define, describe causes of, and respond to DBPs. Methods: We qualitatively assessed the definitions, responses, and care-seeking patterns for DBPs in Alexandria, Egypt. Up to two qualitative in-depth interviews were carried out with a sample of 37 mothers of 6-11-year-old children with DBPs, 17 who sought medical care and 20 who did not. Transcribed audio-recordings of IDIs, field notes, and observational notes were thematically analyzed. Results: Thematic analysis of participants accounts indicate a constant negotiation of the meaning of DBPs and their attribution as medical or criminal issues. Participants linked their child's DBPs in part to the extreme poverty and the physical and social environment where they live. This construction impacted their perception and response to their child's problems and partially informed their care-seeking practices and expectations. Employing a gender lens, we found that perceptions of child DBPs were influenced by gender roles and expectations. Additionally, mothers described how maternal stressors, resulting from the burdensome expected gender roles and exposure to domestic violence, profoundly affected children's behavioral problems. Conclusions: Our findings highlight the limitations of a western biomedical understanding and diagnosis of child DBPs. To design an intervention addressing DBPs in Egypt in urban slums, we need to consider the social construction of disruptive child behavior and the multifaceted influences at the environmental, cultural and structural levels that affect parents and children.

Behavioral psychology

Forensic anthropology

Mental health

Elaraby, Sarah

Ensminger, Margaret

p

[Thesis]

276903

a

Y