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ORIGINAL ARTICLE |
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Year : 2018 | Volume
: 5
| Issue : 1 | Page : 42-47 |
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The relationship between self-knowledge sources and mental disorders in Iranian population
Seyyed Jalal Younesi1, Mohamad Rostami2, Mojtaba Abbasi Asl3, Javad Kazemi2
1 University of Social Welfare and Rehabilitation Sciences, Tehran, Iran 2 Department of Counseling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran 3 Department of Counseling, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
Date of Submission | 19-Jul-2017 |
Date of Acceptance | 23-Oct-2017 |
Date of Web Publication | 30-Apr-2018 |
Correspondence Address: Dr. Seyyed Jalal Younesi University of Social Welfare and Rehabilitation Sciences, Tehran Iran
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/jhrr.jhrr_69_17
Aim: The aim of this study was to study the relationship between self-knowledge sources and mental disorders in Iranian population. Materials and Methods: This study from the aspect of research design was an ex post facto study and from the aspect of method of collecting data was a survey study. The statistical population included all people between the ages of 20 and 60 years living in Tehran. A total of 800 people were selected using stratified sampling method. To collect data, Depression Anxiety Stress Scale 42 and Self-Knowledge Sources Scale were used. Results: The results showed that there is a significant and negative correlation between self-knowledge sources and depression, anxiety, and stress (P > 0.01). Also there is a significant and positive correlation between the subscales of Self Knowledge Sources with Depression, Anxiety and Stress (P > 0.01). Conclusion: According to the results of this study, any negligence and indulge in each of the sources of self-knowledge may associate the disorders at the individual level and generally at the social level.
Keywords: Anxiety and stress, depression, self-knowledge sources
How to cite this article: Younesi SJ, Rostami M, Asl MA, Kazemi J. The relationship between self-knowledge sources and mental disorders in Iranian population. J Health Res Rev 2018;5:42-7 |
How to cite this URL: Younesi SJ, Rostami M, Asl MA, Kazemi J. The relationship between self-knowledge sources and mental disorders in Iranian population. J Health Res Rev [serial online] 2018 [cited 2024 Mar 19];5:42-7. Available from: https://www.jhrr.org/text.asp?2018/5/1/42/231534 |
Introduction | | |
There are various approaches in explaining the existing disorders at social and individual level: the approach which explains the loss of equilibrium in individuals who form a society, the approach which explains the loss of equilibrium in social conditions, and the approach consisting both of them. In other words, the point here is to study whether to start first by the society or by individuals, by individuals' nobility, or the society's nobility. For instance, in dealing with the problems in a society, this question arises that whether such a problem stems from the social and economic conditions or it roots back to the loss of equilibrium in each and every individual. Psychologists have proposed different interpretations based on their own approaches in this regard.[1]
To reach a profound understanding of human beings, one of the most salient approaches is to know the self of a person who leads to a general knowledge of vulnerability points; therefore, reformative actions can be applied on the damaged factors in social and individual levels.[2],[3],[4] Carrying out a comprehensive study on these disorders, the root of social, cultural, and even economic problems is lucid in the majority of Iranian people. Psychologists have introduced various sources in the formation of self, based on which it develops in human beings and evolves.[5]
Analyzing numerous studies on the formation of self, Schoeneman [6] has introduced three main sources of self-knowledge as follows:
- Self-observation
- Social comparison
- Social feedbacks.
Schoeneman [6] believes that employing each of the aforementioned sources depends on the demand of the level of psychological evolution. Logically, in the formation of self, no other source can be incorporated; employing the sources demands different approaches from one individual to another and even from one population to another population. That is to say that society differs in terms of precedence of the sources as well as the degree to be employed.[1],[7]
Through employing self-observation, people gain more recognition of their thoughts, temperaments, emotions, and they will be able to make considerable changes in themselves.[8] In social comparison, observing other people's situation is an important source for self-knowledge which is also scientific in this process.[9] The concept of “self” can be formed and affected based on social feedbacks that we receive. Accordingly, based on the extent of using these sources and their share in the formation of self, people imply considerable differences based on which the level of health and psychic disorders can be identified.[10]
Most of the problems in the Iranian society such as social anxiety, depression, emotional poverty, cultural problems, profligacy, and dissatisfaction with current situations as well as conjugal problems are resulted by not striking a balance in employing the sources of self-formation.[5] For instance, according to the studies conducted out of Iran on the function of comparison, specifically social comparison, it seems that overusing social comparison is related to hazardous behaviors such as taking drugs and addiction to alcohol,[11] physical dissatisfaction related to the body image disorder,[12] depression,[13] and low self-esteem.[14] Studies also reveal that overusing self-observation sources can be attributed to obsessive-compulsive symptoms and depression.[15] Studies have indicated relations between social feedback and social anxiety as well as general anxiety disorder.[16]
Clinical reports of therapists indicate that severe lack of self-observation sources besides severe activities of social feedbacks and social comparison is visible among Iranians. If we classify our sources in Iranian society, it will be as follows: (1) social feedback, (2) social comparison (especially with superiors), and (3) self-observation.[17]
Such a loss of balance seems to justify the disorders at social and psychological levels in Iranian society. It is notable to mention that psychologists, based on their specialized areas, are seeking psychological issues which are involved in individual and social disorders; undoubtedly, in addition to these psychological issues, socioeconomic factors also affect the social and psychological disorders.[1]
Importantly, these findings are gained based on researchers' clinical experiences in the Iranian society and international studies. However, we are in need of conducting more experimental researches in Iranian society on the relation between the sources of self-knowledge and psychological disorders. In other words, relying solely on the clinical data in this nationally considerable issue to be incorporated in national strategies and planning can be uncertain. The present study set out to explain the relation between self-knowledge sources with psychological disorders in Iranian society.
Materials and Methods | | |
The research design is casual-comparative in which no intervention is applied on the variables under study and only the results as well as the effects left are analyzed. The duration of this research lasted 6 months. This research is a prospective research. Data were collected based on surveys.
The statistical population of this study is those men and women who come to parks of Tehran for recreation in 2016. These people came from five districts of Tehran (the North, the South, center of the city, the West, and the East). The research is intended to be comprehensive enough to incorporate all socioeconomic levels of people in Tehran. Totally 800 participants were selected from five districts of Tehran (the North, the South, center of the city, the West, and the East) based on random stratified sampling. First, Tehran was classified into five districts and then the sampling size (800 people) was divided evenly among the areas; 160 people were incorporated into each district. In the case of sample selection, it should be noted that in the correlation research, at least fifty people should be selected as samples.[18] Eventually, employing random sampling, the samples were selected from each class and participants signed the consent form for the research and questionnaires were distributed among them.
Self-knowledge sources scale
This scale is designed and standardized according to 800 men and women of Tehran city. It provides thirty multiple-choice questions on a Likert scale. The answers to the questions are specified as: disagree strongly (1 point), disagree (2 points), agree (3 points), and agree strongly (4 points). Related questions to self-observation are 1-2-6-10-12-16-17-24-27-29, related questions to social comparison are 3-7-9-13-15-18-19-21-23-26, and related questions to social feedback are 4-5-8-11-14-20-22-25-28-30.
Statistical analysis related to the reliability of self-knowledge sources scale marks satisfactory psychometrical scales. The questionnaire reliability indicates excellent results in which alpha equals 0.86 for all the thirty questions. Notably, no questions were deleted due to lack of correlation coefficient. Split-half coefficient when splitting the test in two 15 questions of self-knowledge sources is 0.79 which again represents an excellent reliability.[17]
The Depression Anxiety Stress Scale
The Depression Anxiety Stress Scale (DASS) was designed by Lovibond and Lovibond [19] in 1995 in which three correlated factors of depression, anxiety, and stress are evaluated through 14 various questions. Depression subscale assesses dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, anhedonia, and inertia. The Anxiety subscale assesses autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect and the Stress subscale highlights the levels of nonchronic arousal through difficulty relaxing, nervous arousal and being easily upset, over-reactive, and impatient. Depression scale includes the following questions 3-5-10-13-16-17-21-24-26-31-34-37-38-42, Anxiety scale includes 2-4-7-9-15-19-20-23-25-28-30-36-40-41, and Stress scale addresses 1-6-8-11-12-14-18-22-27-29-32-33-35-39.
Participants are required to read each sentence and scale the frequency of its occurrence during the previous week on a 4-point scale from 0 to 3. Score 0 means that the participant did not experience the issue over the previous week, score 1 means that the issue under question was experienced to some extent over the previous week, score 2 means that the participant experienced it several times over the last week, and score 3 means that the participant experienced the issue a lot over the last week.
To assess the psychometrical properties of DASS, Lovibond and Lovibond [19] performed the test on a nonclinical sample of 2914 patients. Cronbach's alpha values obtained for subscales of depression, anxiety, and stress are, respectively, 0.91, 0.84, and 0.84. Lovibond and Lovibond presented severity ratings from “normal” to “extremely severe” on the basis of percentile score, with 0–78 classified as “normal,” 78–87 as “mild,” 87–95 as “moderate,” 95–99 as “severe,” and 98–100 as “extremely severe.” Psychometrical properties of DASS have been studied in Iran. Cronbach's alpha for depression scale is 0.94, for anxiety scale is 0.85, and for stress is 0.87.[20]
Prior to the start of the study, relevant legal permissions were obtained from the officials of parks and scales were given to participants separately to answer the scales individually. Whenever participants had problem answering the questions, the researcher would clarify the issue. Participants were told that no “correct” and “incorrect” answer existed in the study, therefore writing down what came to their mind first as their personal opinion would be sufficient. The criteria for selecting the samples were as follows: men and women between the ages of 20–60 (this age spectrum incorporates majority of Iranian society and problems related to senility as well as problems related to adolescence and lack of having an individual characteristic are not seen in this spectrum). Notably, this age group is active and involved in social interactions. The least educational degree for participants was considered third grade of junior high school. The avidity to participate in this study was taken into consideration as well.
Moral considerations of this study were as follows: participants were assured that whenever they wished they would be free to leave the project and there would be no force and obligation in being a part of the study. Identities of participants were considered to remain undisclosed. Participants were first informed of the researcher's educational degree and expertise; the purpose of the study was clarified to them as well. Participants were made assured that findings of the study would remain concealed and they would not be disclosed under any circumstances. After collecting and entering data into SPSS 21 (IBM, Armonk, NY, United States of America), measures of central tendency and index of dispersion such as mean and standard deviation were employed to describe data. Data analysis was carried out based on Pearson's correlation coefficient test.
Results | | |
It is notable to mention that the number of sample group was 800 people at the start of the project; however, 24 people fell out and ultimately 776 men and women remained. The demographic data of participants were as follows: most of the participants were between the ages of 20–28 with a frequency of 40%, male with a frequency of 70%, single with a frequency of 72%, residents of Tehran with a frequency of 70%, graduates with a frequency of 40%, and employed with a frequency of 70%.
[Table 1] represents the maximum subscale which is for social feedback and the minimum subscale which is for self-observation.
[Table 2] represents that Stress subscale shows the maximum mean and two subscales of anxiety and depression show approximately similar means. | Table 2: Mean and standard deviation of Depression Anxiety Stress Scale questionnaire
Click here to view |
[Table 3] indicates that there is a negative and meaningful correlation between social comparison and social feedback and each subscale of depression, anxiety, and stress. Maximum negative correlation coefficient related to social comparison and anxiety is −0.174 (P > 0.01). The minimum negative correlation coefficient related to social feedback and stress is −0.072 (P > 0.05). | Table 3: Results of Pearson's correlation coefficient test on the relation between self knowledge sources and subscales with depression, anxiety, stress scales
Click here to view |
[Table 4] indicates that there is a positive and meaningful relationship between the difference of self-knowledge sources and subscales of depression, anxiety, and stress (P > 0.01). | Table 4: Results of Pearson's correlation coefficient on the absolute value of the difference between Self-knowledge Sources scale and subscales of depression, anxiety, and stress
Click here to view |
Discussion | | |
The main propose of this research was to study the relation between self-knowledge sources and psychological disorders. After collecting and analyzing the data, it was revealed that self-knowledge sources have negative and meaningful relationship with subscales of depression, anxiety, and stress; that is to say that with an increase in self-knowledge sources, depression, anxiety, and stress decrease. Studying the subscales of Self-knowledge Sources scale, it was indicated that only two subscales of social feedback and social comparison have a negative and meaningful relationship with depression, anxiety, and stress, whereas no meaningful relation was observed for the subscale of self-observation. Encountering such a correlation coefficient was not beyond expectation since each self-knowledge source cannot solely result in an increase in problems with psychological health, and this can occur due to not maintaining the balance in employing self-knowledge sources.[1] There are various approaches in explaining the existing disorders at social and individual levels, the approach which explains the loss of equilibrium in individuals who form a society, the approach which explains the loss of equilibrium in social conditions, and the approach consisting both of them.[1] We investigated the relationship between mental disorders with self-knowledge sources approach in our research.
According to Jung's theory [21] revolving around the “principle of equivalence,” a healthy personality is the result of equivalence between contrasting forces; such equivalence comes from a kind of unity created by the congruence and harmonization of the forces of different aspects of the personality. Employing Jung's theory, the researchers addressed the difference of self-knowledge sources with depression, anxiety, and stress to discuss if excessively employing each of the sources would open the door for psychological disorders or would show convergence with psychological orders. Data analysis indicated that there is a positive and meaningful relationship between the absolute value of self-knowledge sources as well as depression, anxiety, and stress. In other words, the more the difference value of self-knowledge sources, the more depression, anxiety, and stress. To put it more precisely, in cases when an individual uses one of the self-knowledge sources more or less than others, and the personality becomes distant from the state of equilibrium and forms a caricature personality, the level of depression, anxiety, and stress increases. Based on the natural relationship between lack of equilibrium in self-knowledge sources and depression, anxiety, and stress, it is expected to observe such a positive correlation coefficient. To explain the findings of this study, Jung's theory [21] is employed: Jung has introduced two primary principles of equilibrium and entropy in personality which is taken from thermodynamics.[22]
According to equilibrium theory, psychic energy tends to be distributed evenly in relation to a belief, thought, or any part of personality. According to the principle of entropy, each belief or thought, or in general terms, each part of the psyche whose energy is more, tends to lose its energy in favor of those parts which lack this psychic energy. To Jung's idea,[21] a healthy personality is the result of equivalence between contrasting energies; such an equivalence comes from the kind of unity created by the congruence and harmonized forces of different aspects of the personality. Importantly, whenever a part of our psyche is overvalued, other parts will signal a kind of thirst. For instance, although our body needs vitamins and carbohydrates, overtaking or undertaking them will cause problems for the body. Therefore, not striking a balance between self-knowledge sources can for sure cause problems for people. These sources must be employed based on a certain equilibrium which can change in accordance with the levels of evolution.[1],[22] Lack of equilibrium in employing self-knowledge sources can be viewed differently as follows:
a. An increase in self-observation and a slump in employing social comparison and social feedback: self-observation always leads to self-awareness. As a result, preoccupation and self-focused attention will develop which can lead to clinical syndromes and disorders such as depression, phobias, social anxiety, schizophrenia, and alcoholism.[15],[23] Researchers have suggested that self-focused attention can be assumed as an unidentified process which exists in all psychological disorders.[24] In this regard, a meaningful relationship was found between self-focused attention and symptoms of depression, anxiety,[25] and stress [26]
b. A severe decrease in self-observation and a surge in using social comparison and social feedbacks: the present research shows that lack of equilibrium in self-knowledge sources is mostly attributed to this part; as verified in findings presented in tables, the minimum mean of self-knowledge sources is related to self-observation and the maximum mean is related to social comparison and social feedback. To clarify this part, it can be stated that if the outer sources are preferred over the inner sources in relation to self-knowledge, a swollen persona [27] will be the result. Persona is a mask which we wear to leave good impression on other people. This term was first used by Jung to justify one part of personality. The fact is that most of the behaviors are formed based on role-plays.[28] Yung [27] asserts that those with active and swollen persona do not accept many manners and behaviors in their conscious level of mind, therefore pressing them back into their individual subconscious will bring about a swell in it. In this case, we can see alienation with oneself.[22]
In fact, lack of knowledge of what one tends to do in interactions with other people can bring about a kind of alienation in an individual.[29] Those people, who have swollen self-knowledge of outer sources, tend to be more vulnerable in social circumstances and easily run into social anxiety (social phobia, speech anxiety, or speaking in a group).[13],[14],[16] One of the factors of social anxiety is determined by the approximation of one's own abilities and other people's evaluation of one's anxiety. People suffering from social anxiety estimate their abilities as extremely low and they believe that their anxious externalizations are extremely high.[30]
The research conducted by psychologists which are in congruence with the findings of the present study indicates that overusing social comparison, especially comparison with the superior, can increase emotional pressures,[31] severely decrease self-esteem,[14] and in some cases it will increase disorders such as eating disorders.[32] Interestingly, the finding of this study is compatible with Quran verses in this regard; striking a balance in all aspects of humane and natural issues is addressed meticulously in religions. The classic example is the issue of prayer which is emphasized in all religions including Islam; although praying is one of the vivid representations of self-observation and Islam believes that self-observation is the first step to recognize God, there are various hadiths in this regard which deter people from going to the extreme in their prayers. Interestingly, a chapter of Osul-al-Kafi addresses the issue of striking a balance in prayer.[1]
The present research did not come across any considerable limitation. Studying how self-knowledge sources relate to other social and psychological disorders as well as studying the effect of teaching self-knowledge sources on the improvement of psychological and mental health is among the suggestions for further studies.
Conclusion | | |
It can be concluded that psychological health is based on a striking equilibrium between different parts of personality and self; going to the extremes in any parts of personality can bring about disorders. Equilibrium and harmonization of these sources can ensure psychological health and hygiene. It seems that this conclusion has a harmony with the Quran note: Quran swears to the soul (God) whose decrees are all moderate and balanced.[33]
We propose that in the future the relationship between mental disorders and self-knowledge sources in children and adolescents should be investigated. We also propose that this research be conducted in different cultures to obtain more evidence to confirm this hypothesis.
Acknowledgment
We would like to express our gratitude to those who participated in this research and those who helped us in this study.
Financial support and sponsorship
This project was financially supported by the University of Social Welfare and Rehabilitation sciences of Tehran.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]
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