ABSTRACT
A longitudinal follow?up design was used to study the psychological distress and coping among 168 individuals immediately after the national lockdown and after 6 months of the pandemic. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS?21). The coping strategies used were measured by the Brief?COPE, and Intolerance of Uncertainty Scale (IUS?12) was employed to measure response to uncertainty. On follow?up, the prevalence rates for severe/very severe levels of depression, anxiety, and stress had increased substantially from time 1 to time 2. The stepwise multivariate regression analyses revealed that the change in the three DASS?21 scores over time was primarily predicted by intolerance of uncertainty as measured by the IUS?12 and dysfunctional style as assessed by the coping Brief?COPE. There is a need to implement public health policies that promote psychological resilience among high-risk groups.
ABSTRACT
Background: Despite steady decline in the age of diagnosis (AOD) at the global level, it has not declined uniformly, and marked disparities are documented by income, education, race, and access to health care. Objectives: The objectives of the study are to examine the urban/rural disparities in the initial age of autism diagnosis and to understand the interplay of the underlying demographic and social factors. Methods: A retrospective case record review of all children who received their initial diagnosis of autism at the Pediatric Psychology Clinic (1997–2018) of a tertiary advanced pediatric center at Chandigarh was conducted. Astructured abstraction data form was used to extract demographic, socioeconomic, and clinical information from the files maintained at the clinic. Results: A total of 1321 case records were examined. The mean AOD was 4.62 years (standard deviation = 2.38) and children from rural communities were diagnosed at 4.87 years, nearly 0.35 years later than urban children (t = 2.47, P = 0.013). Results indicated that 31.1% of the variance in the AOD for children from rural areas was predicted by two variables, namely the number of children in the family and total Childhood Autism Rating Scale (CARS) score (F = 13.62, P = 0.001). For the urban sample, three variables emerged as significant predictors including the number of children in the family, total CARS score, and maternal education and these together explained 20.2% of the variance in the AOD (F = 19.60, P = 0.001). Conclusion: The public health system must be sensitized to the unmet needs of the marginalized socioeconomic groups to access diagnostic and management services in a timely manner.