Filicide in South Asia: Demography, risk factors, psychiatric, and legal aspects.

Background & Objective: Filicide is an act of killing a child up to the age of 18 years committed by his or her parent(s) or parental figure(s), including guardians and stepparents. There is absence of data and research regarding filicide in South Asia. The present study aimed to address the empirical lacuna in South Asia and to expand the literature in order to broaden the understanding of filicide. Method: The search was conducted in the databases of PubMed, PubMed Central, Scopus, and Google Scholar. The original articles, quantitative studies, case studies, and full-length articles were included for the present review. Publications in only the English language, which clarified that the child was killed by parent(s) in eight South Asian countries from 2000 to 2020 were included. Results: A total of 13 reports of filicide were found in the eight South Asian countries; 12 from India and 1 from Pakistan. The most common method of filicide was by administering poisonous substances and burning by parents, depression was responsible for 7 cases of filicide, schizophrenia was responsible for one case. Conclusion: The review identified that there is a scarcity of research on filicide in South Asia. Rigorous research and investment for the compilation of data on filicide are needed to reduce it in South Asia. This may further help in the protection of lives of children as well as for taking steps for rehabilitation of parents and society.

A rare phenomenon of pregorexia in Pakistani women: need to understand the related behaviors.

BACKGROUND: In Pakistan, for a decade or so, there has been a huge increase in body ideals, and thinness and eating disorders reported during pregnancy. The purpose of the present research was to study the lived experiences and behaviors characterized by pregorexia in Pakistani young women. METHOD: A phenomenological approach was used to study eating disorder-related behaviors among pregnant women. A criterion sample of 15 women (22-34 years of age) having difficulty with their body image, the decline in caloric intake, skipping meals, and extensive exercise from a private gynae clinic of Islamabad was selected. The participants were screened on the DSM-5 criteria of anorexia nervosa. They were also asked questions about their diet intake, behaviors executed to lose or maintain weight, use of any medical or chemical substance to control weight, any social activities/behaviors, type of exercise if any, duration or frequency of exercise, and behaviors that made them feel better. RESULTS: The findings revealed that 93.33% of women met the complete criteria of Anorexia nervosa. 86.6% had never been diagnosed or treated with anorexia nervosa, however, 13.33% were diagnosed with anorexia nervosa comorbid with depression. Results indicated a likelihood of having anorexic tendencies in 40% of women and the other 60% developed the symptoms during pregnancy only. Behaviors related to pregorexia were found to be: skipping meals, eating small portions, control on calorie intake, following diet plans available on YouTube, taking fat burn tea, avoiding the presence of elders of the family while taking meals, eating alone to limit food portion, taking laxatives or medicine to control weight, induced vomiting after eating, eating to match the norm of eating (supervised eating by elders) being pregnant and later self-induced vomiting, or eating slowly and consuming more time, pretending to eat the suitable amount of food. Women also engaged in fast walking, light exercise, and intensive cardio to control weight and stay in body shape. Around 86% reported that controlling weight, calorie intake, and exercising made them feel better. CONCLUSION: There is a need to understand and differentiate pregorexia from other eating behaviors and problems among pregnant women with respect to cultural context.

Pregorexia is a term used to describe a condition where an individual displays a heightened fear of pregnancy-related weight gain. The present study is the first to examine this eating disorder in Pakistan. Some behaviors related to pregorexia were commonly identified to include skipping meals, eating small portions, following diet plans available on YouTube, eating alone to limit food portion, taking laxatives or medicine to control weight, induced vomiting after eating, and pretending to eat the suitable amount of food. We recommend clinicians interacting with pregnant women to screen for these behaviors when taking histories to provide better support, education and increased awareness.

Suicide prevention in Bangladesh: The role of family.

BACKGROUND: Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed. OBJECTIVES: We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh. METHODS: We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing suicidality and family dynamics in Bangladesh. RESULTS: Risk factors for suicide prevailing in the family have been organized, and several strategies for coping with family risk factors, including marital discord and family conflict have been proposed for testing empirically. CONCLUSIONS: The family has an important role to play in suicide prevention in Bangladesh. However, potential prevention strategies and their effectiveness have been untapped in the country. Studies are warranted to test the effectiveness of the proposed strategies.

Depression and suicidal behavior in South Asia: a systematic review and meta-analysis.

Background: Estimates of depression in suicidal behavior in South Asia would help to formulate suicide prevention strategies in the region that hasn't been assessed yet. Objectives: We aimed to systematically assess the prevalence of depression in fatal and non-fatal attempts of suicide in eight South Asian countries. Methods: We searched Medline, Embase, and PsychINFO by specific search terms to identify articles assessing depression in fatal and non-fatal attempts of suicide in South Asian countries published between 2001 and 2020. Two separate meta-analyses were conducted for fatal and non-fatal attempts. Due to the high heterogeneity of studies (96-98%), random-effects models were used to calculate pooled prevalence rates. Results: A total of 38 studies was identified from five south Asian countries (India [27], Pakistan [6], Sri Lanka [3], Nepal [1], and Bangladesh [1]). The majority of studies (n = 27) were published after 2010. Twenty-two studies reported non-fatal attempts, and sixteen reported suicide. The prevalence of depression among non-fatal attempts ranged from 14% to 78% where the pooled prevalence rate was 32.7% [95% CI 26-39.3%]. The prevalence of depression among suicides ranged from 8% to 79% where the pooled prevalence estimate was 37.3% [95% CI 26.9-47.6%]. Conclusions: This review revealed the pooled prevalence of depression among fatal and non-fatal suicidal attempts in South Asian countries, which seems to be lower when comparedto the Western countries. However, a cautious interpretation is warranted due to the heterogeneity of study methods, sample size, and measurement of depression.

Psychological autopsy study and risk factors for suicide in Muslim countries.

BACKGROUND: Suicide and risk factors have been poorly studied in the Muslim-majority countries that hinder the formulation of prevention strategies and affect suicide prevention eventually. OBJECTIVES: We aimed at identifying and analyzing the psychological autopsy studies assessing the risk factors for suicide conducted in Muslim-majority countries. METHODS: We did a search to trace all the available psychological autopsy studies in the Muslim countries with the search term "psychological autopsy study in Muslim countries." We also checked the available bibliographies to identify the psychological autopsy studies in the Muslim countries so that all the possible studies could be included. RESULTS: Out of the Muslim countries, only eight psychological autopsy studies were identified in five countries (Bangladesh [1], Indonesia [1], Iran [1], Pakistan [2], and Turkey [3]). Six studies adopted a case-control study design, and all were carried out in urban settings. The prevalence of psychiatric disorders among case-control studies varied from 52.8% in Turkey to 96% in Pakistan. Psychiatric illness, self-harm, and stressful life events were the commonly replicated risk factors for suicide across studies. CONCLUSIONS: Psychological autopsy studies have been conducted only in five Muslim countries revealing that the risk factor for suicide is certainly under-researched in the incumbent countries. This review identified a similar list of risk factors for suicide, namely, psychiatric disorder, past non-fatal attempts, and adverse life events compared to the Western countries even though the rate varies.

Relationship between psychological distress, quality of life and resilience among medical and non-medical students.

OBJECTIVE: To explore inherent associations between psychological distress and resilience, and its effect on quality of life among medical and non-medical students. METHODS: The cross-sectional study was conducted from December 2018 to January 2020 after approval from the Department of Psychology Ethics Committee of the International Islamic University, Islamabad, and comprised medical and non-medical students of either gender enrolled with different institutions of higher learning in Rawalpindi and Islamabad. Data were obtained using Brief Resilience Scale, Kessler Psychological Distress Scale and Quality of Life Scale. Data was analysed using SPSS. RESULTS: Of the 300 subjects, 150(50%) each were medical and non medical students. Within both groups, 75(50%) each were males and females. Psychological resilience was a positive predictor of quality of life ( =0.30) whereas psychological distress served as a negative predictor of quality of life ( =-0.54). Medical students were significantly higher on psychological distress (p=0.001), whereas non-medical students were higher on quality of life (p=0.001) and resilience (p=0.001). Female students were higher on quality of life and male students were higher on psychological distress (p=0.002). CONCLUSIONS: Resilience needs to be promoted among students, particularly medical students, as it may help in reduction and adequate management of academic distress levels.

Development and validation of perceived sexual resentment scale for women (PSRS-W).

OBJECTIVE: To develop a valid and reliable scale to asses perceived sexual resentment among married women. METHODS: The cross-sectional validation study was conducted from September 2018 to July 2019 at the International Islamic University, Islamabad, Pakistan, and had three phases. Phase I comprised initial generation/selection of items regarding sexual resentment among married women. Phase II comprised pilot testing of the perceived sexual resentment scale for women items before applying the scale on the actual sample. Phase III determined convergent validity by estimating correlation of the newly developed scale with the Sexual Coercion in Intimate Relationship Scale, and its divergent validity by finding correlation with the Satisfaction with Life Scale. Data was analysed using SPSS 23. RESULTS: The pilot study, done on 20 married women, established the internal consistency of the newly developed scale (α=0.82). Overall, three factors emerged following factor analysis. The scale had 29 items and reliability analysis of the entire scale indicated adequate internal consistency (α=0.93). The convergent validity of the scale and the Sexual Coercion in Intimate Relationship Scale was positive (p<0.001), and the correlation with the Satisfaction with Life Scale was negative (p<0.01), indicating that the newly-developed instrument had a good convergent and divergent validity. CONCLUSIONS: The Perceived Sexual Resentment Scale for Women was found to be a precise and concise 29-item self-reporting tool developed to assess sexual dislikes and displeasures among married women.

Suicide methods in South Asia over two decades (2001-2020).

BACKGROUND: Suicide is a global preventable public health problem. About a quarter of all suicides in the world occur in South Asia. As means restriction is an important suicide prevention strategy, gaining knowledge of the common suicide methods and their changing trends in each country and region is crucial. AIMS: We aimed to assess the suicide methods in South Asian countries over the last two decades. METHODS: A search was performed in PubMed, PubMed Central, Scopus, and Google Scholar with the search terms. Original articles of quantitative studies, published in the English language, from 2001 to 2020, with full-accessible text, that rank different methods of suicide in eight South Asian countries, were included. RESULTS: A total of 68 studies were found eligible for review. The Maximum number of studies were found from India (n = 38), followed by Bangladesh (n = 12), Pakistan (n = 9), Sri Lanka (n = 6), and Nepal (n = 3). Hanging (n = 40, 55.8%) and poisoning (n = 24, 35.3%) were the two most common suicide methods reported, in that order. Hanging followed by poisoning were the commonest suicide methods in Bangladesh, India, and Pakistan while in Sri Lanka, poisoning was the preferred method to hanging. There is a decline in suicide by poisoning and an increase in suicide by hanging in Sri Lanka, Bangladesh, and India. Although hanging is still the commonest method in Pakistan, the use of firearms is growing in recent years (2011-2020). CONCLUSIONS: There is a steady decline in the incidence of suicides by poisoning following pesticide regulations in South Asian countries. However, there is heterogeneity of study methods, probable under-reporting of suicide, and lack of robust suicide data.

Indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU): A randomized controlled trial.

This study aims to assess whether 12 sessions of indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU) would reduce excessive smartphone use. A single-blind randomized controlled trial was conducted in students (12 to 19 years of age) to examine the potential beneficial effects of IACBT-ESU (n = 62) compared with brief educational data alone (n = 62). Symptoms of depression, anxiety, stress, and peer relations were also compared between the two groups. The IACBT-ESU group demonstrated significant reductions in excessive smartphone use, with reduced symptoms of depression, anxiety, stress, hyperactivity, and emotional difficulties at both trial end and at 3-month follow-up (p < .01) compared with control participants. IACBT-ESU was associated with reduced excessive smartphone use and improved psychological well-being, with beneficial findings maintained 3 months after the trial's end. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Self-esteem among eunuchs of Hazara Division, Pakistan.

Self-esteem among eunuchs is highly influenced by a variety of factors. The aim of the current study was to investigate the differences in self-esteem of eunuchs on the basis of education, income, age and marital status. The study was conducted at the University of Haripur, Pakistan, from December 2015 to November 2016. A sample of 140 eunuchs was collected from different areas of Hazara division, through purposive and snowball sampling technique. A self-esteem scale with four sub-scales was used to measure the self-esteem of eunuchs. One-way analysis of variance was used to determine education level differences. The t-test was applied to find out the impact of demographics differences such as marital status, income level, and age on self-esteem of eunuchs. The scale used was found to be quite reliable with alpha coefficient of 0.85. The outcomes are significant and showed that educated, higher income, younger and unmarried eunuchs had higher self-esteem (p<0.05).