Assessing the Mental Health of Girls in Nepal: A Study of the Impact of Societal Factors on Former Child Soldiers Conscripted into Nepal's Maoist Movement and Non-Conscripted Children Open Access

Abstract

The present study was developed to assess the mental health of young adolescent
girls in Nepal with special consideration towards young girls that were conscripted into the
Maoist Army during the 10-year civil war between the Royal Nepalese Army (RNA) and the
Maoist movement from 1996-2006. Utilizing a combined model, which incorporates the
Theory of Gender and Power, the Social Ecological Model, and Cultural Consonance, we
hope to add insight to a complex phenomenon in this population. Using multiple theories to
outline the study of mental health and society, the aim is to gain a deeper understanding of
how external factors influence individual mental health as well as provide areas for future
research among this population. This study was conducted using a cross-sectional
correlational design. Using variables related to theoretical constructs, univariate statistics,
bivariate statistics, and regressions were utilized to test relevant hypotheses. Independent
t-tests comparing mental health outcomes based on conscription status revealed that
former child soldiers experienced significantly more functional impairment, depression,
and anxiety. Regressions testing variables based on constructs of the Theory of Gender and
Power, including the Sexual Division of Labor and Sexual Division of Power were used to
explain how mental health is influenced by societal factors. The Social Ecological Model was
used to categorize variables and their relationship to the participants and understand the
influence of aggregate social groups on mental health. Mental health outcomes in this study
were then classified as the Structure of Cathexis. All three regression models predicting
each individual mental health outcome were found to be significant. This study is limited in
the capacity to make causal inferences and generalize to a larger population.
Recommendations include considering social determinants when assessing mental health
and considering the implications it has for future studies, especially with respect to the role
of women involved in political movements and their overall mental health.

Table of Contents

2

Table of Contents
INTRODUCTION ....................................................................................................................................................1
DEFINITION OF THE PROBLEM................................................................................................................................................1
JUSTIFICATION OF THE PROBLEM...........................................................................................................................................4
THEORETICAL FRAMEWORKS .................................................................................................................................................7
Cultural Consonance.........................................................................................................................................................10
Gender and Power..............................................................................................................................................................11
FORMAL STATEMENT OF PROBLEM ....................................................................................................................................14
LITERATURE REVIEW ...................................................................................................................................... 15
WOMEN IN NEPAL..................................................................................................................................................................15
YOUTH SOLDIERING AND FEMALES.....................................................................................................................................16
APPLICATIONS OF THEORY IN ASSESSING MENTAL HEALTH.........................................................................................23
SOCIAL CONSIDERATIONS TO CONSCRIPTION AND MENTAL HEALTH .........................................................................28
CASTE/RELIGION....................................................................................................................................................................29
GENDER ....................................................................................................................................................................................30
FUNCTIONAL IMPAIRMENT...................................................................................................................................................31
DEPRESSION ............................................................................................................................................................................32
ANXIETY ...................................................................................................................................................................................33
FEMALES AND COMORBIDITY...............................................................................................................................................34
HEALTH STATUS, SOMATIZATION, AND ITS RELATION TO MENTAL HEALTH ............................................................35
STUDY AIM...............................................................................................................................................................................37
HYPOTHESES ...........................................................................................................................................................................38

3
METHODS............................................................................................................................................................. 39
PARTICIPANTS.........................................................................................................................................................................39
MEASURES................................................................................................................................................................................40
Demographics Questionnaire........................................................................................................................................40
Screen for Child Anxiety Related and Emotional Disorders (SCARED--5) ..................................................40
The Birleson Depression Self--Rating Scale (DSRS)..............................................................................................41
Functional Impairment....................................................................................................................................................42
DESIGN AND PROCEDURE......................................................................................................................................................42
DATA ANALYSIS ......................................................................................................................................................................43
RESULTS ............................................................................................................................................................... 44
DEMOGRAPHICS ......................................................................................................................................................................44
CORRELATIONS .......................................................................................................................................................................46
T-TEST...........................................................................................................................................................................46
REGRESSIONS ..........................................................................................................................................................................47
DISCUSSION......................................................................................................................................................... 50
FILLING IN THE THEORETICAL FRAMEWORK WITH DATA .............................................................................................50
SIGNIFICANCE OF RESULTS ...................................................................................................................................................55
LIMITATIONS ...........................................................................................................................................................................57
PUBLIC HEALTH IMPLICATIONS...........................................................................................................................................58

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Psychology, Social Health Sciences, Mental Health
Keyword	Functional Impairment Depression Social Ecological Maoist Cultural Consonance Mental Health Nepal Gender and Power Child Soldiers Anxiety
Committee Chair / Thesis Advisor	Lang, Delia L, Emory University
Committee Members	Kohrt, Brandon A, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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