ADDIS ABABA UNIVERSITY

SCHOOL OF PSYCHOLOGY
CLINICAL, HEALTH, AND COUNSELING
PSYCHOLOGY PROGRAMS UNIT

A Comparative Study of Psychological Wellbeing between

Orphan and Non-orphan Children in Addis Ababa: The
Case of Three Selected Schools in Yeka Sub-city

Afework Tsegaye

June 2013
Addis Ababa

ADDIS ABABA UNIVERSITY

SCHOOL OF PSYCHOLOGY
CLINICAL, HEALTH, AND COUNSELING
PSYCHOLOGY PROGRAMS UNIT

A Comparative Study of Psychological Wellbeing between

Orphan and Non-orphan Children in Addis Ababa: The
Case of Three Selected Schools in Yeka Sub-city.
A THESIS SUBMITTED TO THE SCHOOL OF PSYCHOLOGY ADDIS ABABA
UNIVERSITY IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
DEGREE OF MASTER OF ARTS IN COUNSELING PSYCHOLOGY

By

Afework Tsegaye

June, 2013
Addis Ababa

ADDIS ABABA UNIVERSITY

SCHOOL OF PSYCHOLOGY
CLINICAL, HEALTH, AND COUNSELING
PSYCHOLOGY PROGRAMS UNIT

A Comparative Study of Psychological Wellbeing between

Orphan and Non-orphan Children in Addis Ababa: The
Case of Three Selected Schools in Yeka Sub-city

By
Afework Tsegaye

APPROVED BY:
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Graduate Committee
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Advisor

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Examiner, Internal

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Acknowledgement

I would like to express my gratitude of all who generously gave their time, energy and
knowledge in helping me while understanding this research. Without the contribution of
these people the study could not have come to completion.

First and foremost, I would like to express my deepest gratitude to Ato Daniel Tefera and
Ato Teshwal Ashagrie my thesis advisors, for their efforts in providing me with relevant
advice, critical comments and constructive suggestion throughout the course of my thesis
work.

Further, this study could not have been concluded without the deep love and the real
commitment of my best friends Engida Sisay, Eyosiyas Yilma, Henok Senay, Natnael
Terefe. Furthermore, I want to express my deepest love, acknowledgment, and appreciation
to my beloved family: for their love, support and wisdom; without them I never could have
made it this far.

It also want to extend my deepest gratified to the study participants for providing me with
invaluable information without any kind of inhabitations.

Table of Contents
Acknowledgement.....i
Table of contents..ii
Appendices..iv
Acronyms..........v
List of tables....vi
Abstract...........vii
CHAPTER ONE: INTRODUCTION
1.1. Background........1
1.2. Problem Statement....................6
1.3.

Objective..................8
1.3.1. General objective ...8
1.3.2. Specific objective 9

1.4. Significance of the study .9

1.5. Limitation of the study ..10
1.6. Definition of important terms.10

CHAPTER TWO: REVIEW OF RELATED LITERATURE

2.1. Conception of psychological wellbeing .12
2.1.1. Meaning of psychological wellbeing 14
2.1.2. Component of psychological wellbeing ...15
2.1.3. Measuring of psychological wellbeing .18
2.1.4. Demographic variable and psychological wellbeing .21
2.2. Problem and challenges of orphans ...23
2.3. Major psychological problems and manifestations of orphans .26
2.4. Empirical Quantitative studies on orphans and vulnerable children in different countries
of the world .28
2.5. Summary of review literature 34

ii

CHAPTER THREE: METHODS

3.1 Research design ..36
3.2. Study Area and Target Population .37
3.3. Sampling.37
3.4. Inclusion and exclusion criteria for the Children Sample ..39
3.5. Research variable ...39
3.5.1. Independent variable 39
3.5.2. Dependent variable...39
3.6. Data collecting instrument .........39
3.6.1 Demographic Questionnaire .39
3.6.2. Psychological wellbeing scale .39
3.6.3. Semi-structured interview guide ..41
3.7. Pilot testing 42
3.8. Data collection procedure ..42
3.9. Ethical Considerations43
3.10. Data analysis 43
CHAPTER FOUR: RESULTS
4.1. Background Information of Study Subjects ...45
4.2. Descriptive Summary of Psychological Wellbeing among Orphan and Non-orphan
Children..48
4.3 Status of psychological wellbeing of orphan and non-orphan children ..49
4.4. Difference in psychological well-being between orphan and non-orphan children ..52
4.5. Psychological well-being and demographic factors ..55
CHAPTER FIVE: DISCUSSIOND
CHAPTER SIX: SUMMARY, CONCLUSION AND RECOMMENDATIONS
6.1 Summary .61
6.2 Conclusion ..62
6.3 Recommendations ...62
References.64

iii

APPENDICES

Appendix-A Demographic data questioner and Ryffs psychological wellbeing scale (Amharic
version)
Appendix-B Demographic data questioner and Ryffs psychological wellbeing scale (English
version)
Appendix- C Interview guide line (English version)
Appendix-D Interview guide line (Amharic version)

iv

ACRONYMS

AIDS:

Acquired immunodeficiency syndromes

AU:

Autonomy

CSA:

Central Statistics Authority

DHS:

Demographic and Health Survey

EM:

Environmental mastery

EMOH:

Ethiopian ministry of health

HIV:

Acquired immunodeficiency virus

MOLSA:

Ministry of Labour and Social Affairs

NGO:

Non-governmental organisation

OVC:

Orphans and vulnerable children

PG:

Personal growth

PL:

Purpose in life

PR:

Positive relations with others

SA:

Self-acceptance

PWB:

Psychological Well-Being

UN:

United Nations

USAID:

United Nations Program for HIV and AIDS

UNAIDS:

United Nations Agency for International Development

UNICEF:

United Nations Children Education Fund

WHO:

World Health Organisation

LIST OF TABLES

Table 1: Demographic characteristics of study subject ...46

Table 2: Respondent characteristics on parental status ...47
Table 3: Summary statistics of the total and sub-scales of psychological well-being for
orphan and non-orphan children ...48
Table 4: Summary result of the status of psychological well-being of orphan
children........50
Table 5:- Summary result of the status of psychological well-being of nonorphan51
Table 6: Independent sample t-test for difference in psychological wellbeing between
orphan and non-orphan children 53
Table 7: Correlation between psychological well-being and demographic measures .56

vi

Abstract
The general objective of this study was to compare the psychological well-being of orphan
and non-orphan children in Addis Ababa and to explore the conditions or situation that
could promote the psychological wellbeing for the orphan. Both quantitative and qualitative
methods were employed to achieve the research objectives. Three groups of respondents,
recruited from three randomly selected schools in Yeka Sub-city of Addis Ababa,
participated in the study. The participants were: 120 orphan children, 120 non-orphan
children, and 3 representatives of charity clubs in the selected schools. The orphan and
non-orphan children were selected using systematic random sampling technique while the
three representatives were purposively taken as a sample. A demographic questionnaire, a
psychological wellbeing scale and interviews instruments was administered. Data from the
quantitative survey were analysed using percentages, t-test, and Pearson correlation. The
qualitative data were analysed using inductive thematic analysis. Using mean split
technique on the psychological wellbeing scores of orphan and non-orphan children,
orphan had low psychological wellbeing whereas the non-orphan had high psychological
wellbeing. T-test for group mean difference on psychological wellbeing revealed that
orphans were found to have a significantly lower psychological wellbeing as compared to
the non-orphan children. Results from Pearson correlation analysis revealed that grade
level was significantly and positively correlated with psychological wellbeing whereas
parental status was significantly and negatively correlated with psychological wellbeing.
Gender and age were not significantly related with psychological wellbeing. From the
analysis of the qualitative data, encouraging the orphans individuality and autonomy and
enhancing their self-esteem, and respect and care by adults were identified as the major
themes that could promote orphan childrens sense of well-being.

vii

CHAPTER ONE
INTRODUCTION
1.1. Background
Orphans frequently lack sufficient food, shelter, schooling and medical care and
are at risk of abuse and economic exploitation (Berry and Guthrie, 2003). Most research
work on orphan concentrates on basic need. There is little available research, but increasing
concern, regarding the psychological well-being of orphans in Africa (Cluver and Gardner,
2006).
HIV AIDS have been one of the severest clinical and public health problems ever
faced by human being. The epidemic has caused a substantial increase with mortality
among adults during reproductive ages (Porter and Zaba, 1986; Blacker, 2004) and as a
consequence, rising numbers of children are orphaned by AIDS (Monasch and Boerma,
2004). Despite AIDS being a major reason for stigmatization and discrimination, orphan
children are being discriminated based solely on their status as orphans (Subbarao,
Mattimore, and Plangemann, 2001).
Globally, an orphan is defined by international organizations based on age and
parental status. According to (UNAIDS, USAID AND UNICEF, 2002) an orphan is defined
as a child less than 15 years of age who has lost its mother. Recently, however, it changed
its definition to cover the loss of both parents and to include children below 18 years of age
(UNAIDS, 2004). In Ethiopia, most Governmental and non-governmental organization are
using this definition the concept. The Amharic words equivalent to the word orphan are
Yemut Lij or Wolaaj Alba
From 2001 to 2003, the global number of AIDS orphans has increased from 11.5 to
15 million. Although Africa is proportionally the region hardest hit by HIV AIDS, the
1

number of orphans is largest in Asia due to much larger populations (UNAIDS, UNICEF
and USAID, 2004). The recent report on orphans and vulnerable children (OVC) by the
United States of Government (USG) and partners estimated that, in 2008, 163 million

children (age 017 years) across the globe were orphans (referring to loss of one or both
parents to all causes) and that 17.5 million of these children lost one or both parents to
AIDS (USG, 2009). The global figure of 17.5 million orphans as a consequence of AIDS
represents an increase from the 2007 estimate of 15 million AIDS-related orphans
(UNAIDS, 2010). Almost 14.94 million children orphaned by AIDS live in sub-Saharan
Africa (UNAIDS, 2010).
Ethiopia has OVC burden, with almost 5.4 million orphans, with around 15% of
these believed to have been orphaned as a result of HIV/AIDS (EMOH, 2007). The majority
of children orphaned as a result of HIV/AIDS are in Amhara (39%), Oromia (22.4%) and
SNNPR (14.1%) and the remaining causes of orphan hood and vulnerability are due to food
insecurity, poverty, conflict, natural disasters, malaria, and other infectious diseases
(PEPFAR, 2012). According to the 2011 Ethiopian Demographic and Health Survey,
Seventy-two per cent of children under the age of 18 live with both parents; 14 per cent live
with their mothers but not their fathers; 3 per cent live with their fathers alone; and 11 per
cent live with neither of their natural parents and also 18 per cent of households are cared
by an orphan (EDHS, 2012).
The impacts of parental death on children are complex and affect the childs
psychological and social development. Fredriksan and Kandous (2004) state that, orphaned
children might have stunted development of emotional intelligence, and life skills such as
communications, decision making, negotiation skills etc.. Moreover, they often show lack
of hope for future and have low self-esteem (Kedija, 2006).

Evidence on the health status of OVC is less clear, however; a cross-sectional study
in urban Uganda found no differences between orphans and non-orphans in reported
treatment-seeking behavior and in anthropometric measures (Sarker, Neckermann and
Muller, 2005). Comparing orphans and non-orphans living in the same households in a
rural area of South Africa, Parikh, Desilva, Cakwe, Quinlan, et al. (2007) found no
significant health disadvantage for orphans on a series of wellbeing indicators. A study in
rural western Kenya similarly compared several health and nutritional indicators (including
fever, malaria, history of illness, anemia, and stunting) for orphaned and non-orphaned
children under age 6 and concluded that orphaned children are at no greater risk of poor
health than non-orphaned children (Lindblade, Odhiambo, Rosen, and DeCock, 2003)
although orphans were somewhat more likely to be wasted than non-orphans (USAID,
2008).
The losses of the parents continue to affect the childrens developmental stages. For
example, a study conducted in Zambia by Family Health International (2003) on 788
orphans concerning their emotional well-being revealed that orphans often had scary
dreams or nightmares while other were sometimes unhappy. In addition, the study find out
that some were sometimes, or often, fighting with other children, desired to be alone and
often were worried.
A study conducted in Ethiopia by Ministry of Labour and Social Affairs (2003)
revealed that the score for emotional adjustment level of AIDS orphans was lower than that
of the non-AIDS orphans. According to MOLSA, this low level of emotional adjustment
among AIDS orphans was reflected in the degree of unhappiness, worry, low level of
patience, fatigue, depression and feeling of hopelessness and pessimism among AIDS
orphans. Another study which dealt with the psychological distress of non-ADIS and ADIS
orphan adolescent in Addis Ababa concluded that large proportion of orphan adolescents

are having psychological problems that can affect their present and future life ( Hiwot,
Fentie, Lakew and Wondoesn, 2011).
Children whose parents are ill because of HIV/AIDS or those who have been orphan
by the disease face stigma and discrimination; they may be rejected by their friends and
school mates, as well as at health centre. Studies of HIV-infected mothers have shown high
levels of depression linked to their diagnosis and AIDS-related illness, which may impact
on childrens mental health both directly and via reduced parenting capacity (Cluver, Orkin,
Boyes and Gardner, 2012)
In general, the long term effects of orphan-hood to be negative. These children are at
an increased risk for suffering from malnutrition, poor physical and mental health, as well
as being at risk for stigmatization and exploitation and also orphans are at a high risk for
contracting HIV themselves as a result of maternal transmission, prostitution, and sexual
exploitation, many orphans are forced to drop out of school for financial reasons this would
hinders their future opportunities for jobs and economic growth (Brown and Sittitrai, 2005;
UNICEF, 2006). The effects of malnutrition and poor health are far reaching. In addition to
potentially causing early death, they can also lead to low educational achievement and
productivity because malnutrition can lead to delayed intellectual development (Brown and
Sittitrai, 2005; UNICEF, 2006).
In Africa most of researcher focusing orphaned children health and nutritional issues
only few studies mention psychological aspects of orphan child for example in Dar-esSalaam, Tanzania, Makame, Ani and

Grantham-McGregor (2002) found adverse

psychological consequences of orphan hood, such as anxiety, sense of failure, pessimism,

and suicidal tendency, in Uganda Atwine, Cantor-Graae and Bajunirwe (2005) found
much higher levels of anxiety, depression and anger among orphans than among nonorphans, in Rwanda Thurman, Brown, Richter, Maharaj and Magnani (2006) found that

orphans living in youth-headed households were significantly more likely than those in
adult-headed households to report emotional distress, depressive symptoms and social
isolation and in rural Zimbabwe, Nyamukapa, Gregson, Lopman, Saito, Watts, Monasch,
& Jukes (2007) found that orphans had significantly higher psychosocial distress than nonorphans (USAID, 2008)
Most of studies revealed that orphans suffer higher level of psychosocial problems
than their non-orphan peers. In particular, maternal and double orphans are more likely to
experience behavioural and emotional difficulties, suffer abuse and low rate of trusting
relationships (Baaroy and Webb, 2008; Mikang, 2008; Qunzhao, 2010). It has also been
reported that orphans are more likely to suffer from behavioural or conduct problems and
report suicidal thoughts than non-orphans (Cluver, Gardner & Operario, 2007; Cluver &
Gardner, 2006).
In general, Orphan children seem socially deprived and they tend to encounter
higher emotional distress, hopelessness, and frustration than non-orphans (Mbozi, Debit,
and Munyati, 2006). Most orphans may be distressed by their new circumstance that may
require them to cater for themselves and/or assume care-giving responsibility for their
younger ones Sexual abuse (Pridmore and Yates, 2005) and social discrimination (Cluver,
Gardner, and Operario, 2008; Nyambedha, Wandibba and Aagaard-Hansen, 2003) against
orphan haven reported.
To date, research on orphan is focused on the health and nutritional status (e.g.
Panpanich, 1999), treatment-seeking behavior and in anthropometric measures (Sarker et
al., 2005), socio-economic problems (Case, Paxson and Ableidinger, 2002), psychological
wellbeing of institutionalized orphan children (Laurg, 2008), mental health problems
(Cluver and Gardner, 2006), the psychological effect of orphan-hood ( Sengendo and
Nambi, 1997), psychosocial and developmental status (Nagy and Amira, 2010),

psychosocial wellbeing of OVC (Grace, 2012), psychological well-being and socioeconomic hardship among AIDS orphans and other vulnerable children (Delva, Vercoutere,
Loua, Lamah et al., 2009), and the psychosocial well-being of teenaged orphans (Gumed,
2009). In Ethiopia emotional adjustment among AIDS orphans and the psychological
distress of non-ADIS and ADIS orphan adolescent had been studied (MOLSA, 2003;
Hiwot, Fentie, Lakew and Wondoesn, 2011). The status of the psychological well-being of
Ethiopian orphan is not explored. Therefore, the focus of the present study is to fill this gap
in research.

1.2. Statement of the problem

In Ethiopia, the lives of orphans and working children (Tatek, 2008) and the
psychological distress and its predictors in AIDS orphan adolescents (Hiwot, et al., 2011)
were studied. Overall, in most studies little attention has been given to the psychological
wellbeing of orphan in Ethiopia.
Orphans and vulnerable children (OVC) continue to maintain a spot at the forefront
of the international agenda with millions of children worldwide being orphaned or made
vulnerable by HIV/AIDS and with the numbers of projected to increase in the next decade
(UNAIDS, 2004). Large and growing numbers of OVC children are a worldwide concern;
Whereas sub-Saharan Africa has the highest proportion of children who are orphaned,
where more than one in seven children are orphaned (UNAIDS, UNICEF, & USAID,
2004). Orphan children may face many hardships during childhood including a decline in
health, nutrition, and psychological well-being (Laura, 2008).
Orphan-hood is frequently accompanied with multidimensional problems including
prejudice, school services, inadequate food, sexual abuse and others that can further expose
childrens prospects of completing school. Moreover, the death of one or both parents has a
profound and lifelong impact on the psychological wellbeing of children. Children and
6

adolescents in particular are at increased risk for unresolved or complicated bereavement

because of their developmental vulnerability and emotional dependency. Being an AIDS
orphan may further place them at heightened risk of prolonged mental problems (Hiwot et
al., 2011).
Quite recently there has been a growing international interest in research on orphans
(Pivnick and Villegas, 2000; Forehand, Steele,
Operario, 2006; Cluver

Gardner, and

Armistead et al., 1998; Gardner and

Operario, 2007; Atwine, Cantor-Graae, and

Bajunirwe, 2005; Andrews, Skinner and Zuma, 2006; Doku, 2009; Earls, Raviola and
Carlson, 2008; Wild, Flisher, Laas, and Robertson, 2006) because of the realization that
parental death is a risk factor for psychological distress (Bauman and German, 2005).
The number of children experiencing orphan-hood is increasing at an alarming rate.
Although specific data on the number of orphans are highly inconsistent, most of this
increase is explained by HIV/AIDS-induced adult mortality. The impact of the HIV/AIDS
epidemic in creating a burden of care of orphans for the traditional family structure is well
documented in a handful of culture-specific studies (e.g. Foster, 2000; Hunter, 1990; Oleke,
Blystad, Moland, Rekdal and Heggenhougen, 2006).
The consequences of the HIV epidemic in Ethiopia are seen in the eyes of children
who have lost one or both of their parents, traumatized by events beyond their control and
understanding. These children are often stigmatized by relatives and rejected by
communities which tend to think that caring for a child orphaned by AIDS is a lost
investment. Millions of children have lost their childhood. They live on the streets and are
forced to endure countless humiliations in order to meet their basic needs like clothing and
food. Other children are forced to become heads of households; yet without the necessary
resources, they abandon school and the opportunities that come with it.

The Ethiopian literature on psychological wellbeing orphan children is very small.

The limited research that has been carried out focused on HIV orphans who suffer from
particular social and economic disadvantages and mental health problems. Although
orphaned children seem to attract the attention of researchers GOs and NGOs in Ethiopia,
much of the attempt are on the economic needs of children not on the psychosocial
problems affecting their wholesome development. Few exceptions, of course, could be cited
which have recently conducted local surveys in Addis Ababa and elsewhere. Among these,
Belay and Belay (cited in Desalegn, 2006) conducted a psychosocial survey of orphaned
and vulnerable children, their family and communities in both rural and urban settings. It
explicitly found out the psychosocial situations of orphaned children before, during and
after parental death and the support and care they get from all levels on the other hand,
Tedla (2005) witnessed the prevalence of stigma and discrimination against AIDS orphans.
Study on the psychological wellbeing of orphan children in Ethiopia is lacking.
Thus, this study explores the psychological well-being of the orphan and compares
their psychological well-being with that of non-orphans, and examines if socio demographic
backgrounds associate with the psychological well-being of the orphan children.

1.3. Objective of the study

1.3.1 General objective
This study explores the psychological wellbeing orphan to compares the status of
their psychological well-being with non-orphan children in Addis Ababa Yeka sub-city.

1.3.2 Specific objective

The study more specifically addresses the following specific objectives:
1. Explore the status of the psychological well-being of orphan and non-orphan
children.
2. Compares the status of psychological wellbeing of orphan and non-orphan children.
3. Examines the association between socio demographic variables (age difference,
gender difference, educational level and having or loss of parent) and psychological
well-being of orphan children.
4. Explores the psychological and social conditions or situation that could promote the
psychological wellbeing of orphan children.

1.4. Significance of the study

The results of the study are believed to be helpful in the following ways:
The study assesses the status and comparing the psychological well-being of
orphan and non-orphan children. As a result, the concerned bodies, policy makers, schools,
family, governmental and non-governmental organization will work together on orphans or
strengthen the existing programs in order to increase the psychological well-being of orphan
children. This research is important for those involved in therapy and in counselling to
identify children who are at low level of psychological wellbeing and to develop and
improve prevention and intervention methods for orphans. The finding of this study will
also provide important direction for conducting further research in the areas of
psychological wellbeing and mental health of orphans.

1.5. Limitations of the study

The data collected for this study was based on self-reported scale that was provided
by children targeted by the study. Therefore, there is some potential reporting bias which
may have occurred because of respondents interpretation of the questions or desire to
report their emotions in a certain way or simply because of inaccuracies of responses.

1.6. Definition of important terms

Psychological well-being:- individual meaningful engagement in life, selfsatisfaction, optimal psychological functioning and development at ones true highest
potential. It has six dimensions that are autonomy, environmental mastery, personal growth,
positive relationship with other, purpose in life and self-acceptance of individuals (Ryff,
1989).
Autonomy: the extent to which childrens view themselves as being independent
and able to resist social pressures
Environmental mastery: the extent to which childrens feel in control of and able
to act in the environment
Personal growth: the extent to which childrens have a sense of continued
development and self-improvement.
Positive relations with others: the extent to which childrens have satisfying,
trusting relationships with other people.
Purpose in life: the extent to which childrens hold beliefs that give life meaning
Self-acceptance: the extent to which childrens have a positive attitude about
themselves.

10

Orphan children:-A child under 18 years of age whose mother, father or both
parents have died from any cause (UNICEF, 2006). Orphans from all causes can be more
specifically described as follows:
Single orphan: - A child who has lost one parents.
Double orphan: - A child who has lost both parents
Maternal orphan: - A child whose mother has died (including double orphans)
Paternal orphan: - A child whose father has died (including double orphans

11

CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.1. Conception of psychological well-being

Throughout human history, normative understandings of well-being have defined

particular human characteristics and qualities as desirable and worthy of pursuit or
emulation (Taylor, 1989). Such normative understandings are represented by traditional
philosophies and religions that often stress the cultivation of certain virtues (Diener, 1984).
In contemporary Western society, these norms are largely provided by
philosophies of psychological well-being. Psychological well-being is among the most
central ideas in counseling. It plays a crucial role in theories of personality and development
in both pure and applied forms; it provides a baseline from which we assess
psychopathology; it serves as a guide for clinical work by helping the counselor determine
the direction clients might move to alleviate distress and find fulfillment, purpose, and
meaning; and it informs goals and objectives for counseling-related interventions
(Christopher, 1999).
Psychologists and health professionals (Campbell, 1981; Deci and Ryan, 2008)
have studied well-being extensively. While the distinct dimensions of well-being have been
debated, the general quality of well-being refers to optimal psychological functioning and
experience. Two broad psychological traditions have historically been employed to explore
well-being.
The Eudaimanic is deriving from ancient Greek philosophy notably the work of
Aristotle and were later championed by mills among other. Eudaimanic measures
emphasishuman flourishing literally eu (wellbeing or good) and Daimonia (demon or
sprit) and virtuous action, which is argued to be not always congruent with happiness or

12

satisfaction, but to reflect a broader and multi-factored set of need. Hedonic measures
follow the criteria of maximizing pleasure and avoiding pain an approach dating back to
ancient Greek philosophy that found later expression in the work of Bentham and his
followers (OPHI, 2007). Ryff and Singer (1998) define eudaimonia as the idea of striving
towards excellence based on ones own unique potential.
The hedonic view equates well-being with happiness and is often operationalized
as the balance between positive and negative affect (Ryan and Deci, 2001). The eudaimonic
perspective, on the other hand, assesses how well people are living in relation to their true
selves (Waterman, Schwartz, and Conti, 2008; Ryff, 1989). There is not a standard or
widely accepted measure of either hedonic or eudaimonic well-being, although commonly
used instruments include Bradburns Affect Balance, Neugartens Life Satisfaction Index,
Ryff psychological wellbeing scale, Rosenbergs self-esteem scale, and a variety of
depression instruments (Ryan and Deci, 2001).
Recent years have witnessed an exhilarating shift in the research literature from an
emphasis on disorder and dysfunction to a focus on well-being and positive mental health.
This paradigm shift has been especially prominent in current psychological research but it
has also captured the attention of epidemiologists, social scientists, economists, and policy
makers (Huppert, 2005). This positive perspective is also enshrined in the constitution of
the World Health Organization, where health is defined as a state of complete physical,
mental and social well-being and not merely the absence of disease or infirmity (WHO,
1948). More recently, the WHO has defined positive mental health as a state of well-being
in which the individual realizes his or her own abilities, can cope with the normal stresses of
life, can work productively and fruitfully, and is able to make a contribution to his or her
community (Huppert, 2009).

13

2.1.1. Meaning of psychological wellbeing

Psychological well-being is perhaps the most widely used construct among

psychologists and mental health professionals. However, there is still no consensus
regarding the operational definition of this construct (Khan and Juster, 2002). Yet, many
theories of well-being have been proposed and an extensive body of empirical research
using different indices of this construct has been conducted. However, theorists have found
that the concept of psychological wellbeing (PWB) is much more complex and
controversial. Practically speaking, psychological wellbeing serves as an umbrella term for
many constructs that assess psychological functioning (Girum, 2012).
Psychological well-being is about lives going well. It is the combination of feeling
good and functioning effectively. Sustainable well-being does not require individuals to feel
good all the time; the experience of painful emotions (e.g. disappointment, failure, grief) is
a normal part of life, and being able to manage these negative or painful emotions is
essential for long-term well-being. Psychological well-being is, however, compromised
when negative emotions are extreme or very long lasting and interfere with a persons
ability to function in his or her daily life (Huppert, 2009).
Ryffs (1989) defined well-being is the optimal psychological functioning and experience.
Shek (1992) defines psychological well-being as that state of a mentally healthy person
who possesses a number of positive mental health qualities such as active adjustment to the
environment and unity of personality
Dzuka and Dalbert (2000) defined psychological well-being is the overall
satisfaction and happiness or the subjective report of ones mental state of being healthy,
satisfied or prosperous and broadly to reflect quality of life and mood states.

14

Deci and Ryan (2008) defined Psychological well-being refers to living life in a
full and deeply satisfying manner. This conceptualization maintains that well-being is not so
much an outcome or end state as a process, and is concerned with living well or actualizing
ones human potentials.
2.1.2. Component of psychological well being

Ryff (1989) critiqued research on subjective well-being for what she saw as its
impoverished theoretical basis. She acknowledged that current approaches to subjective
well-being have been extensively evaluated and that psychometrically solid measures have
been constructed (Christopher, 1999).
Ryff (1989) developed an alternative approach to well-being that she refers to as
psychological well-being. Synthesizing ideas from the personality theories of Malsow,
Jung, Rogers, Allport, Erikson, Buhler, Neurgartens, and Jahoda, she constructed a measure
of well-being around six subscales: Autonomy, Environmental Mastery, Positive Relations
with Others, Purpose in life, Personal Growth, and Self-Acceptance.
Autonomy

Ryff (1989) equates autonomy with attributes such as self-determination,

independence, internal locus of control, individuation, and internal regulation of behavior.
Underlying these attributes is the belief that ones thoughts and actions are ones own and
should not be determined by agencies or causes outside ones control. The fully functioning
person is described as having an internal locus of evaluation, whereby one does not look to
others for approval, but evaluates oneself by personal standards (Ryff and Singer, 1996).
Most orphans are at risk of being confronted by powerful cumulative and often
negative social changes in their lives over which they have no personal control. Experiences
in continuously adverse circumstances do not make life appear to be subject to control
15

through a person's own efforts (Cilliers, 1998). Perceived lack of control produces a feeling
of helplessness and loss of hope, and diminishes an individual's will power (Tsihoaane,
2006).

Environmental Mastery
Ryffs (1989) defined environmental mastery as the ability to choose or create
environments that is suitable to whom they are as a person, as well as the ability to be
flexible in various environmental settings.
Maturity is seen to require participation in a significant scope of activity outside of
oneself. Life-span development is described as requiring the ability to manipulate and
control complex environments and also one's ability to advance in the world and change it
creatively through physical or mental activities. These active participation in and mastery of
the environment are key ingredients in an integrated framework of positive psychological
functioning (Ryff and Singer, 1998).

Positive Relations with Others

Ryff (1989) defined positive relations with others as warm, trusting interpersonal
relations and strong feelings of empathy and affection. At first glance this subscale/criterion
seems most sympathetic to or compatible with collectivism. However, there is a significant
difference between having relations with others and being psychologically constituted by
ones location in a social network (Christopher, 1999)
Many of the preceding theories emphasize the importance of warm, trusting
interpersonal relations. The ability to love is viewed as a central component of mental
health. Self-actualizers are described as having strong feelings of empathy and affection for
all human beings and as being capable of greater love, deeper friendship, and more

16

complete identification with others. Warm relating to others is posed as a criterion of

maturity (Ryff and Singer, 1996). Orphans who do not establish a supportive relationship
with their care given are unable to create new components and risk for poor psychological
adjustment (Kodero, 2000).

Purpose in Life
Ryff (1989) suggested that having a clear comprehension of lifes purpose, a sense
of directedness, and intentionality are important parts of the feeling that there is purpose and
meaning to life. One who functions positively has goals, intentions, and a sense of direction,
all of which contribute to the feeling that life is meaningful (Ryff and Singer, 1996).

Personal Growth
Ryff (1989) defined personal growth as the continuing ability to develop ones
potential, to grow and expand as a person. Openness to experience, for example, is a key
characteristic of the fully functioning person. Such an individual is continually developing,
rather than achieving a fixed state wherein all problems is solved. Life-span theories also
give explicit emphasis to continued growth and to facing new challenges to tasks at
different periods of life (Ryff and Singer, 1996).
The dimension of personal growth parallels Aristotelian conceptions of human
excellence, human flourishing, and the realization of one's true potential (waterman, 1993).
Eudaimonistic accounts of ethics and the good life in fact, to the imperative to know oneself
(one's daimon) and to choose to turn it, as completely as possible, from an ideal to an
actuality (Ryff and Singer, 1996).

17

Self-Acceptance

Ryff (1989) maintained that holding positive attitudes toward oneself emerges as a
central characteristic of positive psychological functioning. This is defined as a central
feature of mental health as well as characteristic of self-actualization, optimal functioning,
and maturity. Life span theories also emphasize acceptance of one's self and one's past life.
Thus, holding positive attitudes toward oneself emerges as a central characteristic of
positive psychological functioning (Ryff and Singer, 1996). Ideas of self-love, self-esteem,
and self-respect are also evident in lists of criteria goods showing parallels to selfacceptance.

2.1.3. Measuring of psychological well being

The main strands of the literature on psychological and subjective wellbeing focus
on Eudaimonic, hedonic and mental health measures, respectively. Equating well-being
with hedonic pleasure or happiness has a long history. Aristotle, a Greek philosopher from
the fourth century B.C., taught that the goal of life is to experience the maximum amount of
pleasure, and that happiness is the totality of ones hedonic moments. His early
philosophical hedonism has been followed by many others. Hobbes argued that happiness
lies in the successful pursuit of our human appetites, and De Sade believed that pursuit of
sensation and pleasure is the ultimate goal of life. Utilitarian philosophers such as Bentham
argued that it is through individuals attempting to maximize pleasure and self-interest that
the good society is built. Hedonism, as a view of well-being, has thus been expressed in
many forms and has varied from a relatively narrow focus on bodily pleasures to a broad
focus on appetites and self-interests (Ryan and Deci, 2001). Psychologists who have

18

adopted the hedonic view have tended to focus on a broad conception of hedonism that
includes the preferences and pleasures of the mind as well as the body (Kubovy, 1999).
There are many ways to evaluate the pleasure/pain continuum in human
experience; most research within the new hedonic psychology has used assessment of
subjective well-being (SWB) (Diener and Lucas, 1999). SWB consists of three components:
life satisfaction, the presence of positive mood, and the absence of negative mood, together
often summarized as happiness (Ryan and Deci, 2001).
There are same philosophical arguments about equating hedonic pleasure with
well-being; there has been considerable debate about the degree to which measures of SWB
adequately define psychological wellness (e.g. Ryff and Singer, 1998). Accordingly, there
are two important issues concerning the hedonic position in research on well-being. One
concerns the validity of SWB and related measures as operational definitions of (a)
hedonism and/or (b) well-being. The other concerns the types of social activities, goals, and
attainments theorized to promote well-being; however it is assessed (Ryan and Deci, 2001).
The term Eudaimonia is valuable because it refers to well-being as distinct from
happiness perse. Eudaimonic theories maintain that not all desires, not all outcomes that a
person might value would yield well-being when achieved. Even though they are pleasure
producing, some outcomes are not good for people and would not promote wellness. Thus,
from the Eudaimonic perspective, subjective happiness cannot be equated with well-being
(Ryan and Deci, 2001).
Waterman (1993) stated that, whereas happiness is hedonically defined, the
Eudaimonic conception of well-being calls upon people to live in accordance with their
daimon, or true self. He suggested that Eudaimonia occurs when peoples life activities are
most congruent with deeply held values and are holistically or fully engaged. Under such
circumstances people would feel intensely alive and authentic, existing as whom they really

19

area state Waterman labeled personal expressiveness (PE). Empirically, Waterman showed
that measures of hedonic enjoyment and PE were strongly correlated, but were nonetheless
indicative of distinct types of experience. For example, whereas both PE and hedonic
measures were associated with drive fulfillments, PE was more strongly related to activities
that afforded personal growth and development, furthermore, PE was more associated with
being challenged and exerting effort, whereas hedonic enjoyment was more related to being
relaxed, away from problems, and happy(Ryan and Deci, 2001).
Ryff and Singer (1998) have explored the question of well-being in the context of
developing a lifespan theory of human flourishing. Also drawing from Aristotle, they
describe well-being not simply as the attaining of pleasure, but as the striving for
perfection that represents the realization of ones true potential (Ryff, 1995). (Ryff and
Keyes, 1995) thus spoke of psychological well-being (PWB) as distinct from SWB and
presented a multidimensional approach to the measurement of PWB that taps six distinct
aspects of human actualization: autonomy, personal growth, self-acceptance, life purpose,
mastery, and positive relatedness. These six constructs define PWB both theoretically and
operationally and they specify what promotes emotional and physical health (Ryff and
Singer, 1998). They have presented evidence, for example, that Eudaimonic living, as
represented by PWB, can influence specific physiological systems relating to
immunological functioning and health promotion.
PWB is measured through different assessment devices such as self-reported
questionnaire, informant reports memory measures, interview, behavioral observation and
biological measures. Taken together these measures provide a more accurate assessment of
PWB (Girum, 2012).

20

2.1.4. Demographic variable and psychological well being

Among the general population, gender differences in psychological functioning

and health are well documented (Dekker et al., 2007). During childhood, the prevalence of
psychiatric disorders is significantly higher in boys, while in adulthood, women have twice
the risk of depression compared to men (Strunk, Lopez and De Rubeis, 2006). In Africa
gender plays an important role in the socio-cultural set up of families and societies.
Parenting practices, socialization, roles and expectations differ according to the sex of the
child. This makes investigation into gender difference among orphans on psychological
distress critical (Dahlback, 2008). Compared to girls, orphaned boys were found to show
lower self-awareness and to perform more poorly at school (He and Ji, 2007 and Rutter,
2008).
Demographic characteristics also show some differential effects for wellbeing and
ill-being. Women have substantially higher rates of symptoms (or diagnosis) of common
mental disorders such as anxiety and depression than men, but the effect of gender is much
less clear when it comes to mental well-being. Most large surveys showed little evidence of
gender differences (e.g. Donovan and Halpern, 2002; Helliwell, 2003). Some showed higher
scores for men (e.g. Stephens, Dulberg, and Joubert, 1999), while others showed higher
scores for women on some sub-scales such as those assessing social functioning (e.g. Ryff
and Singer, 1998).
Girls tend to suffer from more emotional difficulties, whereas boys tend to have
more behavioral problems. For example, depression increases from the early teens to the
mid-twenties for both girls and boys (Kessler, Avenevoli and Merikangas, 2001), but girls
show larger increases than boys during this period (Hankin, Abramson, Moffitt, Silva,
McGee and Angell, 1998). Boys however, tend to show a greater increase in their
engagement in problem behaviors than girls (Bongers, Koot, Van der Ende and Verhulst,
21

2004), although behavioral problems often peak in early to middle adolescence and then
decline in later adolescence for both genders (Hirschi and Gottfredson, 1983). This gender
difference may be due, in part, to the way in which boys and girls react to stressful periods
and traumatic events. Boys are more likely to externalize their behaviors by acting up,
whereas girls tend to internalize their problems, leading to depression, anxiety and other
psychological problems (Gutman, Brown, Akerman and Obolenskaya, 2010).
A study among US college samples showed gender difference in depression scores,
with women reporting more frequent experience of depression. While women showed to be
as happy as the men in the study of Fujita, Diener and Sandvik (1991) a more recent study
however showed similarity in the experience of affect between males and females (Gutman
et al., 2010).
Contrasting findings same components of psychological well-being between the
genders were also noted. Previous researches claim the distressingly low self-esteem among
female than men however, recent researches report that gender difference in self-esteem
ranged only from small to medium effect sizes (Perez, 2012). Autonomy was also found to
be different between the genders where boys showed higher autonomy than girls and was
associated with greater parental disobedience and also earlier study, women showed higher
score in personal growth than men (Ryff, Lee, Essex, and Schmutte, 1994). In a later study,
no difference was found in personal growth between the genders (Ryff and Keyes, 1995).
Likewise, there was also no difference between the boys and girls in environmental mastery
(Ryff and Keyes, 1995).
According to Perez (2012) females are significantly higher scores in the aspects of
daily spiritual experience, relationship with father, relationship with peer, positive
relationship with others and purpose in life, male in other side highly scores autonomy than

22

their female and there is no significant gender difference in terms of environmental mastery,
personal growth and self-acceptance (Perez, 2012).
According to the statistical report on the Health of Canadians (1994/95) three
indicators of Psychological well-being were assessed across a wide range of ages in the
population the three measures used were high self-esteem, high mastery and high sense of
coherence. For twelve to fourteen years olds 36 percent indicated having high self-esteem, 7
percent indicated having high mastery and data was unavailable for sense of coherence, for
fifteen to seventeen years olds, 41 percent indicated having high self-eseteem,16 percent
indicated having high mastery, and data was unavailable for sense of coherence. For
eighteen and nineteen years olds, 41 percent indicated having high self-esteem, 21 percent
indicated having high mastery and 12 percent indicating having sense of coherence (De
Lazzari, 2000).
Sarka, Neckermann and Muller (2005) found that households with orphans had
more children under 18years than those without orphans. Orphans and vulnerable children
experience frequent interruptions in education (Ankrah, 1993) and their school fees often
unpaid (UNAIDS, 2004). Children who drop out of school lose the benefit of education as
well as school friends. Significantly, many children affected by HIV/AIDS were found not
to be attending school and this correlates with increased psychological distress (Nyamukapa
et al., 2008; Cluver, Gardner and Operario, 2007).

2.2. Problem and challenges of orphans

The impacts of parental death on children are complex and affect the childs
psychological and social development. Fredriksan and Kandours (2004) stated that,
orphaned children might have stunted development of emotional intelligence, and life skills

23

such as communications, decision making, negotiation skills etc. Moreover, they often show
lack of hope for futures and have low self-esteem (Kedija, 2006)
Majority of orphans are living with surviving parents or extended family, many of
them are being cared for by a remaining parent who is sick or dying, elderly grandparents
who themselves are often in need of care and support, or impoverished relatives struggling
to meet the needs of their own children. Increasing numbers of children are living in childheaded households, with minimal or no adult supervision or support (Smart, 2003).
Orphans are at increased risk of losing opportunities for school, healthcare, growth,
development, nutrition, and shelter. Moreover, with the death of a parent, children
experience profound loss, grief, anxiety, fear, and hopelessness with long-term
consequences such as psychosomatic disorders, chronic depression, low self-esteem,
learning disabilities, and disturbed social behavior. This is frequently compounded by selfstigma children blaming themselves for their parents illness and death and for the familys
misfortune (Smart, 2003).
Fewer School Opportunities:

Faced with limited resources, foster households

might be expected to favors their biological children over foster ones, and so deny orphans
proper access to basic needs such as education, health care, and nutrition. For orphans living
with their remaining parent, income shortfalls after the death of one parent may induce
children to leave school. A study using data collected by the Demographic and Health
Surveys and Living Standards Surveys for 22 countries in Sub-Saharan Africa in the 1990s
shows much diversity in the relationship among orphan status, household wealth, and child
school enrolment (Ainsworth and Filmer, 2002).
According to, Paxson and Ableidinger (2002) based on data drawn from a crosssection of countries. Orphans of any type were less likely to be in school than the nonorphans with whom they lived. The largest effect was for double orphans, who were 1030

24

per cent less likely to go to school than the children with whom they lived. The authors also
note that the schooling outcome is very much predicted by the degree of relatedness to the
household head the more distant the relationship of the household head to the orphan, the
less likely it is that the orphan will be enrolled in school (USAID, 2008).
In general, the large numbers of studies documenting the detrimental effects of
parental loss on the education of orphaned children, not all studies have found adverse
effects. For example, Ainsworth and Filmer (2002) identified a considerable variation in the
effect of orphan-hood on school attendance, including higher school attendance rates for
orphans than non-orphans in some countries. Another study in rural Zimbabwe found no
difference between orphans and non-orphans in primary school completion rates, although
maternal orphans (but not paternal or double orphans) were less likely to complete primary
school education than non-orphans (Nyamukapa and Gregson, 2005). Parikh et al. (2007)
found no significant differences in educational outcomes between orphans and non-orphans
living in the same household.
Health risks of orphans: Studies on the consequences of parental illness and death
for their childrens health and nutritional status are scarcer than studies of how orphan-hood
affects childrens education, and they have mixed results (USAID, 2008).
Evidence on the health status of OVC is less clear, however; a cross-sectional
study in urban Uganda found no differences between orphans and non-orphans in reported
treatment-seeking behavior and in anthropometric measures (Sarker et al., 2005).
Comparing orphans and non-orphans living in the same households in a rural area of South
Africa, Parikh et al. (2007) found no significant health disadvantage for orphans on a series
of wellbeing indicators. A study in rural western Kenya similarly compared several health
and nutritional indicators (including fever, malaria, history of illness, anemia, and stunting)
for orphaned and non-orphaned children under age 6 and concluded that orphaned children

25

are at no greater risk of poor health than non-orphaned children (Lindblade et al., 2003),
although orphans were somewhat more likely to be wasted than non-orphans (USAID,
2008).
In another report Andrews et al. (2006) indicated that orphans in sub-Saharan
countries are more vulnerable than non-orphans on a series of health indicators. Using data
from Zimbabwe, Watts et al. (2007) also found strong associations between OVC status and
nutritional and health outcomes such diarrhoea, acute respiratory infection, and underweight
status even after controlling for household poverty. In a recent study in Kenya, Mishra et al.
(2007) found that children (age 0-4 years) of HIV-infected parents were significantly more
likely to be underweight and wasted and less likely to have received medical care for acute
respiratory infections and diarrhea than children living with both parents who were not HIV
infected (USAID, 2008).

2.3. Major psychological problems and manifestations of orphan

Most the psychological impacts are often not visible, they take different forms, and
they may not arise until months after the traumatic event. The death of a parent leaves
children in a state of trauma. Sengendo and Nambi reported in 1997 that in Uganda many
orphans were showing signs of stress and trauma. Many, orphans may become withdrawn
and passive or develop sadness, anger, fear, and antisocial behaviors and become violent or
depressed (World Bank, 2004).
According to Furman no other event is comparable in psychological significance
because the death of a parent deprives children of so much opportunity to love and be loved
and confronts with a formidable adaptive task" (cited by Kodero, 2000).

26

Orphans may experience additional trauma from lack of nurturance, guidance, and a sense
of attachment, which may impede their socialization process (through damaged selfconfidence, social competencies, motivation, and so forth). Children often find it difficult to
express their fear, grievance, and anger effectively. In addition, when willing to express
their feelings, they may find it difficult to find a sensitive time (UNAIDS, 2001).
Many orphaned children continue to experience emotional problems and little is
being done in this area of emotional support. There are several reasons. First, there is a lack
of adequate information on the nature and magnitude of the problem; secondly, there is a
cultural belief that children do not have emotional problems and therefore there is a lack of
attention from adults. Thirdly, since psychological problems are not always obvious, many
adults in charge of orphans are not able to identify them. However, even where the problem
may have been identified, there is a lack of knowledge of how to handle it appropriately. In
many cases children are punished for showing their negative emotions, thereby adding to
their pain. In schools, there is an obvious lack of appropriate training of teachers in
identifying psychological and social problems and therefore offering individual or group
attention (Sengendo and Nambi, 1997).
Like adults, children are grieved by the loss of their parents. However, unlike
adults children often do not feel the full impact of the loss simply because they may not
immediately understand the finality of death. This prevents them from going through the
grieving process which is necessary to recover from the loss (Brodzinsky, Gormly and
Ambron, 1986). Children therefore are at risk of growing up with unresolved negative
emotions which are often expressed with anger and depression. Adults may also experience
negative emotions in times of bereavement, but, unlike children, adults have the intellectual
ability, life experience and emotional support that enable them to control their anger and
depression (Sengendo and Nambi, 1997).

27

Death of parents introduces a major change in the life of a vulnerable child. This
change may involve moving from a middle or upper-class, urban and rural home. It may
involve separation from siblings, which is often done arbitrarily when orphaned children are
divided among relatives without due considerations of their needs. It may mean the end of a
childs opportunity for education because of lack of school fees. Those children who choose
not to move or who may not have any other relative to go to may be forced to live on their
own, constituting child-headed families. All these changes can easily affect not only the
physical, but also the psychological well-being of orphans child. They can be very stressful
as they pose new demands and constraints to childrens life (Sengendo and Nambi, 1997).

2.4. Empirical Quantitative studies on orphans and vulnerable children in

different countries of the world
Here most relevant empirical studies on the psychological wellbeing of orphan children are
reviewed and summarised in the following way:
Poulter (1996) in Zambia, interviewed carers in 22 households with orphans, 66
households with HIV-positive parents, and 75 control families. However, as controls were
randomly selected from the community, this group may have included HIV-affected
families. The researchers used the Rutter Scales (Rutter, Tizard and Whitmore, 1970) with
caregivers. Caregivers reported that orphans were significantly more likely to be unhappy or
worried than children with HIV-positive parents, and both groups were significantly more
likely to be unhappy, worried, fearful, solitary and fearful of new situations than children in
non-affected families (no p-values reported). The study found no clear link between
psychological disturbance and economic stress. It also found no evidence of conduct
disorders or antisocial behaviour (Cluver and Gardner, 2007).

28

Sengendo and Nambi (1997) interviewed 169 orphans under the education
sponsorship of World Vision in Uganda, and a comparison group of 24 non-orphans (using
systematic random sampling from all eligible sponsored youth). They used a nonstandardised 25-item depression scale and interviews with orphans, teachers and some
guardians. They found that orphans had significantly higher depression scores (p < .05) and
lower optimism about the future than non-orphans (p < .05) (Cluver and Gardner, 2007).
Makame, Ani and McGregor (2002) in urban Tanzania, interviewed 41 orphans
and 41 non-orphaned controls, using a non-standardised internalising problems scale based
on the Rand Mental Health Inventory (Veit-Wilson, 1998) and items from the Beck
Depression Inventory (Beck et al., 1961). They found that orphans had increased
internalising problems compared with non-orphans (p < .0001) and 34% reported that they
had contemplated suicide in the past year, compared to 12% of non-orphans (p < .016)
(Cluver and Gardner, 2007).
Manuel (2002) in rural Mozambique used a non-standardised internalising
problems questionnaire adapted from the instrument used by Makame et al. (2002). They
interviewed 76 orphans, 74 non-orphaned controls from the area, and their careers. Orphans
had higher depression scores (p < .001) were more likely to be bullied (p < .001), and were
less likely to have a trusted adult or friends (p < .001). Caregivers of orphans reported more
depression (p < .001) and less social support than for the controls (Cluver and Gardner,
2007).
Atwine et al. (2005) in rural Uganda interviewed 123 orphaned children and 110
matched non-orphaned controls aged 1115. Using the Beck Youth Inventory (BYI) (Beck
et al., 1961), it was found that orphans were more likely to be anxious (OR = 6.4) depressed
(OR = 6.6) and to display anger (OR = 5.1) and showed significantly higher scores for
feelings of hopelessness and suicidal ideation. A range of questions was asked concerning

29

current and past living conditions, and a multivariate analysis of factors with possible
relevance for BYI outcomes found that orphan status was the only significant predictor of
outcomes (Cluver and Gardner, 2007).
In Rwanda and Zambia, Chatterji et al. (2005) compared orphans, children with
chronically ill caregivers, and non-affected children. Children aged 612 (n = 1160)
completed a seven-item unstandardized worry or stress scale developed from existing
instruments. On this scale, Zambian orphans scored higher than children with ill caregivers,
who scored higher than other children (p < .04). In Rwanda, there were no differences
between orphans and children with ill caregivers, but both groups scored higher than other
children (p < .03). In Rwanda, worry or stress was correlated with socioeconomic status (p
< .03) and community cohesion (p < .001) (Cluver and Gardner, 2007).
In Ethiopia, Bhargava (2005) analysed data from a survey of 479 children who had
been maternally orphaned by AIDS, with a control group of 574 children orphaned for other
reasons. Children completed 60 items from the 657-item Minnesota Multiphasic Personality
Inventory 2 (MMPI) (Hathaway and McKinley, 1989) with subscales of social adjustment
( = .80) and emotional adjustment ( = .86). Children orphaned by AIDS showed more
emotional and social adjustment problems, and girls reported higher levels of difficulties
than boys. Significant predictors of higher scores in both groups included presence of the
father, school attendance, household income, clothing conditions, distribution of food and
emotional support within the fostering family (Cluver and Gardner, 2007).
Cluver and Gardner (2006) interviewed 30 children orphaned by AIDS, and 30
matched non-orphaned controls, in Cape Town, South Africa. Standardised questionnaires
were used: the Strengths and Difficulties Questionnaire (Goodman, 1997) and the Impacts
of Events Scale (Dyregrov and Yule, 1995). Both groups scored highly for peer problems,
emotional problems and total scores. However, orphans were more likely to view

30

themselves as having no good friends (p = .002), to have marked concentration difficulties

(p = .03), and to report frequent somatic symptoms (p = .05), but were less likely to display
anger through loss of temper (p = .03). Orphans were more likely to have constant
nightmares (p = .01), and 73% scored above the cut-off for posttraumatic stress disorder
(PTSD). However, the PTSD scale was not administered to the non-orphaned control group
(Cluver and Gardner, 2007).
A national survey in Zimbabwe (Nyamukapa et al., 2006) applied factor analysis to
compare orphans and non-orphaned children aged 12-17 (n = 5321). Psychosocial disorders
were measured using a 16-item unstandardized scale, with items from the Child Behaviour
Checklist, Rand Mental Health and Beck Depression Inventories. Findings showed more
psychosocial disorders amongst orphans (p < .05) which remained when controlling for
poverty, gender, age of household head, school enrolment and adult support. Depression
showed group differences, but anxiety did not (Cluver and Gardner, 2007).
Also in Zimbabwe, Gilborn et al. (2006) interviewed 1258 orphans and vulnerable
children, comparing groups by exposure to various psychosocial support programmes. An
unstandardized instrument was developed from formative qualitative research, and included
six items suggestive of depression and two items suggestive of poor psychosocial wellbeing. Orphans reported higher stress (p < .05) and more psychosocial distress (p < .05)
(Cluver and Gardner, 2007).
Wild et al. (2006) have recently completed a study with adolescents (1019 years
old) in the Eastern Cape of South Africa. They compared 81 AIDS-orphaned children, 78
orphaned as a result of deaths not related to AIDS, and 43 non-orphans. AIDS-orphaned
children were recruited through NGOs. The researchers used the Revised Childrens
Manifest Anxiety Scale (R-CMAS) (Reynolds and Richmond, 1978) the 10-item Child
Depression Inventory (CDI) (Kovacs, 1992) items from the Child Behaviour Checklist

31

(CBCL-YSR) (Achenbach, 1991) and items from the Self-esteem Questionnaire (DuBois et
al., 1996). The study also looked at potential moderating factors of adult, peer and
neighbourhood connection and regulation, and psychological autonomy. Findings showed
that adolescents orphaned as a result of deaths unrelated to AIDS reported more depression
(p < .05) and anxiety (p < .05) than non-orphans, with AIDS orphan scores falling between
the two groups and not differing significantly from either. There were no group differences
in terms of externalising problems. Other orphans showed lower self-esteem than both
non-orphans and AIDS orphans. Of the potential protective factors for all orphans, greater
autonomy from caregiver and greater neighbourhood regulation were significantly
associated with lower anxiety (p < .001). Greater connection with caregiver and greater peer
regulation were associated with lower depression (p < .001) (Cluver and Gardner, 2007).
In Cape Town, South Africa, Cluver, Gardner and Operario (2007) interviewed
1061 children (455 orphaned by AIDS, matched controls of 278 non-orphaned children and
243 orphaned as a result of deaths from other causes, with 85 children orphaned as a result
of deaths from unknown causes). Standardised psychological questionnaires included the
Child Depression Inventory (Kovacs, 1992), The Revised Childrens Manifest Anxiety
Scale (Reynolds and Richmond, 1978) the Child Behaviour Checklist (Achenbach, 1991)
and the Childrens PTSD Checklist (Amaya- Jackson, Newman and Lipschitz, 2000). The
study also explored a range of potential risk and protective factors identified through
qualitative data (Cluver and Gardner, 2007) and suggested by a range of NGOs and South
African government departments. AIDS-orphaned children reported higher levels of
depression, peer problems, post-traumatic stress, conduct problems and delinquency (p <
.001) than both non-orphaned children and children orphaned as a result of deaths from
other causes. Differences remained when controlling for socio-demographic factors such as
age, gender, poverty, migration and household composition. No differences were found in

32

terms of anxiety. Multivariate and meditational analyses found strong meditational effects
of risk factors poverty, stigma and caregiver illness and of protective factors such as receipt
of social security and school attendance (all p < .001) (Cluver and Gardner, 2007).
In New York, an intervention-based study (Rotheram-Borus, Stein and Lin, 2001;
Rotheram- Borus et al., 2004) used longitudinal assessments with standardised instruments.
The study compared adolescents orphaned by AIDS (73) with adolescents whose parents
were alive and HIV-positive (138). At two years after parental death, the researchers found
that bereaved children reported more emotional distress on the Brief Symptom Inventory
(Derogatis and Melisaratos, 1983) and more problem behaviours (smoking, alcohol, crime
and aggressive behaviour) than children whose parents were still alive (p < .05). Further
factors increasing adolescent distress at two years after parental death included baseline
severity of parental physical health symptoms and parental emotional distress. Postintervention results found significant differences of fewer problem behaviours and fewer
sexual partners amongst the intervention group, but no effect on emotional distress (Cluver
and Gardner, 2007).
In New York, Pivnick and Villegas (2000) interviewed 25 children aged 1018, all
of whom were orphaned or had a parent who was HIV-positive. Participants were recruited
from a mental health and primary healthcare programme for HIV-positive women. There
was no control group. The researchers used ethnographic and clinical interviews and the
Beck Depression Inventory (Beck et al., 1961). Findings included heightened anxiety and
depression, as well as sleeping, eating and somatisation problems. Children also reported
difficulty concentrating at school. No evidence was found of conduct problems or risk
behaviours (Cluver and Gardner, 2007).
A cross sectional survey was conducted to assess the psychological well-being and
socio-economic hardship of orphan and non- orphan children in Conakry, Guinea. The

33

study included 133 orphan and 140 non-orphan children. Multi way analysis of variance and
multiple logistic regression models were used to measure the association. The result shows
that the psychological well-being score was significantly lower among orphan children than
non- orphan children. The study recommends for sustainable and holistic approaches to
ensure the psychological and socio-economic stability of orphans and other vulnerable
children (Delva et al., 2009)

2.5. Summary of review literature

In these day orphan are the basic concerned issue of world population especially
high HIV and AIDS affected country. HIV AIDS have one of the severest clinical and
public health problems ever faced by human being. The epidemic has caused a substantial
increase with mortality among adults during reproductive ages and as a consequence, rising
numbers of children are orphaned by AIDS.
Orphans are at increased risk of losing opportunities for school, healthcare, growth,
development, nutrition, and shelter. Moreover, with the death of a parent, children
experience profound loss, grief, anxiety, fear, and hopelessness with long-term
consequences such as psychosomatic disorders, chronic depression, low self-esteem,
learning disabilities, and disturbed social behavior. This is frequently compounded by selfstigmachildren blaming themselves for their parents illness and death and for the
familys misfortune.
There are done a lot of empirical researches in concerning orphan for example,
Parikh et al. (2007), Lindblade et al. (2003), Sarker et al. (2005) ,Watts et al (2007) ,
Andrews et al. (2006), Delva et.al. (2009), Wild et al. (2006), James Sengendo and Janet
Nambi (1997) Cluver, Gardner and Operario (2007), Bhargava (2005), Nyamukapa et al.
(2006), Gilborn et al. (2006).

34

Psychologists and health professionals (Campbell, 1981; Deci and Ryan, 2008)
have studied well-being extensively. While the distinct dimensions of well-being have been
debated, the general quality of well-being refers to optimal psychological functioning and
experience. Two broad psychological traditions have historically been employed to explore
well-being these are Eudaimanic and Hedonic. Recent years have witnessed an exhilarating
shift in the research literature from an emphasis on disorder and dysfunction to a focus on
well-being and positive mental health. Psychological wellbeing measured in different form
of scale, according to Ryffs constructed a measure of well-being around six subscales:
Autonomy, Environmental Mastery, Positive Relations with Others, Purpose in life,
Personal Growth, and Self-Acceptance.

35

CHAPTER THREE
METHOD

This chapter deals with the description of the research design, population and sample,
research instruments, the procedure of data collection, and statistical methods.
3.1. Research design
The study is descriptive in its nature which involves comparative survey and
correlational. It is descriptive since it attempts to assess the level of psychological wellbeing among orphan and non-orphan children. It is also correlational, since it correlates the
dependent variable of psychological well-being of orphan children with some selected
independent variables such as age, sex and grade level and comparative since it compares
the status of psychological well-being of orphan and non-orphan children. In order to
achieve the stated objectives, both qualitative and quantitative approaches of data collection
were used.
The aim of the quantitative approach is to assess the psychological wellbeing of
orphan and non-orphan children, compare psychological wellbeing between orphans and
non-orphans, and to examine the relationship between demographic variables and
psychological wellbeing of orphan children. For the quantitative approach, structured
questionnaires were employed.
On the other hand, the purpose of the qualitative approach is to explore the
condition or situation that could promote the psychological wellbeing of orphan children as
perceived by the school charity club representatives.

36

3.2. Study Area and Target Population

The study was conducted in Addis Ababa, capital city of Ethiopia. For the
quantitative survey, the target population consists of orphan and non-orphan children living
in Yeka sub-city whose ages range between 12 and 18 years old. This sub-city was selected
based on the fact that there is large number of orphan children in the sub-city. Three
representatives of the charity clubs in the selected schools were the participants for the
qualitative study.
3.3. Sampling
There are 26 primary and junior secondary schools in yeka sub-city which would
enable the selection of both orphan and non-orphan children. From these schools, three
were selected using lottery method.
The required sample size for this study was 20% of the population which is
recommended by Huck (2004). According to him, incorporating a minimum sample size of
20 % from a population is representative to conduct a survey.
A list of orphaned children (sampling frame) was obtained from three schools
charity clubs. Their record represents those orphans and vulnerable children who reported to
the club. The record consists of 325 orphans identified by the researcher in collaboration
with representatives of the clubs. Out of the 325, 36% or 120 orphans were selected using
systematic random sampling technique by taking every 2nd child from the total sampling
frame. This present of the orphans was taken in order to make the sample sizes comparable
with the non-orphan sample size.
Non-orphan children were selected using systematic random sampling technique.
In this process 5th, 6th, 7th, and 8th graders in the three sample schools, who are out of the
charity clubs, and who live with both parents were considered. First, from every grade level,
a section was taken as sample using lottery method. Totally from the three sample schools,
37

12 sections were selected. The sampling frame consists of 621 non-orphan children. From
this sampling frame, 20 % of the students were selected. Thus, a total of 120 samples of
non-orphan children were selected using systematic sampling technique. Using this
technique, every fifth child was selected from non-orphan sampling frame and included in
the sample of the main study. Therefore, a total of 240 orphan and non-orphan children
were taken as a sample. Out of the 240, 120(50%) were orphans and 120(50%) were nonorphans. Out of the total orphan and non-orphan children, 140(47.50%) were males and
126(52.50%) were females. The total number of orphan respondent 54(22.5%) were males
and 66(27.5%) were females and the total number of non-orphan 60(25%) were males and
60(25%) were females. Concerning their grade level, 62(51.66%) orphans and 11(9.16%)
non-orphans were grade 5 and 6 and 58(48.33%) orphan and 109(90.84%) non-orphans
were grade 7 and 8.
In addition, in order to explore the conditions that could contribute to the
psychological well-being of the orphaned children, interviews were conducted with the
representatives of the Charity club in the three selected schools. The respondents were
chosen on the assumption that they were better aware of the childrens needs than other
employees of the schools and were able to make the childrens views explicit because they
are working with matters concerning OVC in the schools.
The age span of the respondents of charity club representatives was 28 to 36 years
old. One of them was female and 2 were males. The educational statuses of male
respondents are BA degree holders whereas the female respondent has diploma.

38

3.4. Inclusion and exclusion criteria

The study included children whose age falls between 12 and 18 years old and
orphaned by any cause. Those orphans whose age is below 12 years old were excluded from
this study.
3.5. Research variable
3.5.1. Independent variable
Age
Gender
Educational level
3.5.2. Dependent variable
Psychological well-being is the dependent variable in this research and has six
dimensions: Autonomy, Environmental Mastery, Personal Growth, Positive Relations with
Others, Purpose in Life, and Self-acceptance.
3.6. Data collecting instrument
3.6.1 Demographic Questionnaire
The respondents were asked to provide information regarding their gender, age,
grade level, parental status, missed parents of orphan and the current living place of orphan
and non-orphans.
3.6.2. Psychological wellbeing scale
In order to assess the psychological wellbeing of the respondents the researcher
employed the Ryff Psychological Wellbeing scale medium form which consists of 54
questions.
Ryff Psychological Wellbeing Scale

39

The theoretical-conceptual dimensions of wellbeing, based on various conceptions

of human achievement (Allport, 1961; Birren, 1961; Buhler, 1935; Erikson, 1959, 1968;
Jahoda, 1958; Jung, 1933; Maslow, 1968; Neugarten, 1968; Rogers, 1961), this author
developed an instrument for self-assessment that enables operationalization of the PWB
model (Ryff, 1989) and which originally consisted of 120 theoretically defined (theorydriven) items (20 per scale). Currently, there are various reduced versions of this instrument
(84, 54, 42, and 18 items), translated into at least 18 different languages (Ryff and Singer,
1996).
The scale consists of a series of statements reflecting the six areas of psychological
well-being: Autonomy, Environmental Mastery, Personal Growth, Positive Relations with
Others, purpose in Life and Self-acceptance. Each sub-scale consists of 9 items.
Respondents rate statements on a scale of 1 to 6, with 1 indicating strong disagreement and
6 indicating strong agreement. The test retest reliability of the sub scales ranges from 0.81
to 0.85 and the internal consistency ranged from .87 to .90 (www.Liberal arts.wabash.edu).
There are four versions of the Ryffs psychological well-being scale. The parent
scale is 20-items version, the medium form is composed of nine items and the short form is
composed of three items. Was used the medium version which has a total of 54 items,
Cornbachs alpha was 0.63 for autonomy, 0.53 for environmental mastery, 0.78 for positive
relations with others, 0.73 for self-acceptance, 0.66 for personal growth and 0.74 for
purpose in life. Individual indicated their response on 6 point liker-type scale, which higher
scores on each scale indicating greater wellbeing on each dimension. As in Sheldon and
Lyubomirskys (2006) study, a total PWB score was calculated by adding all 6 construct.
The number of responses made by the subject on each question depends whether
the question is positive or negative. If it is a positive question responses are rated from 1 to
6, where a score of 6 indicates strong agreement. If it is a negative question scoring done is

40

in reverse order which is from 6 to 1, where 6 indicated strong disagreement. For each
category, a high score indicates that a respondent has a mastery of that area in his/her life.
Conversely a low score shows that the respondent struggles to feel comfortable with that
particular concept (Srimathi and Kumar, 2010).

3.6.3. Semi-structured Interview Guide

A qualitative semi-structured interview was designed to explore the conditions and
situation that could promote the orphaned childrens psychological well-being. The aim
was to allow the respondents (charity club representatives in the selected schools) to inform
the study from their point of view, using their words (Lofland et al., 2006). A semistructured interview guide consisting of themes and questions was written in English and
then translated into Amharic.
The first questions placed focus on the respondents and their backgrounds that is
education and work experience. These questions set the respondents within their present
context and made possible a general appraisal of their knowledge and experience in the
field. The purpose of the first topic, Psychological aspects, was to gather information about
the children's psychological needs and how these are perceived, handled, and understood.
The aim of the second topic, social support, was to find out what the respondents
knew about the social aspects of the childrens lives. It is important to point out that the
questions referred to the group of children with whom the respondent worked, thus eliciting
general information about them and not single-case information. The third and final topic,
the future, was created in order to round off the interview with questions regarding what
could and should be done in the matters discussed. To close the interviews, respondents
were asked if they wanted to add something or had any questions.

41

3.7. Pilot testing

The aim of pilot test is to solve ambiguity (clarity, language and structure
problems), to check validity, reliability and feasibility of the instrument. In the present
study, the Amharic version of the instrument was administered to 30 children from which
13 were orphan and 17 were non-orphans children in Wonderad primary and junior schools.
No time limit was made for the completion of the questionnaire.
Item-total correlation was computed for each sub-scale of the Psychological
Wellbeing Scale. Based on the criterion of 0.30 as an acceptable corrected itemtotal
correlation (Nunnally and Bernstein, 1994), eight items were identified as unacceptable.
Three items from the personal growth sub-scale, three questions from the purpose in life
sub-scale, and two from the self-acceptance sub-scale were not included in the final study
instrument.
Internal consistency reliability of the Amharic versions of the instrument was
determined for the total and for the subscales using Cronbachs alpha. The computed
Cronbachs alpha coefficients were 0.8 Autonomy, 0.67 Environmental mastery, 0.75
Positive relation with other, 0.69 Self-acceptance, 0.6 Personal growth, 0.67 Purpose in life
and total PWB scales were 0.89
3.8. Data collection procedure
After obtaining informed consent from the school principals and from students, the
structured questionnaires which include demographic and psychological wellbeing variables
were administered to the sample orphan and non-orphan children.
In the qualitative study, the respondents were first contacted and asked to provide
their consent in case they are willing to participate. After their consent had been secured,
the respondents were asked to indicate the most appropriate time for them to conduct the
interview. Then, using the semi-structured interview guide, interviews were conducted in
42

Amharic with each of the respondent. Each interview began with an explanation of the
purpose of the interview. The duration of the interviews oscillated between 45 and 70
minutes. All interviews were held at the respondents place of work. No payment was
offered nor requested. As is standard in qualitative interviews, follow-up questions were
used to clarify vague responses. All interviews were audio taped for transcription. Each
interview was terminated when data started to repeat itself. At the end of each interview, the
researcher made sure that the recorded interviews are audible. After this, they were thanked
for their participation.
3. 9. Ethical Considerations
Participation of respondents was strictly on voluntary basis. Participants were fully
informed as to the purpose of the study and consented verbally. Measures were taken to
ensure the respect, dignity and freedom of each individual participating and to assure
confidentiality in the study. Participants were informed that the information they provide
would be kept confidential and would not be disclosed to anyone else including anyone in
the schools.
3.10. Data analysis
Descriptive statistical measures mean and standard deviation were used to see
general pattern of psychological wellbeing of the respondents according to sex, age and
grade level. T- test was computed to determine whether there is a significant mean
difference between orphan and non-orphan in their psychological wellbeing.
Person correlation coefficient was computed to provide information whether the
independent variables and dependent variables correlate each other and to measure the
degree of relationship between variables.

43

Data collected through semi-structured interviews were analysed using inductive

thematic analysis. The procedure outlined in Braun and Clarke (2006) was applied in this
analysis and consisted of the following stapes: Transcribing and familiarisation with the
data, reading re-reading and noting down initial ideas, searching for themes, and producing
the report.

44

CHAPTER FOUR
RESULTS

Here the result of the study is presented in line with the research questions and
presented in different parts. The first part focused on the background information of the
respondents, the second part presents the psychological wellbeing of orphan and non-orphan
children, the third one is about difference in psychological wellbeing between orphan and
non-orphan children, the fourth part presents the relationships between demographic
variables and psychological well-being, and the fifth part presents the sources of
psychological wellbeing in orphan children.

4.1. Background Information of Study Subjects

In this section, the socio-demographic characteristics of the participants were
presented. The socio-demographic characteristics analyzed include the age, gender and
grade level, types of orphan-hood and the person(s) with whom the orphan children are
currently living with and also age, gender, grade level and the person(s) with whom nonorphan children are currently living with. Table 1 and Table 2 below summarize this sociodemographic information about the study subjects.

45

Table 1: Demographic characteristics of study subject (N=240)

Variables

Sex

Age

Grade

Orphan

Non-orphan

Total

Male

54

22.5

60

25

114

47.5

Female

66

27.5

60

25

126

52.5

Total

120

50

120

50

240

100

12-14

66

55

69

57.5

135

56.2

15-18

54

45

51

42.5

105

43.9

Total

120

50

120

50

240

100

5 and 6

62

51.66

11

9.16

73

30.4

7 and 8

58

48.33

109

90.84

169

69.6

Total

120

99.99

120

100

240

100

As it is shown in Table 1 above, out of 240, 66(55%) and 69(57.5%) orphan and
non-orphan were in the age range of 12-14 years old and 54(45%) orphan and 51(42.5%)
non-orphan were in the age range of 15-18 years old respectively.

46

Table 2: Respondent characteristics on parental status

Variables

Orphan

Orphan

Non-orphan

Parental

70

58.33

Maternal

25

20.83

Double

25

20.83

Total

120

100

Bothe parents

___

___

With father

10

8.33

With mother

61

50.83

With relatives

38

31.66

With non-relatives

1.66

Institution

0.83

Others

6.66

Total

120

100

120

100

types

Current
situation of
living

As Table 2 shows that, 70(58.33%) were paternal orphan, 25(20.83%) were

maternal and 25(20.83%) were double orphans. Concerning current living condition of
orphan children the data uncovered that 61(50.83%) of them are living with their mother,
38(31.66%) were with relatives, 10(8.33%) were with father, 8(6.66%) were with others,
2(1.66%) were with non-relatives, and 1(0.83%) were with institutions.

47

4.2. Descriptive Summary of Psychological Wellbeing among Orphan and Non-orphan

Children

The minimum, maximum, mean, standard deviation scores and sum total were
calculated to summarize the raw data for the total and sub-scales of Psychological wellbeing treated in the study. The results are presented in table 3 and 4 below.

Table 3: Summary statistics of the total and sub-scales of psychological well-being for
Orphan and non-orphan children (N=240)

Orphan

Non-orphan

Variable
Female

Male

Female

Male

Mean

S.D

Mean

S.D

Mean

S.D

Mean

S.D

AU

34.83

6.19

34.05

6.77

40.26

6.31

39.31

6.64

EM

30.48

6.10

29.35

6.31

37.15

7.32

35.83

7.75

PR

34.51

6.48

34.37

6.48

40.85

7.82

38.48

7.75

SA

27.80

6.38

26.16

4.58

33.01

5.68

32.41

6.66

PL

22.68

4.80

22.55

4.08

27.65

4.95

27.96

5.05

PG

22.71

3.96

22.16

4.32

28.75

4.65

27.83

4.69

PWB

173.03

21.87

168.66

21.21

207.68

27.73

201.85

30.4

AU autonomy, EM environmental mastery, PR positive relation with others, SA selfacceptance, PL purpose in life, PG personal growth and PWB psychological wellbeing
scale.
Table 3 shows that the lowest mean scores, for both male and female, were
obtained for sub scales of purpose in life and personal growth. On the other hand the sub

48

scales with the highest mean include autonomy and positive relation with others for males
and autonomy, environmental mastery and positive relation with others for females. In the
total psychological wellbeing scale, the mean scores of male is 168.66 were as for females it
is 173.03. This means the mean of orphan females on the total psychology wellbeing scale
is slightly higher than that of orphan male.
The mean scores of non-orphan range from 39.3 to 27.8 for males and 40.8 to 27.6
were as the females respondents. The sub scale purpose in life and personal growth for
both males and females were shows the lowest mean score compared to other sub scales. In
the total psychological wellbeing scale the mean scores of male is 201.85 were as for
females it is 207.68. This means the mean of non- orphan females on the total psychology
wellbeing scale is slightly higher than that of non-orphan meals

4.3 Status of psychological well-being of orphan and non-orphan children

To find out the status of the psychological well-being of orphan and non-orphan
children, percentage values and alternatively frequency counts were computed. To
determine the levels of psychological wellbeing as high and low, mean split was used. Mean
scores were determined for each dimension and for the total psychological wellbeing.
Accordingly, the mean scores were 36.86, 36.80, 36.86, 34.42, 25.03, 25.29, and 187.87 for
Autonomy, Environmental mastery, Positive relations with others, Self-acceptance, Purpose
in life, personal growth, and the total Psychological well-being respectively. The reasons for
selecting mean split over median split are: 1 you can always find an equivalent analysis that
respects the continuous nature of the variable (e.g., regression); 2 when creating median
splits, you lose a lot of information; 3 the cut-off tends to be relatively arbitrary and it varies
between samples; 4 the resulting model based on a median split does not reflect the
underlying nature of the variable; 5 in most cases a binary split will have less statistical

49

power; 6 if the purpose is to communicate to a scientific audience, respecting the

continuous nature of the variable is a necessary complexity(http://www.uvm.edu/~dhowell/
gradstat/psych341/lectures/Factorial2Folder/Median-split.html). Those who scored above
the mean were considered as having high levels and those who scored below the mean were
considered as having low levels of psychological wellbeing. The result is shown in Table 5
below.
Table 4: Summary result of the status of psychological well-being of orphan children

Orphan
Variabl

High

Low

e
Male

Female

Total

Male

Female

Total

AU

17

31.48

23

34.84

40

33.33

37

68.51

43

65.15

80

66.66

EM

21

38.88

24

36.36

45

37.5

33

61.11

42

63.63

75

62.5

PR

19

35.18

24

36.36

43

35.83

35

64.81

42

63.63

77

64.16

SA

23

42.59

26

39.39

59

49.16

31

57.40

40

60.60

71

59.16

PL

20

37.03

25

37.87

45

37.5

34

62.96

41

62.12

75

62.5

PG

17

31.48

23

34.84

40

33.33

37

68.51

43

65.15

80

66.66

PWB

19

35.18

25

37.87

44

36.66

35

64.81

41

62.12

76

63.33

As Table 4 shown that, 40(33.33%) orphan children had high scores on autonomy
out of which 17(31.48%) males, 23(34.84%) females and 80(66.66%) scored low out of
these 37(68.51%) were males and 43(65.15%) were females. With regard to environmental
mastery, 45(37.5%) of the orphan respondents had high scores out of which 21(38.88%)
were males and 24(36.36%) were females and 75(62.5%) had low scores out of which
33(67.11%) were males and 42(63.63%) were females. Concerning the positive relation sub
scales of psychological well-being, 43(35.83%) scored high out of which 19(53.18%) were

50

males and 24(36.36%) were females and 77(64.16%) had low level of scores out of which
35(64.81%) were males and 42(63.63%) were females. On self-acceptance 59(49.16%) had
high scores out of which 23(42.59%) males and 26(39.39%) were females and 71(59.16%)
scored low level out of which 31(57.40%) were males and 40(60.60%) were females. On
the dimension of purpose in life 45(37.5%) had high sores out of which 20(37.03%) were
males and 25(37.87%) were females and 75(62.5%) scored low scores 34(62.96%) being
males and 41(62.12%) females. With regard to personal growth 40(33.33%) had high scores
out of which 17(31.48%) were males and 23(34.84%) were females and 80(66.66%) scored
low out of which 37(68.51%) were males and 43(65.15%) were females.
With regard to the total psychological wellbeing, 76 (63.33%) of the orphans had
low psychological wellbeing whereas only 44(36.66%) of them had high psychological
wellbeing. This analysis is done by mean spilt using the mean score of the total wellbeing
which is 187.87.
Table 5:- Summary result of the status of psychological well-being of non-orphan
High

Low

Male

Female

Total

Male

Female

Total

AU

35

58.33

38

63.33

73

60.83

25

41.66

22

36.66

47

39.16

EM

36

60

39

65

75

62.5

24

40

21

35

45

37.5

PR

34

56.66

41

68.33

75

62.5

26

43.33

19

31.66

45

37.5

SA

38

63.33

43

71.66

81

67.5

22

36.66

17

28.33

39

32.5

PL

40

66.66

38

63.33

78

65

20

33.33

22

36.66

42

35

PG

36

60

40

66.66

76

63.33

24

40

20

33.33

44

36.66

PWB

38

63.33

39

65

77

64.16

22

36.66

21

35

43

35.83

As shown in Table 5 above 73(60.83%) subjects scored high on autonomy among

these 35(58.33%) were males and 38(63.63%) were females and 47(39.16%) had low score

51

out of which 25(41.66%) were males and 22(36.66%) were females. On environmental
mastery, 75(62.5%) of the subjects had highly scores out of which 36(60%) were males and
39(65%) were females and 45(37.5%) had low score out of which 24(40%) were male and
21(35%) were female. On positive relation with others, 75(62.5%) of the subjects had
highly scores out of which 34(56.66%) were male and 41(68.33%) were females and
45(37.5%) had low score out of which 26(43.33%) were male and 19(31.66%) were
females. On self-acceptance 81(67.5%) of the responds highly score out of which
38(63.33%) were male and 43(71.66%) were female 39(32.5%) had low score out of which
22(36.66%) were male and 17(28.33) were female. On purpose in life, 78(65%) subjects
high scored out of which 40(66.66%) were males and 38(63.33%) were females and
42(35%) had score low out of which 20(33.33%) were males and 22(36.66%) were females.
With regard to personal growth 76(63.33%) had high scores out of which 36(60%) were
males and 40(66.66%) were females and 44(36.66%) scored low out of which 24(40%)
were males and 20(33.33%) were females.
Regarding the total psychological wellbeing, 77(64.16%) of the non-orphans had
high psychological wellbeing whereas only 43(35.83%) of them had low psychological
wellbeing.

4.4. Difference in psychological well-being between orphan and non-orphan

children
One of the purposes of this study was to investigate whether or not there is
significant difference in psychological well-being between orphan and non-orphan children.
The results obtained were presented as follows in Table 6.

52

Table 6: Independent sample t-test for difference in psychological wellbeing between

orphan and non-orphan children
Levenes Test for
Equality of Variance
F
Sig.
PWB Equal variance
assumed
Equal variance
not assumed

9.52

0.002

t-test for Equality of Means

t
df
Sig (2- Mean
tailed) difference
3.41
238
0.001 11.65
3.41*

220.82

0.001

11.65

*p<0.05; PWB=Psychological wellbeing

Table 6 above shows the Levenes test for equality of variance and the actual t-test
for significant mean difference between orphan and non-orphan children. As can be seen
from the table, the p value for Levenes test is 0.002 which is less than 0.05 (alpha level
selected in the analysis). This means that the variability between the groups is significant.
Hence, using the equal variance not assumed test, the t-test revealed that there is
significant mean difference in psychological wellbeing between orphan and non-orphan
children. Non-orphan children (M= 193.70, SD= 22.47) had higher mean than orphans (M=
182.04, SD= 29.97); t (238)= 3.41, p=0.001).
In addition to quantitative data, in-depth interviews were conducted with the three
employees who have daily contact with the orphan children in the selected schools with the
objective to explore the psychological and social aspects that could potentially contribute to
the psychological well-being of orphaned children.
All respondents of charity club representative believed that like physiological
need psychological care should be an equal importance in the care of orphan children.
Also, any effects of interventions made would be observed immediately. On the other hand,
psychological needs were seen as more difficult to understand and appease. Also, effects

53

could take years to show something respondents claimed was the real reason behind why
most Ethiopians did not give these needs due attention.
Respondents viewed the desire to relate to others and to belong as innate:
Children must first be loved in order to learn how to love, if not this dies and so does the
soul. However, respondents feared that many children who had lost their families or spent
many years in institutions or relative/ non- relative would lose this yearning: Wanting to
love can of course be lost by () actually not having someone left to love. The desire to
love was also discussed in relation to attachment difficulties. One respondent explained this
as the children wanting to be close and then far away, and then close, and then far away,
and then want hugs and kisses and then you cant touch them. Others described that some
children could not form strong bonds with adults, had poor relationships to their peers, and
that they avoided looking others in the eye. A majority of respondents believed these
difficulties were the result of having lost the primary caregiver.
The following are the major components of the psychological aspect of childrens
well-being emerged as the data from the respondents are analysed:
Increasing individuality and autonomy: The respondents believe that orphans
have to be given the right to express themselves as individuals through simple means.
Examples include allowing them to adorn their beds, letting them put up drawings, write
their names, make small objects anything that expresses who they are and that they
actually matter, have a value, and are not forgotten.
Enhancing self-esteem through play: In interviews, some respondents related
self-esteem to play one of important psychological aspect for psychological wellbeing of
orphans. They believed play could develop the childrens sense of self in a positive
direction: It is simple really, if they are good at something, like running fast () that
makes them proud so they feel better about whom they are. Expressing themselves

54

creatively enhances childrens sense of well-being. Although the respondents believe that
psychological care should be of equal importance in the care of orphan children as that of
other needs, they noticed based on their experiences that the majority of Ethiopians do not
believe so.
Respondents believed that if children are respected and cared for, their
psychological well-being and their visibility in society increases. They believed that
children needed to be close to the familiar, not to be uprooted, and to have emotional
support: () hopefully they can stay in their old neighbour-hood or city, have the same
friends and stay in the same school, () this is where they will get a lot of support.
A respondent said,
Children need to feel valued, respected, empowered, and cared for. They also need
to respect themselves, others, and their environment. They become positive about
themselves and their learning when adults value them for who they are and when
they promote warm and supportive relationships with them.

4.5. Psychological well-being by demographic factors

To check whether there are significant relationships between demographic
measures and measures of psychological well-being, Pearson correlation was computed.
The result of the correlation analysis is presented in the Table 7 below.

55

Table 7: Correlation between psychological well-being and demographic measures

AU

EM

PR

SA

PL

PG

PWB

Age

-.032

.003

-.044

-.065

.004

-.005

.029

Sex

.043

.059

.066

.063

-.033

.043

.056

Grade

.170**

.107

.094

.113

.252**

.248**

.199**

Parental
status

-.381**

-.428**

-.344**

-.431**

-.481**

-.566**

-.551**

** Correlation is significant at the 0.01 level (2- tailed)

As it can be seen from Table 7 above, grade level and parental status were found to
have significant correlation with the total psychological wellbeing and with some of its
dimensions. Grade level has significant positive relationship with autonomy (r=.170,
p<0.01), purpose in life (r=.252, p< 0.01), personal growth (r=.248, p<0.01) and with the
total psychological wellbeing (r=.199, p<0.01). Gender has weak positive relation with
autonomy, purpose in life, personal growth and total psychological wellbeing scale.
Parental status has significant negative relation with autonomy (r=-.381, p<0.01),
environmental mastery (r=-.428, p<0.01), positive relations with others (-.344, p<0.01),
self-acceptance (-.431, p<0.01), purpose in life (-.481, p<0.01), personal growth (-.566,
p<0.01) and with total psychological wellbeing (-.551, p<0.01). Autonomy, environmental
mastery, positive relation with other, self-acceptance, purpose in life, personal growth and
total psychological wellbeing has a moderate negative relation with parental status.

56

CHAPTER FIVE
DISCUSSION

This section of the study aims at discussing the major findings of the current study
in line with previous research findings reviewed in the literature.
In the presenting study result shows that orphan children has low psychological
wellbeing which compared to non-orphan child. The findings of the present study are
consistent with the findings of other studies conducted on the psychological wellbeing of
orphan and non-orphans children. For example, Zhao et al. (2011) conducted a study on
orphan children psychological wellbeing using a sample of 1625 children aged 6 to 18
years, in China. Their finding revealed that orphan and vulnerable children showed lower
psychological wellbeing than comparison groups. Moreover, Delva et al. (2009) conducted
on the psychological wellbeing of orphan and non-orphan children in Guinea. The number
of children participated in their study were 257 orphans and 140 non-orphans. In this study,
it was reported that orphan children had significantly lower psychological wellbeing than
non-orphans. Another study by Sengendo and Nambi (1997) interviewed 169 orphans and a
comparison group of 24 non-orphans. Found that orphans had significantly higher
depression scores (p < .05) and lower optimism about the future than non-orphans (p < .05).
Makame, Ani and McGregor (2002) in Tanzania, interviewed 41 orphan and 41 nonorphaned controls. They found that orphans had increased internalizing problems compared
with non-orphans (p<.0001) and 34% reported that they had contemplated suicide in the
past year, compared to 12% of non-orphans (p<.016). A study was conducted by He and Ji
(2007) in China with the purpose to compare orphans and non-orphans on their
psychological wellbeing (self-esteem, subjective life quality, and depression). They found

57

that orphans had less self-esteem and lower quality and were more depressed than nonorphan.
With regard to demographic variables, grade level was positively correlated with
psychological wellbeing whereas parental status was negatively correlated with
psychological wellbeing. Gender and age were not significantly related with any of the
dimensions and the total psychological wellbeing. Consistent with the findings of the
present study is

a study conducted by Zhao et al. (2011) on orphans psychological

wellbeing using a sample of 1625 children aged 6 to 18 years in China which reported no
significant differences with regard to gender and age of orphan children. This shows that
psychological wellbeing has no relationship with gender and age which is consistent with
the findings of the present study.
On the contrary to the present findings, He and Ji (2007) reported gender
differences in psychological wellbeing and life quality of orphan children. Their study
involved 93 orphans and 93 non-orphans and standardized instruments of depression, selfesteem, and subjective life quality were employed. It was found that boys were more
vulnerable than girls in psychological wellbeing and life quality.
A review of the related literature shows that among the general population, gender
differences in psychological functioning and health are well documented (Dekker et al.,
2007; Mezulis and Abraham, 2008). During childhood, the prevalence of psychiatric
disorders is significantly higher in boys, while in adulthood, women have twice the risk of
depression compared to men (Strunk, Lopez and DeRubeis, 2006; Burwell and Shirk,
2007). In Africa gender plays an important role in the socio-cultural set up of families and
societies. Parenting practices, socialization, roles and expectations differ according to the
sex of the child. This makes investigation into gender difference among orphans on
psychological wellbeing critical (Dahlback et al., 2008).

58

The result of the qualitative data revealed that psychological care is as equally
important as the physiological need of orphan children. Although the respondents believe
that psychological care should be of equal importance in the care of orphan children as that
of other needs, they noticed based on their experiences that the majority of Ethiopians do
not believe so. This view of the respondents is consistent with the findings of Bicego,
Rutstein, and Johnson (2003) and Browne and Hamilton-Giachritsis (2004) which indicate
that placing survival above all other needs is a common practice in poverty-stricken
societies. This is also in line with Maslows (1943) contention that when all needs are
unsatisfied, the organism is dominated by the physiological needs, all other needs may
become simply non-existent or be pushed into the background.
The types of psychological care that were identified from the analysis of the
interview data were: encouraging individuality and autonomy which involves, according to
the respondents, giving children the right to express themselves as individuals through
simple means. These means can include anything that can help the children to expresses
who they are and that they actually matter, have a value, and are not forgotten. Moreover,
the respondents believed that enhancing the self-esteem of the children could develop the
childrens sense of self in a positive direction thereby improving their psychological
wellbeing. Respondents also stated that children must first be loved in order to learn how to
love. However, the respondents feared that many children who had lost their families or
spent many years in institutions or relatives would lose this yearning.
The respondents view on love as something innate (Maslow, 1999; Schore, 2001),
and of attachment as an affectional connection between child and adult has been echoed in
the literature (Sperling and Berman, 1998). Attachment difficulties similar to the above
described have been observed specially in orphanages around the world (Rutter and Taylor,

59

2002; Vorria et al., 2006). Most often, these difficulties are related to children not having
access to primary caregivers (Zeanah et al., 2006).
The important element identified for the enhancement of the psychological wellbeing of orphan children was the respect and care/support given to the children by adults.
Respondents believed that if children are respected and cared for, their psychological wellbeing and their visibility in society increases.
Similar to the respondents views, experts believe that if children are respected and
cared for, their visibility in society increases. However, this visibility tends to dissipates
once they become parentally bereaved, neglected, or abused, and when this happens, the
distance to open discrimination is not far (UNICEF, 2005). Social support is also important
in terms of education and psychological health as it has been shown to play a fundamental
role in the prevention of future mental health problems (Davidson and Doka, 1999; Schmitz
and Crystal, 2000), in the advancement of psychosocial well-being, and the decrease of
psychosocial distress among orphans (Gilborn et al., 2006).

60

CHAPTER SIX
Summary, Conclusion, and Recommendations
6.1 Summary
The general objective of this study was to compare the psychological well-being of
orphan and non-orphan children in Addis Ababa. Both quantitative and qualitative methods
were employed to answer the stated research questions. Demographic questionnaire and
psychological wellbeing scale were administered and completed by the orphan and nonorphan children. Moreover, interviews were held with the three representatives of Charity
clubs in selected schools based on an interview guide who aims at exploring the major
element that could promote the psychological wellbeing of the orphan children.
To analyse the data from the quantitative survey percentages, t-test, and Pearson
correlation were employed. The qualitative data obtained from the in-depth interview were
analysed using inductive thematic analysis. This means that the researcher generated themes
in accordance with the themes available in previous quantitative literature.
The following major findings were found from the analysis of the quantitative and
the qualitative data:
Using mean split technique on the psychological wellbeing scores of orphans, 76
(62.5%) of the orphans had low psychological wellbeing whereas only 44(36.66%) of them
had high psychological wellbeing. With regard to non-orphans, 77(64.16%) scored high in
psychological wellbeing whereas 43(35.83%) of them had low psychological wellbeing.
The t-test comparison of group means on psychological wellbeing of orphans and
non-orphans showed a significant difference. The mean of non-orphans was significantly
higher than the mean of orphans.
Among the demographic variables considered in the study, grade level and parental
status were significantly correlated with psychological wellbeing of orphans. Grade level
61

was positively correlated whereas parental status was negatively correlated with
psychological wellbeing.

6.2 Conclusion
Based on the major findings of the study, the following conclusions are drawn:
While the majority of the orphan children scored low on psychological wellbeing,
the majority of non-orphans scored high on psychological wellbeing. In general, the
psychological wellbeing of orphans is low.
The result of this study shows that the majority of orphan children have poor
psychological wellbeing. Encouraging orphan childrens individuality and self-esteem and
providing care and support were suggested by the interviewees as solutions to enhance the
psychological wellbeing of these children.

6.3 Recommendations

Based on these major findings of the study, the following are recommended:
As the researcher observed during the research process, there are no psychological
services in those selected primary and junior schools in the sub-city. Orphans need special
child guidance and counselling programs. This is a specialized service which demands
adequate training on the part of the counsellors. It is therefore recommend that the schools
may have to consider the possibility of recruiting a qualified school counsellors or child
psychologist. The task here is to offer early warning of psychological conditions that may
prevent a child from benefiting from school services; and to offer referral services for the
cases the professionals in the schools are not able to handle. The psychologist so employed
will have the skills to diagnose psycho-social problems and to offer psychotherapy to
children in need.

62

Counselling and Child Psychology should be taught to teachers and health care
providers and all schools will need to have a child guidance counsellor to help not only the
orphans and other vulnerable children but also their caretakers and the teachers in dealing
with the children.
Psychological care should be of equal importance in the care of orphan children as
that of other needs such as providing food. Community development workers and guardians
need to understand signs of emotional problems and should provide love and care for the
orphans. A great amount of time, love and care must be given to the orphans. Not only does
the child have to deal with the death of the parent(s), but also he/she may be discriminated
by other children. Hence, periodic workshops and seminars should be organized for
guardians and community development workers to train them in problem identification and
counselling.
Families with orphans should be helped in terms of food security, income
generation and counselling including information on the Rights of the Child, so as to be
able to better look after their orphans.
Finally, there is also a need for future in-depth qualitative studies to gain detailed
and rich understanding in answering the how and why of the behaviours and
experiences of orphans in their real world. Moreover, there is a need for more research to
delineate the specific psychological and other problems faced by the caretakers of orphans.

63

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Appendices

77

Appendices A

- -

- /


!!

- ()

1. : ______________________________
2. :

3. /: __________________________________
4. /
.

5. / /
. /
. /
.
6. /?
. /

. /
.
. /
.
. /

78

_________

1.

.
2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

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13.

14.

15.


16.


17.

18.

19.

20.

21.

22.

23.

24.

25.


26.


27.

80


28.
/
29.

30.

31.

32.

33.

34.

35.


36.

37.

38.

39.

40.

41.

81

42.

43.


44.


45.

46.

82

Appendices: B

Addis Ababa University

College of Education and Behavioral Studies
Institute of psychology
The purpose of this questionnaire is to gather information regarding to psychological wellbeing of
orphan and non-orphan children. This questionnaire has two parts: the first part has demographic
questions about the respondents; the second part has Ryffs Scale of Psychological Wellbeing Scale.
The information you provide has a very important input in the direction and completion of this
study, so please try to be honest, and careful. There is no one to judge you because there is not right
or wrong answer for the questions.
The information will be kept confidential and be only applied for the study. Yours right information
helps to reach the goals of the study.
Thank you for investing your time and honesty completing this questionnaire.
Part one Background Information
Direction: please indicate your answer by making ( ) in the box that corresponds to your answer
or to write the correct answer on blank space
1. Age ________________
2. Sex

A. Male

B. Female

3. Grade level ______________________________

4. Do you alive yours parent?
A. Yes

B. no

5. Your answer for question 4 no which parent is missed

A. Father
B. Mather
C. Both
6. Current living
A. With father
B. With mother
C. With relatives
D. With non-relatives
E. Institutions
F. With both parents
G. Other ________________

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RYFF SCALES OF PSYCHOLOGICAL WELL-BEING

The following set of statements deals with how you might feel about yourself and your life.
Please remember that there are neither rights nor wrong answers. Put mark that best
describes the degree to which you agree or disagree with each statement
Put mark that best describes the degree to
which you agree or disagree with

1.

Strongly
Disagree

Most people see me as loving and

affectionate.
each statement.
2. I am not afraid to voice my opinion,
even when they are in opposition to
the opinions of most people.
3. In general, I feel I am in charge of
the situation in which I live.
4. When I look at the story of my life, I
am pleased with how things have
turned out.
5. Maintaining close relationships has
been difficulty and frustrating for
me.
6. My decisions are not usually
influenced by what everyone else is
doing
7. The demands of everyday life often
get me down
8. In general, I feel confident and
positive about myself
9. I often feel lonely because I have few
close friends with whom to share my
concerns
10. I tend to worry about what other
people think of me
11. I do not fit very well with the people
and the community around me

84

Disagree

Disagree

Agree

Slightly

Slightly

Agree

Strongly
Agree

12. I think it is important to have new

experiences that challenge how you
think about yourself and the world

13. My daily activities often seem trivial

and
unimportant to me
14. I feel like many of the people I know
have gotten more out of life than I
have.
15. I enjoy personal and mutual
conversations with family members
or friends
16. Being happy with myself is more
important to me than having others
approve of me.

17. I am quite good at managing the

many responsibilities of my daily life
18. When I think about it, I havent
really improved much as a person
over the years
19. I dont have a good sense of what it
is Im trying to accomplish in my life
20. I like most aspects of my personality
21. I dont have many people who want
to listen when I need to talk
22. I tend to be influenced by people
with strong opinions
23. I often feel overwhelmed by my
responsibilities
24. I have a sense that I have developed
a lot as a person over time.

85

25. I used to set goals for myself, but

that now seems a waste of time.
26. I made some mistakes in the past, but
I feel that all in all everything has
worked out for the best

27. It seems to me that most other people

have more friends than I do.
28. I have confidence in my opinions,
even if they are contrary to the
general consensus.
29. I generally do a good job of taking
care of my personal finances and
affairs.
30. I do not enjoy being in new
situations that require me to change
my old familiar ways of doing
things.
31. I enjoy making plans for the future
and working to make them a reality.
32. In many ways, I feel disappointed
about my achievements in my life.
33. People would describe me as a
giving person, willing to share my
time with others.
34. Its difficult for me to voice my own
opinions on controversial matters.
35.

I am good at juggling my time so

that I can fit everything in that needs
to be done.

36. For me, life has been a continuous

process of learning, changing, and
growth.

86

37. I am an active person in carrying out

the plans I set for myself.
38. I have not experienced many warm
and trusting relationships with
others.
39. I often change my mind about
decisions if my friends or family
disagree.
40. I have difficulty arranging my life in
a way that is satisfying to me.
41. I gave up trying to make big
improvements or change in my life a
long time ago.
42. Some people wander aimlessly
through life, but I am not one of
them.
43. I know that I can trust my friends,
and they know they can trust me.
44. I judge myself by what I think is
important, not by the values of what
others think is important.
45. I have been able to build a home and
a lifestyle for myself that is much to
my liking.
46. When I compare myself to friends
and acquaintances, it makes me feel
good about who I am.

87

Appendix: C
Interview Guide
1. Introduction
Present myself, the study and its purpose, approximate length of interview. Tell participants
about anonymity, confidentiality, voluntary participation. The interview will be recorded
with your permission and later destroyed. Offer a summary of the report.
2. Is there anything you'd like to ask me before we begin?
Taping begins.
3. Background of the respondent.
*Education in what area and how long?
*Work how long have you held this job position? Training for the job? Earlier
experience.
4. Topics and Questions:
Topic 1: Current psychological status of the children
- In your view, what are the children's primary psychological needs? Is there any room for
psychological needs?
- Can you tell me about the common psychological problems that the children suffer from?
How are you able to observe these problems?
Topic 2: Social aspects of childrens psychological health
- What social needs do you thing the children have?
Topic 3: The future
- What could be done? What would you like to see done? Why does it not happen?

Thank you for your time and for taking part in the study.

88

Appendix: D

89