Psychology Research-Issue 5 PDF

Psychology Research
Volume 6, Number 5, May 2016 (Serial Number 59)
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Psychology
Research
Volume 6, Number 5, May 2016 (Serial Number 59)
Contents
General Psychology
Identifying Conceptual Differences Between Psychiatric Disorders and Neurological

Disorders Although Both Are Disorders of Brain 259
Shrirang S. Bakhle
The Influence of the Family on the Development of Psychosomatic Disorders in Preschool

Children With Mental Retardation 270
Svetlana Aleksandrovna Mugal
Developmental and Educational Psychology
Using FAST Test for Diagnosing of Cohesion and Hierarchy of Primary Families of
University Students 275
Lucia Lackova, Martin Malcik
Inclusion in International Schools: Theoretical Principles, Ethical Practices, and

Consequentialist Theories 287
Julie M. Lane, David R. Jones
Applied Psychology
Psychological Distress in Anorectic Women, Their Fathers and Mothers 301

Elisabeth Bratt Neuberg, Gerhard Andersson
Representation of Youth Generation in the Mobile Phone and Internet Media in Sri Lanka 311
Manoj Jinadasa
Psychology Research, May 2016, Vol. 6, No. 5, 259-269
doi:10.17265/2159-5542/2016.05.001
D DAVID PUBLISHING
Identifying Conceptual Differences Between Psychiatric

Disorders and Neurological Disorders Although Both Are
Disorders of Brain
Shrirang S. Bakhle
Dr. Bakhle Clinics, Mumbai, India
With increasing understanding of neurobiological basis, Psychiatric Disorders are being considered Brain
Disorders. As neurobiological basis of Psychiatric Disorders becomes known, some questions arise. Should all
these disorders be called Neurological Disorders and be treated by Neurologists? If, both, Psychiatry and Neurology
treat disorders of the same organ, brain, then, should departments of Psychiatry be merged with departments of
Neurology? What are the defining features of Psychiatric Disorders as a group that differentiate them from
Neurological Disorders? There is a need to define inclusion and exclusion criteria for distinguishing between
Psychiatric and Neurological Disorders. There are practical needs for this. For example, what criteria guide the
decision to admit a patient in Psychiatry Ward or Neurology Ward? This is also important from legal and stigma
point of view. The theoretical need is nosological. What criteria determine whether a particular disorder should be
included in Neurology or Psychiatry? The paper shows how it is impossible to differentiate between Psychiatric and
Neurological Disorders on the basis of neuroanatomy or neurophysiology. The paper describes the vital importance
of the term “mental” in Psychiatry (e.g., “Mental” Disorders, “Mental” Status Examination, etc.) and how it cannot
be replaced by “Neurological” or “Brain”. The paper discusses how Psychiatric Disorders are basically “Mental”
Disorders (disorders of mind). It shows how mind is a real and specific entity. It gives a novel definition of mind
using a specific concept of “functional organization”. The article gives a precise description of mind-brain
relationship using the concepts of physical parts, functional parts and active functional organization. This
description answers many questions such as “Why no biomarkers have been found for any of the Mental Disorders”
and the topic in the title. The article also explains how this concept of mind provides a better framework for
describing the mental events in normal persons and in Mental Disorders—as compared to the concepts of Cognition
or Higher Functions or Executive Functions. It shows the fallacy of using the term “Behavioral” Disorders. The
article shows how there is no other answer to the question of “What is the difference between Psychiatric and
Neurological Disorders?”
Keywords: behavioral disorders, cognition, DSM-5, functional organization, mental disorder, mind, mind-brain
With increasing understanding of neurobiological basis, Psychiatric Disorders are being considered Brain
Disorders. As neurobiological basis of Psychiatric Disorders becomes known, some questions arise. Should all
these disorders be called Neurological Disorders and be treated by Neurologists? If, both, Psychiatry and
Shrirang S. Bakhle, M.B., Director, Dr. Bakhle Clinics.

260 IDENTIFYING CONCEPTUAL DIFFERENCES BETWEEN PSYCHIATRIC DISORDERS
Neurology treat disorders of the same organ, brain, then should departments of Psychiatry be merged with
departments of Neurology?
What are the defining features of Psychiatric Disorders as a group that differentiates them from
Neurological Disorders?
There is a need to define inclusion and exclusion criteria for distinguishing between Psychiatric and
Neurological Disorders. There are practical needs for this. For example, what criteria guide the decision to
admit a patient in Psychiatry Ward or Neurology Ward? This is also important from legal and stigma point of
view.
The theoretical need is nosological. What criteria determine whether a particular disorder should be
included in Neurology or Psychiatry?
Intuitively everyone understands the difference. But as a scientific method, it is important to precisely
describe the specific differentiating criteria that distinguish Psychiatric disorders from Neurological disorders
although both the disorders happen in the brain. It is relatively easy to say that Neurological Disorders are
disorders of the brain (and the nervous system). But it is more difficult to pinpoint the defining and
differentiating features of Psychiatric disorders as a group.
Answering these questions is also important to establish the unique specialty of Psychiatry and to answer
some of the objections of the Anti-Psychiatry proponents, who have called Psychiatry a pseudoscience and
Psychiatric Disorders a myth (Torrey, 1975; Szasz, 1960; Weitz, 2016; Ross & Pam, 1995; Nasrallah, 2011).
No one says that Neurological Disorders are a myth. So, what are the reasons behind people saying that about
Psychiatric disorders? Thus answering this question is vital to establish the unique identity of Psychiatry and
Psychiatric Disorders.
This is not merely an exercise to divide the turf for Psychiatrists and Neurologists by randomly allocating
disorders. It is a fundamental effort to identify the conceptual differences between these two sciences.
With advancing understanding of neurobiological basis of Psychiatric Disorders, it can no longer be said
that Psychiatric Disorders are “functional” and Neurological Disorders are “structural” or “organic”. But on the
other hand, just because neurological basis has been found does not mean that all Psychiatric Disorders should
be called Neurological Disorders and that all psychiatric patients should be treated by Neurologists.
Psychiatric Disorders and Neurological Disorders cannot be differentiated on the basis of neuroanatomy or
neurophysiology. Can it be said that disorders of some parts of brain (such as hippocampus) are Psychiatric
Disorders and disorders of other parts are Neurological? The answer is negative. Or, can it be said that
disorders of Dopaminergic system are Psychiatric Disorders and disorders of other systems are Neurological
Disorders? Again, the answer is negative.
To say that there is a specialty of Neuropsychiatry is bypassing the question, not answering it. When it is
said that Neuropsychiatry is a merger of the two sciences, it is acknowledged that these are two distinct
sciences. There is a conceptual difference between Psychiatry and Neurology, and this paper seeks to present it.
Different Viewpoints about the Differences Between Psychiatric

Disorders and Neurological Disorders
There are a variety of positions regarding this issue.
In ICD-10, the chapters from III to XIV are dedicated to different physiological systems (such as
Circulatory system or Respiratory system) or to different anatomical parts (such as eye or ear). Therefore, it is

IDENTIFYING CONCEPTUAL DIFFERENCES BETWEEN PSYCHIATRIC DISORDERS 261
important to note that the ICD-10 has assigned Mental Disorders and Neurological Disorders to separate
chapters (V and VI). It underlines the important conceptual distinction between these two categories of disorders
even though both are related to the brain (ICD-10, 2010). Even in the draft of the forthcoming ICD-11, Mental
Disorders and Neurological Disorders have been assigned to separate chapters (ICD-11 Beta Draft, 2016).
Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th Ed., (Michels, 2009) says the following
about this issue: “There is much greater difference in the skill sets of neurologists and psychiatrists than in their
scientific knowledge bases, and there are certainly more than enough patients for both. We can look forward to
a healthy continued debate about where best to draw the boundary...” Two important points can be noted from
this. First, there is a boundary between Neurology and Psychiatry. So, these two are distinct sciences. Secondly,
Neurologists and Psychiatrists require different skill sets even if they both deal with the brain.
This concept is echoed by Ronald Pies in his article “Why Psychiatry and Neurology cannot simply merge”
(Pies, 2005). He describes how the discourses and terms used in Psychiatry and Neurology are different.
On the other hand, there are many who wish or predict that Psychiatry and Neurology will eventually
merge. For example, White, Rickards and Zeman, in their article, “Time to end the distinction between mental
and neurological illnesses”, say the following: “Yet the dominant classifications of mental disorder—the
International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual (DSM)—continue to
draw a sharp distinction between disorders of the mind, the province of psychiatry, and disorders of brain, the
province of neurology.” The article expresses a wish that both “the conditions should be grouped together as
disorders of the nervous system” (White, Rickards, & Zeman, 2012).
The proponents of the Anti-Psychiatry movement also recommend that only Neurology should remain.
But they say this from a different perspective. According to them, the concept of mental disorders is a myth.
There are either brain disorders or there are difficulties in social adaptation. Hence the “pseudoscience” of
Psychiatry should be abolished.
The Stanford Encyclopedia of Philosophy, in the article “Mental Illness” predicts, “It is likely that as
neuroscience progresses, the domains of neurology and psychiatry will start to merge” (Perring & Zalta, 2010).
Psychiatric Disorders Are “Mental” Disorders

The word “mental” is ubiquitous in Psychiatry: “Mental” Status Examination (MSE), DSM-5 is the DSM
of “Mental” Disorders, National Institute of “Mental” Health and so on. Will it be appropriate to substitute
“mental” with, say, “brain” or “neurological”? Will it be correct to say, “Brain” Status Examination or National
Institute of “Neurological” Health? Will it mean the same?
The DSM- IV-TR said the following about this issue: “... unfortunately the term (mental) persists in the
title of DSM-IV-TR because we have not found an appropriate substitute” (DSM-IV-TR, 2000). Thus, in spite
of long deliberations, they could not replace the term “mental” with other terms such as “brain” or
“neurological”. And the DSM-5 continues to carry the term “Mental” in its title: “Diagnostic and Statistical
Manual of Mental Disorders”, 5th Ed (DSM-5, 2013).
Thus Psychiatric Disorders are basically “mental” disorders.
What Is the Meaning of “Mental”?

It is interesting to note that such an important term is not even mentioned or defined in Psychiatry or
Psychology dictionaries such as Campbell’s Psychiatric Dictionary (Oxford, 2009), Oxford Dictionary of

Psychology (Colman, 2009), American Psychological Association’s Online Glossary of Psychological Terms
(accessed 2016).
According to the Oxford English Dictionary (2010), “mental” means “1. Relating to the mind; 2. Relating
to disorders or illnesses of the mind”.
So can it be said that Psychiatric (“Mental”) Disorders are disorders of the mind and Neurological
Disorders are disorders of the brain? Is “mind” the unique identifying and differentiating feature of Psychiatry
and Psychiatric Disorders?
To understand this point, there is a need to understand the inclusion criteria for determining that a
particular disorder is a “Mental” Disorder. And what are the exclusion criteria that can used to determine that a
particular disorder is not a “Mental” Disorder but is a Neurological Disorder?
Understanding the Inclusion and Exclusion Criteria of the DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, 5th Ed. (DSM-5) is a comprehensive
compendium of “Mental” (Psychiatric) Disorders. This means that every “Mental” (Psychiatric) Disorder is
included in the DSM-5. It also means that no non-mental disorder is included in the DSM-5. Hence
Neurological Disorders are not included in the DSM-5.
So by studying the inclusion and exclusion criteria of DSM-5, it will be possible to understand the
identifying and differentiating features of Mental (Psychiatric) Disorders as compared to Neurological Disorders.
Unfortunately, the DSM-5 does not describe any inclusion or exclusion criteria for a disorder to be
included in DSM-5 or to be excluded from it.
But an attempt can be made to understand these criteria by studying some disorders that have been
included and some disorders that have been excluded.
For this, three disorders can be examined: (1) Conversion Disorder with Paralysis; (2) Hemiplegia due to a
vascular event (for example, Hemiplegia due to Cerebral Infarct); and (3) Vascular Neurocognitive Disorder.
The Conversion Disorder and Vascular Neurocognitive Disorder are considered “Mental” Disorders and
hence are included in the DSM-5. Hemiplegia is excluded from the DSM-5 as it considered a Neurological
Disorder and not a Mental Disorder. This is in spite of the fact that all these disorders are related to the brain.
So what are the features that differentiate these two groups?
(1) Clinical features:
Both, Conversion Disorder with Paralysis as well as Hemiplegia, have paralysis as the presenting feature.
Hence this is not a differentiating feature between them.
(2) Vascular etiology:
Both, Hemiplegia and Vascular Neurocognitive Disorder, have vascular etiology. Hence this is not a
differentiating feature.
(3) Dysfunctions in mind:
Both Conversion Disorder and Vascular Neurocognitive Disorder have “mental” dysfunctions, i.e.,
dysfunctions in the mind. And therefore, they are considered as “Mental” Disorders and are included in DSM-5.
But Hemiplegia does not have any dysfunction in the mind and hence is excluded from the DSM-5.
Every “Mental” Disorder has dysfunctions in the mind—with or without demonstrable dysfunctions in the
brain. Are there any disorders in the DSM-5 that do not have “mental” dysfunctions (dysfunctions in the mind
of the patient)? The answer is negative.

Thus “mind” and “dysfunctions in the mind” are the unique identifying and differentiating features of
Psychiatry and “Mental” (Psychiatric) Disorders.
“Mind and Brain! Here We Go Again!”

Undoubtedly, the moment the terms mind and brain are used, a set of questions arises: What is mind? Is it
different from brain? What is the relationship between mind and brain? Are “Mental” Disorders, disorders of
mind or brain or both?
Also, why should the seemingly old fashioned term “mind” be used? Why not use the more modern
scientific terms like “Cognition” or “Higher Functions” or “Executive Functions”? And, is it correct to use the
term “Behavioral” Disorders instead of “Mental” Disorders?
Mind: The Central Key Piece of this Entire Puzzle

The mysterious nature of the mind and its relationship with the brain has been a philosophical conundrum
for millennia. Psychiatry is the medical science that evolved to treat “mental” disorders, i.e., the disorders of the
mind. The NIH’s US National Library of Medicine Website describes the “Diseases of the Mind: Highlights of
American Psychiatry through 1900”. It says: “Benjamin Rush, often called ‘The father of American Psychiatry’,
wrote the first systematic textbook on mental diseases in America entitled Medical Inquiries and Observations
upon Diseases of the Mind published in Philadelphia in 1812” (accessed 2016).
Please note how the US NLM’s webpage that describes the history of American “Psychiatry” is titled
“Diseases of the ‘Mind’”. And the Father of American “Psychiatry” wrote the first textbook of “mental”
diseases describing the diseases of the “mind”.
But the inability to define and describe the mind has resulted in the all the confusions in Psychiatry such as
the dilemma of the DSM-IV-TR (described above) and the challenges of the Anti-Psychiatry movement who
have called Psychiatric Disorders a myth. This inability has also resulted in Psychiatry dumping the enigmatic
mind in favour of the more concrete brain in search of a solid basis for Psychiatry and Mental Disorders. For
example, see the direction of the Research Domain Criteria Project (RDoC Project) of National Institute of
Mental Health (Cuthbert, 2013).
But the shift of focus from mind to brain has resulted in the fundamental unanswerable question: What is
the difference between Psychiatric Disorders and Neurological Disorders if both are disorders of the brain? If
the Psychiatric Disorders are disorders of the brain, then what about Neurological Disorders? They, too, are
disorders of the brain. So what is the difference between the two? This and the other questions can be answered
only by acknowledging that “Mental” Disorders are primarily disorders of the mind. There is no other answer
to this question.
But to solve this confusion, there is a need for a precise definition and description of mind.
What Is “Mind”?
The humans are conscious, intelligent creatures. They are aware of different sensations, beliefs, wishes,
emotions present in the mind. The metacognition occurs in the mind. The perception of environmental events
also occurs in the mind.
Humans can consciously analyze every event: what has happened, why it has happened, what could have
happened, what is likely to happen in future, etc. As a result of this analysis or processing, people experience

emotions in the mind: happiness, sadness, fear, anger. Then based on the wishes, people take conscious
decisions in the minds and do purposeful, deliberate actions to fulfill the wishes.
All this happens in the mind.
“Mind is the aggregate of everything that a person is aware of”.
Thus mind is the aggregate of the beliefs, wishes, emotions, the attention, the mental abilities and all the
mental events.
Mind Is an “Active Functional Organization” and Not Just a Random Collection of all
These Functional Parts
Mind is a specific functional organization of all these specific interactive parts. It is not just a random list
of all these. An “active functional organization” is capable of receiving specific inputs, processing them to
produce specific outputs. Thus it is capable of doing work which is more than the sum of work that its
individual parts can individually do. All the parts function cohesively in a unified manner to do the processing.
This enables each person to process different inputs to produce different outputs consciously and purposefully.
If a human can consciously do any thinking or voluntary activities, it is the result of this “active functional
organization” called mind.
Is Mind the Same as Brain? What Is the Relationship Between Mind and Brain?
Undoubtedly, the mind is created in the brain. But the mind is not the same as brain.
First, there is a category difference between the two: People are aware of the mind and its contents. But
they are not aware of brain, neurons, etc.
Secondly, there is a function-structure relationship between mind and brain. The parts of the mind are
functional parts: beliefs, wishes, emotions and all the mental events (events in the mind that people are aware
of). The parts of brain are the physical or structural parts. When brain parts perform their functions, they
produce the functional parts of the mind. These interactive functional parts lead to the formation of the active
functional organization called mind. This is a very crucial concept to understand.
In order to illustrate this concept of “functional parts, physical parts and functional organization”, the
example of another functional organization, a school, can be studied. The building, the people and the children
are the physical parts. The Dean, teachers, students and classrooms are the functional parts. Here, can it be said
that the physical parts are different from functional parts? When an individual physical part performs its
function, that function becomes a functional part. For example, when a man becomes a teacher or a child
becomes a student. The interactions between the functional parts, lead to the formation of the “functional
organization”. Then this functional organization becomes capable of processing complex inputs to produce
complex outputs. In this case, the output is educating the children.
For this functional organization, specific physical parts and functional parts are required. For example, if
people and children are randomly picked up from the street and put in any randomly picked building, it will not
become the active functional organization called school. It will not be able to process the inputs to produce the
specific output.
On the other hand, consider the turnover in a school. The teachers retire or leave and new teachers join.
Students pass out and new students join. The building may change. Yet the functional organization
remains—performing its function of processing inputs to produce outputs. Thus a “functional organization” is a

well-defined real entity although there may not be a strict one to one correlation between physical parts and
functional parts.
The mind is a similar active functional organization of functional parts that are produced in the physical
parts of the brain.
The Importance of Understanding the Difference Between Physical Parts,

Functional Parts and the Functional Organization
When a school is photographed, what exactly is being photographed? Is the functional organization called
school being photographed or are only the physical parts that generate the functional parts are being
photographed? Is it possible to photograph the education that is being created in the minds of the students by
taking photo with a camera? The answer is negative. Here the ontological difference between the physical parts
and the functional parts comes into the picture.
This point has tremendous relevance to the discussion about the mind-brain relationship. When an fMRI
or a PET scan is done, what is being photographed? Are the mind parts (functional parts) being photographed
or brain parts (physical parts) being photographed? Clearly, the brain parts are being photographed. At the
most, it can be said that the scans are photographing the brain parts while they are producing the
functional mind parts. It is impossible to photograph the functional mind parts such as beliefs, wishes or
emotions with an fMRI. Can an “fMRI Report” be like this: “The subject was thinking angrily about the
office colleague, John, who had insulted him yesterday in front of the office staff. The subject was thinking
about when and how to take revenge”? Such an fMRI report would mean photographing the mind. This is
impossible in the present or the near future. It is important to note this point when the mind and brain is being
studied.
The Properties of a “Functional Organization”

It is important to understand this concept in more detail in order to understand the enigmatic nature of the
mind. A “functional organization” is formed when individual physical parts are aligned in a particular manner.
Each individual physical part is capable of performing a small function depending on its properties. When these
aligned individual physical parts perform their functions in a definite temporal sequence, the result is the
formation of a functional organization. The net resulting function of this functional organization is far greater
than the mere sum of the functions of each individual part.
The example of another functional organization, a robot, can be studied to understand this point.
Consider all the parts of a robot lying in a heap. All the parts are exactly the same as present in a
functional robot. If the physical properties such as weight or volume are measured, there will be no difference
between the parts of the robot lying in a heap or the parts in a functional robot. Even when the parts are kept
separately, each individual part is capable of doing a small job that it is made for. Yet, when the same parts are
aligned as a “functional organization”, they can do work which is far bigger than the sum of the works that they
can do individually. In the example of the robot, the different motors individually do simple work: rotate the
axles. But when they are arranged as a part of a “functional organization”, they, together with other parts, can
effect highly complex robotic movements.
There are plenty of examples of functional organizations. Each biological cell is a functional organization
of specific physical parts. The physical parts are aligned in such a way that the interactions of their functional

parts lead to the formation of an active functional organization called a living cell. This functional organization
is capable of receiving and processing complex inputs to produce complex outputs. Different organs or living
creatures, too, are examples of functional organizations. Schools, companies or governments are some
examples of functional organizations.
Thus it is important to recognize an entity called “active functional organization”.
A “functional organization” is a real entity but it does not have a separate material existence that can be
measured in physics terms like weight or volume. It is a pattern created in an alignment of physical parts. Its
existence can be understood by observing its ability to process complex inputs to produce complex outputs. If
the existence of a functional organization like government can be accepted, the existence of the active
functional organization called mind can also be accepted.
If a human can consciously do any thinking or voluntary activities, it is the result of this active functional
organization called mind.
Mind and the “Mental” Disorders

The “mental” disorders are disorders of this functional organization called mind. Each “mental” disorder
involves dysfunctions in one or more of the functional parts of mind. Sometimes they may involve
demonstrable dysfunctions in the physical parts of the brain but not always. As seen earlier, investigations such
as fMRI or PET scan cannot photograph the functional mind parts. Hence they cannot photograph the
dysfunctions in the functional mind parts that are seen in the mental disorders. At best they can photograph the
physical brain parts while they are producing the dysfunctions in the functional parts of the mind.
It is important to note that there is no strict one to one correlation between physical brain parts and
functional mind parts as well as in the dysfunctions in both of these. Hence it is not possible to diagnose
dysfunctions in functional mind parts using investigations like fMRI or PET scan that can photograph the
physical brain parts. This point clarifies the reason why no biomarkers (based on brain investigations) have
been found for any of the mental disorders. At the most, these investigations can be used in the other direction:
to find out the brain part correlates of the functional mind parts and their dysfunctions.
Yet it is important to acknowledge the reality of the active functional organization called mind as well as
the dysfunctions in the functional parts of the mind seen in “mental” disorders.
Are “Mental” Disorders, Disorders of Mind or Brain?

Since mind is created in the brain, is it correct to say that “mental” disorders are disorders of the brain?
The brain performs many different functions. Producing mind is one of them. Thus mind is one subset of the
functions produced by the physical parts of the brain.
Is it appropriate to say that a Department of Psychiatry is the same as the Medical College in which it is
housed? By pointing to the Department of Psychiatry (DoP), it can be said that “This is DoP” or it can be said
that “This is Medical College”. Both the times it will be correct. Yet, it is easy to know that the DoP is not the
same as the Medical College. Similarly, it can be said that “Mental Disorders are disorders of mind” or it can be
said that “Mental disorders are disorders of brain”. Both the descriptions are right. But the description that
“Mental Disorders are disorders of the mind”, is scientifically precise. The original topic of this article needs to
be seen in this light.

What Is the Difference Between Psychiatric Disorders and Neurological

Disorders If Both are Disorders of the Brain?
It can be said that the Psychiatric (or Mental) Disorders are disorders of the brain. But the description that
the Psychiatric (or Mental) Disorders are disorders of the mind, is scientifically precise.
Similarly, it can be said that Psychiatry is study of disorders of the brain. But the description that
Psychiatry is study of disorders of the mind, is scientifically precise.
It is important to note that the statement, “Psychiatric Disorders are disorders of the mind”, does not
contradict the fact that Psychiatric Disorders happen in the brain.
After the Clinical Examination of a Patient, Does a Psychiatrist Conclude

“This Patient Has Dysfunction in Ventral Tegmental Area”?
After the clinical examination, does a Psychiatrist diagnose dysfunctions in different parts of the brain
such as Ventral Tegmental Area or Nucleus Accumbens? The Psychiatrist may conclude that this patient is
suffering from “intense sadness and mild fear related to the topic of failure in exam”. These are dysfunctions in
parts of the mind. The Psychiatrists may use different methods of treatment (such as Pharmacotherapy or Brain
Stimulation Therapies) that involve modifying various aspects of brain. But the goal of Psychiatrists is to
diagnose and treat the dysfunctions in the mind.
Why Use an Old Fashioned Term like “Mind”? Why not Use the More Modern
Terms like “Cognition”, “Executive Functions” or “Higher Functions”?
There are two distinct advantages of using the term mind as compared to the use of the other terms. Firstly,
mind is a more comprehensive concept as compared to the other terms. And secondly, the term “mind” denotes
an active functional organization of interactive parts capable of receiving inputs and processing them to
produce outputs. The other terms are merely lists of functions.
For example, consider the term “cognition”. The Oxford Dictionary of Psychology defines cognition as
“the mental activities involved in acquiring and processing information” (Colman, 2009). Obviously, the
emotions are not included in the concept of cognition. The textbook “Cognition” by Ashcraft and Radvansky, is
an example of this. It defines “Cognitive science” as: “the scientific study of thought, language, the brain—in
short, the scientific study of mind”. As can be seen, the emotions are missing in this definition. Not only that,
but in this entire textbook of 477 pages, just one and half page is devoted to the description of emotions
(Ashcraft & Radvansky, 2010).
The tremendous importance of emotions in mind and mental disorders as well as the intense interplay
between cognition and emotions is well known. By excluding emotions, the term cognition becomes an
incomplete account of the mental events in normal persons and in persons with “mental” disorders. In
comparison, the mind is a complete and comprehensive term when the mind is defined as the aggregate of
everything that a person is aware of: sensations, beliefs, wishes, emotions, attention, mental abilities as well as
the mental events.
The terms Executive Functions (EF) or Higher Functions (HF) are even narrower. Both are merely lists of
a few functions. As compared to the entire scope of the mind (as the aggregate of everything that a person is
aware of), the EF or HF represent only very few of the functions that the human mind is capable of. Also, the
mind represents an “active functional organization” as compared to EF or HF which are just lists. So if a

comprehensive framework to describe the mental events (in normal persons as well as in persons with Mental
Disorders) is required, the mind is a much better option as compared to EF or HF.
Is It Correct to Use the Term “Behavioral Disorders” Instead of “Mental Disorders”?

“Introduction to Psychology” by Morgan, King, Weisz and Schopler defines behavior: “Behavior includes
everything a person or animal does that can be observed in some way” (Morgan, King, Weisz, & Schopler, 2001).
So, can any “altered behaviour” be termed as “Behavioral Disorder”? Consider orthopedic problems. They, too,
lead to markedly altered or abnormal “behavior”. For example, abnormal facial expressions, movements, gait,
bladder and bowel habits as well as functionality. Can all such disorders be called as Behavioral Disorders? The
answer is negative.
A disorder is called a Behavioral Disorder when the dysfunction is in the mind with resultant behavioral
manifestations. So, Behavioral Disorders are actually disorders of the mind. If the Motor Pathway is studied, it
easy to understand how the behavior is the output from the mind. Behavior is merely the externally “observable”
output of the mind.
Thus Psychiatric or “Mental” Disorders are best described as disorders of the mind. Terming them as
Behavioral Disorders is incorrect.
Conclusion
Mind is a subset of the functions of the brain. But mind is not the same as brain.
The Psychiatric Disorders are “Mental” disorders. This means that they are primarily disorders of the
mind. If “Mental” Disorders are defined as disorders of the brain, it is correct. But, if the “Mental”
Disorders are defined as disorders of the mind, it is being scientifically precise. The statement, “Psychiatric
Disorders are disorders of the mind” does not contradict the fact that Psychiatric Disorders happen in the
brain.
Similarly, if Psychiatry is defined the study of disorders of the brain, it is correct. But if Psychiatry is
defined as the study of disorders of the mind, it is being scientifically precise.
Thus, Psychiatry should be defined as the study of Mental Disorders which means disorders of the mind.
Neurology is a broad term which means study of disorders of the brain (and nervous system).
References
Ashcraft, M. S., & Radvansky, G. A. (2010). Cognition (p. 2). Dorling Kindersley: Pearson Education Inc..
Campbell, R. J. (2009). Campbell’s Psychiatric Dictionary (9th Ed.). New York, N.Y.: Oxford University Press.
Colman, A. M. (2009). Oxford Dictionary of Psychology (3rd Ed., p. 143). Oxford UK: Oxford University Press.
Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: The seven pillars of RDoC. BMC Medicine, 11,
126. doi: 10.1186/1741-7015-11-126
International Classification of Diseases and Related Health Problems (10th Revision) (ICD-10). (2016). World Health
Organization. Retrieved April 2, 2016, from http://apps.who.int/classifications/icd10/browse/2016/en
International Classification of Diseases and Related health Problems (11th Revision-Beta Draft) (ICD 11-Beta Draft) Retrieved
April 1, 2016, from http://apps.who.int/classifications/icd11/browse
Michels, R. (2009). Kaplan and Sadock’s Comprehensive Textbook of Psychiatry (9th Ed., p. lvi). Philadelphia, P.A.: Wolters
Kluwer/ Lippincott Williams and Wilkins.
Morgan, C. T., King, R. A., Weisz, J. R., & Schopler, J. (2001). Introduction to psychology (7th Ed., p. 6). Mcgraw-Hill Inc.: Tata
McGraw-Hill.
Nasrallah, H. A. (December 2011). The antipsychiatry movement: Who and Why. Current Psychiatry, 10(12).

Ozarin, L., & North, M. (Ed.). (2013, September 17). Diseases of the mind: Highlights of American psychiatry through
1900-Benjamin Rush. U.S. National Library of Medicine. Retrieved April 2, 2016, from
http://www.nlm.nih.gov/hmd/diseases/benjamin.html
Perring, C., & Zalta, E. N. (Ed.). Mental illness: The Stanford Encyclopedia of Philosophy (Spring 2010 Edition). Retrieved April
2, 2016, http://plato.stanford.edu/archives/spr2010/entries/mental-illness/
Pies, R. (Summer, 2005). Why psychiatry and neurology cannot merge. Journal of Neuropsychiatry and Clinical Neurosciences,
17, 304-309.
Ross, C. A., & Pam, A. (1995). Psudoscience in biological psychiatry. New York, N.Y.: John Wiley and Sons, Inc..
Soanes, C. (Ed.). In S. Hawker, & J. Elliott (2010). Oxford English Dictionary (26th impression). Oxford University Press.
Szasz, T. (1960). The myth of mental illness. New York: Hoeber-Harper.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Ed., (DSM-5). (2013). Washington, D.C.: American Psychiatric
Association.
The Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., Text Revision, p. xxx, (DSM-IV-TR). (2000). Washington,
D.C.: American Psychiatric Association.
Torrey, E. F. (1975). The death of psychiatry. New York, N.Y.: Penguin Books.
Weitz, D. (1998). 25 Good reasons why psychiatry must be abolished. Retrieved April 1, 2016, from
http://www.antipsychiatry.org/25reason.htm
White, P. D., Rickards, H., & Zeman, A. Z. J. (2012). Time to end the distinction between mental and neurological illnesses. BMJ,
344, e3454.

doi:10.17265/2159-5542/2016.05.002
D DAVID PUBLISHING
The Influence of the Family on the Development of

Psychosomatic Disorders in Preschool Children With
Mental Retardation
Svetlana Aleksandrovna Mugal

National Pedagogical Dragomanov University, Kiev, Ukraine
The article deals with the systematic analysis of theoretical and practical research materials of native and foreign
scholars on a comprehensive study of the family influence on the development of psychosomatic disorders in
preschool children with mental retardation. Also, it deals with the current tendency that identifies factors
affecting the development of preschool children with MR and the issue of identifying the link between
personality characteristics, content, psychotrauma characteristic and frequency of mental trauma. Nowadays the
main risk factors of psychosomatic disorders and mental retardation are clarified, which indicate the existence of
common pathogenic links of their formation. The crisis of the family in modern society is also considered in this
article.
Keywords: family, psychosomatic disorders, mental retardation, mental trauma
Introduction
A characteristic feature currently is the steady accumulation of the number of children with simultaneous
affection of somatic and mental health. In Ukraine, one of the most important and urgent issues in a special and
clinical psychology is the problem of the psychosomatic disorders study in children with mental retardation
(MR) and their impact on the formation and development of the child’s personality and the influence of
psychosomatic disorders on education, parenting and socialization of the children with MR. Recent years have
seen an increasing trend towards the number of children with deviation in mental and physical health, which is
caused by biopsychosocial, ecological, economic and other factors and their complex combinations (V.
Gavenkoetc., V. Galyabar, V. Pidkorytov, T. Hamaganovaetc., V. Kryshtal, B. Myhaylov, S. Tabachnikov, I.
Sergetaetc., O. Lutsenko, G. Beketova, V. Synov, G. Bergmann, and R. Gottlieb). A large number of these
children are children with mental retardation, whose numbers are increasing on the background of deterioration
in children’s health generally.
Most current researches of psychosomatic relations are conducted by experts in medicine (D. M. Isaev, B.
V. Mikhailov, M. Vyrshyng, B. Luban-Plotstsa, N. Pezeshkian, G. Y. Pilyagina, O. S. Chaban) or researchers
base on data they received during the research of the adult population (O. Y. Berezantsev, G. Ammon, M.
Bayer, P. Christian, M. Rad, R. Melzak). Among the child population researches in medicine are rare (G. A.
Svetlana Aleksandrovna Mugal, lecturer, Department of Practical Psychology and Psychosomatic Medicine, Faculty of Social
and Psychological Sciences and Management, National Pedagogical Dragomanov University.

THE INFLUENCE OF THE FAMILY ON THE DEVELOPMENT OF PSYCHOSOMATIC 271
Arina, N. A. Kovalenko, J. Klammer, G. P. Mozgova), especially among the preschool children.

Over the past decade, prevalence of psychosomatic disorders (PSD) among preschool child population
gained urgency all over the world. Currently in Ukraine for PSD it is typical not only high prevalence but
growth of it year after year. The PSD problem in preschool children is urgent and insufficiently explored. In
Ukraine, in literature there is generally no information about psychodiagnostic and psychocorrective processes
of PSD in preschool children with MR. Pathogenesis is complex. The symptoms are not enough structured and
differ due to complaints that do not match objective data. Psychosomatic disorders may be a somatic
manifestation of neurotic disorders and mental diseases, conversion disorders and neurotic accompanying of
non-psychotic diseases.
The modern view of psychosomatics goes beyond notions of health and disease. Psychosomatics is a
bodily reflection of spiritual life, which includes both the physical manifestations of emotions (the result of
their disbalance is psychosomatic disorders) and “mirror” of other unconscious processes, bodily channel of
consciously unconscious communication. If we look from this side, the body is imagined as a kind of screen, on
which symbolic messages of our unconscious are projected. This is the screen, where all the unconscious
becomes conscious, or at least it gets the potential opportunity to become it and where the psychological
problems of the child, his inner, conscious and unconscious conflicts are reflected in obligate and absolutely
compulsory order (A. Smulevych, A. Syrkin, S. Rapoport, and J. Kuchenhoff).
Among the complex of socio-economic problems and the catastrophic deterioration of health of
child population special role has increasing of stress situations in everyday life of children and their families.
Stress reactions essentially affect not only the immunity and physical development of children, but also
contribute to decrease intellectual capacity of the younger generation which directly depends on the features
of temperament, conditions of personality formation and parenting style. The instability of structure of the
child personality, immaturity of personality and its individual components, and also relations in the family
determine the relative easiness of occurrence of psychosomatic disorders (N. A. Belyh, O. V. Temnova, and D.
L. Wood).
From the perspective of biopsychosocial paradigm PSD in preschool children with normal mental
development and with mental retardation are considered as disorders in the genesis and development of which
the significant role is played by impact of mental trauma on the child’s condition. Today, scientists have proven
the existence of common pathogenetic links in factors that affect the formation and development of PSD and
MR in children. This is the impact of genetic predisposition (V. Synov, and J. Frommer); the impact of chronic
and acute stress (J. Kuchenholff); infections of TORCH-complex (toxoplasmosis, herpes, cytomegalovirus) and
metabolic disorders (N. Leonhardt); and the influence of social factors, educational neglect, etc.
Method
Participants
We examined 142 families: 28 families are incomplete and during the test was either mother or father of
the child and 114 families where both mother and father were present. In general, experimental psychological
study involved 398 people: 142 children and 256 parents.
Among the surveyed group of preschool children with MR were found 94 males, accounting for 66.20%
and 48 females, corresponding to 33.80% (see Table 1).

272 THE INFLUENCE OF THE FAMILY ON THE DEVELOPMENT OF PSYCHOSOMATIC
Table 1
Distribution of the Surveyed Preschool Children by Gender (N = 142)
Percentage
Number of preschool children with MD N = 142
Gender 100.00
The absolute number, N %
Boys 94 66.20
Girls 48 33.80
Рrocedure
It is worth noting that in modern society there is a crisis of the family, which is not only on
socio-economic level. Training of adults is also insufficient for family life on psychological and pedagogical,
social and pedagogical levels, and so on. Lack of strategy of creation and development of the family and family
values, lack of consistency in parenting, lack of understanding of the uniqueness and value of each child and
each family member, and the inability of parents to predict the effects of education—all this lead to emotional
health disorders in the family. Also, one of the factors that influence the occurrence of psychosomatic diseases
are attitude of the parents to child’s disease. The emergence of psychosomatic disease of a child is based on the
attitude of parents to their personality. Disputes in many families, that arise between spouses from time to time,
contribute to emergence of psychosomatic problems in the child. It is often impossible to solve these problems
and thus help the child without correction of married couple’s relations.
All children and their families were examined according to the main criteria of psychological diagnosis such
as:
(1) interview (conversation with parents, collecting anamnesis data (report));
(2) monitoring the child; monitoring the relations between parents and relations between parents and child;
(3) study of the micro-social environment;
(4) analysis of products of children’s activities.
To diagnose children we used different projective techniques such as “Animal that does not exist”, “Three
trees”, and “Family Drawing”.
Data Analysis
During conversations with parents, we payed attention to: heredity (hereditary diseases: mental, somatic or
psychosomatic); personal characteristics of parents; development of pregnancy, peculiarities of childbirth;
development of the child from birth to the present time (psychomotor development, development of higher
mental functions of the child, the occurrence of sleep or feeding disorders, study of psycho-emotional sphere of
the child; occurance of diseases in the early stages of child’s development, injury, surgery, intoxication, residual
effects of early demage of central nervous system (CNS); pathologically habitual actions etc.); peculiarities of
formation and development of the child’s relationship with adults and with other children; study of the
micro-social environment of the child (material and living conditions and conflicts in the family, the existence of
violations in the system “mother-child” “parent-child”, defects of parenting, attending child care centers by the
child, presence of sisters and brothers, incomplete family, smoking and alcoholism in parents, loss (desease) of
parents or near relatives, changing of communication stereotypes, psycho-emotional overload).
The main social circle for preschool child is family. Therefore, while using the method of observation, we
paid attention both to the child (behavior, speech, play, etc.) and relationship between parents and relationship
between parents and child.

THE INFLUENCE OF THE FAMILY ON THE DEVELOPMENT OF PSYCHOSOMATIC 273
Also, during the study, we used the method of analysis of products of children’s activities to analyze pictures,
appliques, stories of children and so on. Due to this method, we analyzed children’s pictures that we received
during the study of psycho-emotional state of the child, their perception and attitude towards parents, feelings
about their place in the family and attitude of their parents to them and the feeling of favorable or conflict
situation in the family. This information we obtained using projective techniques such as “Animal that does not
exist” (M. Z. Drukarevych), “Family Picture” (K. Mahover, William Wolf), “Three trees” (E. Klessmann).
Due to the technique “Animal that does not exist”, we studied the general characteristics of the child,
difficulties in communication, aggression, anxiety. Also, this method makes it possible to understand the inner
world of the child, how they perceive the environment.
Using the method of “Family Drawing”, we were able to find out how the child perceived himself and other
members of the family, what feelings he was experiencing in the family, and also we saw the features of
intrafamily relations. Children and parents can see and assess the family situation differently. The situation that is
positively appreciated on all sides by parents, the child can see and perceive differently. One can understand the
causes of many problems and effectively help the child during their solution, knowing how the child sees his
family, parents, himself and the world around.
It is worth noting that during the projective technique “Family Drawing”, we were faced with certain
problems. In families in which there was distorted, conflict and sometimes even hostile relationship―children
refused to do this task. Their behavior and mood changed. Some children closed, others showed aggression. But
we had to receive information about the relationship in the family. After a while, we offered the children another
projective technique “Three trees”. The value of this technique is the fact that first the child is offered to draw any
three trees on one sheet of paper, and only then compare them with family members of the child. So, during this
procedure children gave us detailed information about interfamily relations, the emotional state of the family,
their place in the family environment and so on.
Results
During a comprehensive study of psychoemotional state of the families, we found that each family
member has a high level of anxiety. Also there was aggression and understated or overstated self-esteem. In
relations between parents and parents’ attitude to children there is a conflict. All this leads to the occurance,
formation and development of psychosomatic disorders in preschool children with MR.
Also, we have studied preschool children with MR and their parents about the factors of PSD development.
The obtained data indicates that the first place took factors of psychosomatic disorders which arose as a result
of mental trauma of children due to distorted PSD in the family (there were 73 children or 51.40%). The second
place took disorders of emotional attachment in early ontogenesis (there were 58 preschool children or 40.85%),
and the third place took increased anxiety and depression that led to PSD in parents and adults from close
environment who care for the child. Parents project on the child their PSD and the child assigns and supports
them as his own. It was found 5 people of preschool age with MR (3.52%). It should be indicated that we had
also found a complex combination of factors that influenced the development of psychosomatic disorders in
preschool children with MR. We called them other factors. It was found 6 children (4.23%) (see Table 2).
It is worth mentioning the specifics of experimental study of the influence of family on the development of
psychosomatic in children with mental retardation. Parents of these children have had traumatic experiences
when they learned that their children have mental retardation. It increased the level of their anxiety and

274 THE INFLUENCE OF THE FAMILY ON THE DEVELOPMENT OF PSYCHOSOMATIC
contributed in some cases to distortion of PCR, in other cases to removal of parents from children, that led to
more sustainable disorder of emotional attachment. Accordingly, it affected the psycho-emotional state of the
child and his parents.
Table 2
The Main Factors of Mental Trauma of Surveyed Children in the Family
Number of preschool children with MD
The main factors of mental trauma of surveyed children in the family The absolute
Percentage (%)
number
100,00
(N = 142)
Mental trauma of children due to distorted parent-child relationship 73 51.40
Mental trauma of children due to disorders of emotional attachment in early ontogenesis 58 40.85
Mental trauma of children due to unresolved psychosomatic problems of parents and
adults from the close environment of children that are projected on a child and develop as
5 3.52
PSD in children which were formed by parents and are supported by them. The basis of
PSD in adults were anxiety and depression.
Other 6 4.23
Conclusion
Given all the above, it should be noted that the influence of family on the development of psychosomatic
disorders is very large, it indicates a high level of prevalence of this pathology and confirms the expediency of
early diagnosis and correction as well as the need for the public educative work.
References
Bondarchuk, O. I. (2001). Family psychology (p. 96). O. Bondarchuk. K .: AIDP.
Kulakov, S. A. (2010). Psychosomatics (p. 384). SPb.
Luria, A. R. (2002). Fundamentals of neuropsychology (p. 384). Publishing Center “Academy”.
Mozgova, G. P., & Mugal, S. O. (2014). Prevalence of psychosomatic disorders among child population (Urgent issues of
formation of physician personality in medical students, p. 140). Materials of XIII Int. Scientific and Practical Conference,
Kyiv, March 26, 2014.
Mugal, S. A. (2014). Factors affecting the development of psychosomatic disorders in children with mental and speech
development. Scientific Journal NPU Dragomanov, 19(27), 140.
Semenovich, A. V. (2012). Neuropsychological correction in childhood (p. 474). A V Semenovich: Genesis.
Vlasova, T. A. (1984). Children with mental retardation (p. 184). SRI defectology APS USSR.

doi:10.17265/2159-5542/2016.05.003
D DAVID PUBLISHING
Using FAST Test for Diagnosing of Cohesion and Hierarchy of

Primary Families of University Students
Lucia Lackova Martin Malcik

University of Ostrava, VSB—Technical Univerzity of Ostrava,
Ostrava, Czech Republic Ostrava-Poruba, Czech Republic
This work aims to develop the awareness on the possibilities of diagnosing risk factors of dysfunctional family
systems of primary families, in this case in families of university students. The goal is to inform about discovered
risks as they can significantly affect students’ decision-making processes, their performance, reaction to stress, their
ability to cope with the study environment and also their relationships as adults. In regards to the discovered risk
factors, the authors try to find their opposites, factors that balance and protect.
Keywords: primary family, family hierarchy, family system, family cohesion, emotional attachment, Family
System Test (FAST)
Introduction
People may not fully realize it but many unaddressed problems they encountered in their families frequently
play a role in their adult lives. In order to mitigate the results of dysfunctional family relations experienced, they
try to achieve excellent work results with the aim of financially securing themselves or their procreation families,
but frequently fail to manage occupational and partnership relations. Family is considered the first community
that prepares individuals for different life challenges. Family cohesion is considered an important factor for a
resilient family, however at a certain point a child should be left to create their “own life story” and learn to take
care of themselves and others. Families with low cohesion between members may impress an individual to doubt
the quality of interpersonal relationships, because they did not experience them themselves or experience them
only short-term. They may have seen negative relationships between their parents, between their parents and
siblings or among siblings, etc.. This factor may significantly disrupt their faith in people, society and develop
negative behavior patterns. The moment of negative family relations should be considered together with the
individual’s age; when they began to notice these dysfunctional relations. Did the individual also experience
positive times in the family and its cohesion? If the answer is yes, this may serve as their model for creating
additional relationships outside the family.
Primary Family
Family is the first social system a newborn baby experiences. The baby cannot choose one, it is born to
one. It is an environment that may, and also may not, help their healthy development. Satirová (2007) describes
a resilient family as a certain dynamic balance between maintaining family function in high pressure situations
Lucia Lackova, Department of Pedagogical and School Psychology, University of Ostrava.

Martin Malcik, Department of Social Sciences, VSB—Technical Univerzity of Ostrava.

276 USING FAST TEST FOR DIAGNOSING OF COHESION AND HIERARCHY
and the ability of individual members of the family to support each other. Satirová highlights the ability of
the family to adapt to difficult life situations. The key aspect is the family members supporting each other.
Families that fail, fail to communicate, lose mutual openness and respect between the members that is
first needed to find out the cause of these problems. If the cause is not found and the family continues functioning
this way and keeps the dysfunctional system, it is most probable that the children will repeat the same style,
unless they get the opportunity to experience a different, more constructive way of life. If a family is defined as a
system, it can be described as the collection of its elements and relations between them (Sobotková, 2007).
Psychologists, however, tend to avoid exact definitions of a family system. Phenomena taking place in a family
system are complicated and it is nearly impossible to describe a family system using a unified definition of
family.
Rieger and Vyhnálková (1996) understand family as a type of ecosystem, and examine its function in more
detail, primarily in regards to its dynamic aspects, i.e., changes of the family over time. Systemic approach
therefore understands family not only in the context of space, but also time. In the time context, the term family
process plays a significant role; it includes various interactions of family members inside the family system as
well as outside. Kantor and Lehr (1975) were among the first to describe a family system using the following key
ideas:
(1) A family system is organizationally complex, already because of differently intertwined relations;
(2) Relations between individual members are circular and reciprocally affect each other;
(3) A family system is open which affects its continuity and ability to change;
(4) A family system is adaptable.
A family system develops and changes based on internal impulses as well as outside influences and changes.
Family systems undergo continuous information exchange. Family interactions can hardly be described as right
or wrong; whether they serve their function in the family system or not is more important (or if they do, but with
negative impact). In a family system, it is necessary to focus on family behavior patterns, family interactions;
many experts consider these to be the essence of a family system. It can be assumed therefore that it is not the
number of problems families have to deal with or their seriousness that matter, but the way a family reacts to them
and how, and whether these reactions empower the family or disrupts its functioning. A family system consists of
subsystems, of which the partnership sub-system is the most important one, followed by the parent to child
subsystem and sibling subsystem. Partnership subsystem is the basis; the function of the whole family depends
above all on the ability of the partners to form a well functioning relationship. The parent to child subsystem
begins with the pregnancy and extends the original partnership system. Crises may occur more frequently during
this period. Any problems in the parent to child subsystem always signal certain instability in the family. In the
sibling subsystem, children learn collaboration, mutual support, negotiation, compromise, but they may also get
used to quarrels. A child uses the experience from sibling relationship in different situations later in adulthood.
Experts are not in agreement about the importance of the sibling subsystem for future behavior of an individual,
but there is no doubt it affects the entire primary family system during its existence. The influence is not
one-sided, but reciprocal. In a family other subsystems or coalitions may temporarily arise. Their extraordinarily
strong boundaries or excessively long-term durations frequently signal a significant family problem. A family
system can be described as a complex non-linear system (Chubb, 1990). It is not necessary to explain changes as
the process itself constantly changes. Social systems therefore maintain their stability in time through changes.

USING FAST TEST FOR DIAGNOSING OF COHESION AND HIERARCHY 277
There is a danger in approaching the family only as a system, however. It may lead to omitting the fact that
individual family members gather information on their own. It is important to emphasize the personalities of
individual members, uncover their motives, learn their expectations, fears and also the sources of their hopes and
personal strengths. A family should serve as a natural resource of resistance to stressful environments affecting
individuals. Above all else a family should provide children with a sense of certainty and stability despite the
ongoing changes together with the sense of security. Despite the importance of examining family resilience as a
system, it is an overlooked research area in the Czech Republic (Lacková, 2004, 2008, 2009; Sobotková, 2004).
Foreign works indicate the focus of researchers is shifting away from family problems to healthy family
functioning (Sobotková, 2004; Paulík, 2010; Kaleja, 2013). Research also indicates that families undergoing
highly stressful situations become more resilient if they successfully overcome these situations. Sobotková (2004,
p. 239) defines family resilience as “A quality of a family which enables it to maintain its established behavior
patterns (despite being confronted with risk factors), i.e., family elasticity”. Furthermore, it is the ability of a
family to quickly recover from crises or temporary serious events that elicited possible changes in family
functioning. Theorists tried to uncover the explanation as to what makes a family endure higher levels of stress
and what separates resilient families from the less resilient ones (McCubbin, Thompson, & McCubbin, 1996). To
successfully manage stress, a family needs to identify stress factors. A state of crisis occurring during situations
which a family cannot overcome disrupts the balance in family relations. During this state a family usually needs
to find new behavior patterns that may support the development of the family in the end. The theory of family
resilience therefore points out to a possible positive impact of family crises that serve as a resource and possibility
of further development. The authors further discern factors of family resilience (McCubbin et al., 1996;
Sobotková, 2007):
(1) Protective: important to overcome specific risks and accumulated stress factors (family rituals,
communication between members, time spent together);
(2) Restorative: important for adaptation to crisis situations (optimism, family coherence, focus on family
function).
Benson and Deal (1995) note that autonomy and cohesion are constantly accompanied by tension in all
stages of individual but also family development. It is therefore key to focus on their balance. Family boundaries,
the invisible lines between individual family members, delimiting every family member (husband and wife
boundaries, partner boundaries, children subsystem boundaries, grandparents), should be clearly defined and
respected by all family members. Sobotková (2007) provides the key characteristic of family boundaries, it is the
permeability between individual subsystems and between the family and its environment. The second case
signals the scope of how family members and other people may freely move in and out the family system.
Boundaries may change based on the type of a family system, its development stage and specific situation.
Balanced openness is optimal. Extreme openness signals a dysfunctional family almost every time; disorganized
and falling apart (Sobotková, 2007).
Dysfunction: when a dysfunctional family is mentioned, it means a family in which one or more members
display unhealthy, maladaptive behavior. A dysfunctional family displays one of the following characteristics:
denying or ignoring a problem; reciprocal accusations emerge; suppression of individual identity in favor of
family identity; denial of individual needs of family members; confusing communication; boundaries between
individual family members are missing or insufficiently differentiated (Matoušek, 1997).

Coalition: an alliance between certain members of a family. May appear in functional as well as
dysfunctional forms. Functional example is the coalition between partners, husband and wife (should be the
strongest in a family), open to all other relations in a family. Sobotková (2007) lists the following coalitions as
less functional or even dysfunctional—schismatic coalition: relatively weak or missing husband and wife
coalition, but powerful coalition between generations (e.g., father and daughter, mother and son); asymmetric
family coalition: when one family member becomes isolated from others who form a compact coalition. In
functional families, this is balanced by an adequate personal autonomy of family members. Two tendencies are at
play in these scenarios: the tendency and need to be together, and the tendency towards autonomy and
individuality.
However, views on processes taking place in functional families as well as characteristics of functional
families differ between authors. For example, Plaňava (1994) lists the four following basic components of a
functional family: family structure, family intimacy, personal autonomy and value oriented focus (attitude
orientations). The two most important aspects for him are dynamics and communication in family.
Emotional Attachment
Schmid (2002a; 2002b) notes that the importance of a relationship and contact with other human beings for
healthy development and functional personality is generally acknowledged. People are social beings and those
without human contact are isolated and deprived. Bowlby (1982; 2010) assumes that support and emotional
accessibility of primary persons in early childhood significantly affects the development of child’s emotional
adaptability. Bowlby’s early work is based on his work with problematic boys, shortly after he finished his
studies. This experience led him to believe that serious severance of the mother to child relationship leads to
psychopathology and affects the subsequent behavior and healthy development of a child (Cassidy, 1994).
Bowlby based most of his theory largely on direct observations. Significant long-term systematic observation of
interactions between the mother and her children was also conducted by Mary Ainsworth. Based on these
observations, Ainsworth created a laboratory technique to evaluate the quality of an emotional attachment, it was
called the strange situation procedure (Bretherton & Munholland, 1999).
Bowlby (1982; 2010; 2013) defines emotional attachment as a hypothetic construct that involves lasting
psychological connectedness between human beings characterized by the need to search for and maintain
proximity with a specific person, especially during stressful situations. This person is perceived wiser and
stronger and difficult to be replaced by somebody else. One of the basic biological functions is protection; its
effect is one of the prerequisites for survival and healthy personal development. Externally, emotional attachment
exhibits as a behavior conditioned by emotional attachment, i.e., as attachment behavior, which is activated in
stressful situations, during emotional strain or by real or subjectively perceived danger. The aim of attachment
behavior in these situations is to secure protection and close proximity (psychical and physical). Attachment
behavior in small children involves screaming, crying, protesting, etc., in adolescents it may involve purposeful
communication with the mother to decrease tension and bring satisfaction. This behavior signals the child’s needs
to the mother (or other closest person of emotional attachment). The primary person registers child activating the
attachment system behavior and starts regulating their tension (soothing, calming, explaining, reassuring). The
child may regain the sense of security. This is the external regulation of child’s emotions (Zimmermann, 2002).
The sense of security during the time when attachment system is not active enables a child to explore their
environment and supports their cognitive development (Kindler, 2001). The important role for creating emotional

attachment besides the availability of the primary person (mother) is their responsiveness to the child’s needs,
especially in stressful situations. A responsive mother is able to correctly and timely recognize child’s signals,
correctly interpret them and suitably react to them. According to Meins the central factor in primary person
responsiveness is the so called “mind-mindedness”, i.e., how much the primary persons perceives the child as an
individual with their own emotions, ideas and will (Zimmermann, Maier, Winter, & Grossman, 2001).
Experience with positive (calming, soothing, protection) and/or negative reactions of the mother (disregard,
rejection, unavailability) is internalized by the child and forged into individual conceptions and expectations of
primary person support and integrated into the system of emotional attachment (Bowlby, 1982; 2010). The theory
of emotional attachment in close relationships is based on an important assumption that the system of emotional
attachment that was originally designed for early childhood keeps impacting the behavior, ideas and feelings in
adulthood. Emotional attachment theorists point out cognitive and social mechanisms that indicate that emotional
attachment continuity is the rule, not the exception. They note that although these mechanisms may predict
stability or instability of emotional attachment, it needs to be emphasized that the mechanisms always depend on
precise method of their conceptualization.
Material and Methods

Research Problem
To evaluate the two basic family characteristics, hierarchy and cohesion, Family System Test (FAST) is
used (among other test methods). Czech researches do not frequently use this method (studies mentioned
by Sobotková, 2005). Therefore we set out to carry out this research, which will also serve as a pilot research
of this type, serving as the basis for subsequent studies (of similar focus). Some of the studies on resilience try
to uncover specific factors and conditions that increase the adaptability of an individual dealing with
unfavorable life experiences that may have been caused by the primary family system affecting the individual.
Acosta (2008) points out that resilience is the ability of an individual to successfully deal with stressful situations,
threatening situations or disputes. However, when we try to characterize protective factors, we need to relate
them to the risk experienced. The above mentioned test method (FAST) also servers as a record of possible risk
situations.
Research Aims
(1) Assess hierarchy levels in probands families using Family System Test (FAST).
(2) Assess cohesion levels in probands families using Family System Test (FAST).
Interview. The interview was not standardized and was semi-structured. Five open-ended questions listed
below were used. The interviews took place either at the university or at the psychologist’s. The shortest
interview took half an hour, the longest took eight hours. The average length was two hours. Interviews were
recorded and then transcribed verbatim. Psychology students helped with the transcription.
List of interview topics for FAST administration:
(1) Communication in primary family;
(2) Crises in primary family and overcoming them;
(3) Collaboration during problem solving;
(4) Spending time together.
General perception of the primary family by the proband.

Family System Test (FAST). Diagnosis of relations between family members is a useful addition to the
traditional conception of individual risk factors and also pathological phenomena (Kaslow, 1996). Integrating
both perspectives, individual and family, brings a holistic overview of the complexity of human development.
The prerequisite for a detailed characterization of family systems is to have methods for studying family
relations as well as specific family subsystems from the point of view of its individual members, both
individually and as a group (Cromwell & Peterson, 1983; Gurman, 1983). However, information obtained from
individual family members without observing the complete family interactions is always limited. An individual
may perceive family relations differently compared to other members. Observation of individual interactions
within a family provides objective information. A family can be assigned a task to be solved by its members
and their interaction video recorded; however, such systematic analysis is exceedingly difficult due to time
restrains, technical means as well as expertise (Sobotková, 2007). First, FAST pilot studies were carried with
patients and their families in Child and Adolescent Psychiatry Hospital of the University of Zurich. Studies
were figurine-based test of representing family relations a proband demonstrated how they perceive their family
and family relations between individual members. “Family System Test overcomes the limitations of other
methods by utilizing three dimensions—cohesion, hierarchy and flexibility” (Sobotková, 2005, p. 14).
Cohesion is represented by the distance between the figurines, hierarchy by the difference in their height
(probands can choose from pedestals of different sizes). “Specifically for a clinical use, different-colored
figurines were added to motivate respondents to talk freely about personal characteristics of family members
and their relations. Towards the end of the test, twenty-seven questions in a follow-up interview were added to
explore family structures” (Sobotková, 2005, p. 15). “The test focuses on discovering the closeness between
individual family members and on assessing the influence or power of each member” (Gehring, 2001, p. 19). It
is important to talk about a family system due to the fact that families are complex psychosocial systems that
significantly affect the lives of all family members. Families are affected by the personalities of parents, but
also by the culture in which a family exists. It is interesting to follow the changes in family functioning after
moving the family to a different culture. Families are to be regarded not only as a group of parents and children,
but also as a three-generation system, in which the influence of grandparents needs to be taken into account. In
some of the research countries, women who had taken care of the household needed to be taken into account,
especially women who had taken care of children whose parents were occupationally overextended or ill. This
was not limited to upper class exceptions. In South America and some Spanish provinces, it is a custom
facilitating easy family function. In families and family systems, subsystems play a role as well. These are
mostly formed by people of the same generation; they can however be cross-generational. In functioning
families the parent subsystem is usually presemt and is more cohesive than the sibling subsystem, which
displays different characteristics depending on the age and sex of siblings. Families with impaired functioning
demonstrate unclear generation borders. Members of functional family systems are emotionally close, able to
agree on collective goals or negotiate them, able to express their feelings and various needs and to adapt to
stressful situations. During increased psychosocial stress a family experiences lower cohesion and lower or
higher hierarchy. In a family system there are two important terms—cohesion and hierarchy. By defining them,
it is easier to characterize family relations (Sobotková, 2005). Cohesion can be described as a certain level of
attachment strength and emotional closeness between individual family members. Hierarchy in a family is more
difficult to define. Hierarchy may be connected with authority, dominance, power to enforce decisions or a
sphere of influence that one family members feels over the other (this does not include only the impact of

parents on children, but also the mutual impact among children, and also step-parents or grandparents). The
adaptability of a family system also plays an important role in family functioning. It is defined as the ability of
a family system to adapt its cohesion and hierarchy to developmental changes of the family and also to stressful
and trying situations (Sobotková, 2005).
Grounded Theory. Grounded theory was used to analyze the information from interviews with probands.
We began by identifying meaning units in the text. Then we merged those divided text parts which had
meaningful connections. Next step was the “open coding”: assigning meaning to parts of text for faster and
simpler orientation. After identifying these basic categories we proceeded to “axial coding”, looking for and
identifying connections between these categories. As a result we were able to determine the central core
category. This category has then been connected with the categories already created and their connections, and
other auxiliary categories were added; the process is called “selective coding”. Using the analytic methods of
open coding, axial coding (creating a paradigm model) and selective coding, we processed the information
from case studies of our probands.
Participants. Method of choosing probands, reasons and composition. We decided for a deliberate
selection. We searched for participants that would fit a set of requirements, namely they had to be university
students currently in the last two academic years, raised in primary families with the following characteristics:
authoritarian upbringing style; communication between family members failing (family members communicated
on a minimal level or not at all); family member co-participation on problem solving was non-existent. Based on
these criteria, we nominated suitable participants. First participants were interviewed. At the end of the
interviews, we asked participants to nominate additional people they knew would fit the requirements of this
study. Candidates for subsequent interviews were selected out of this newly formed group, which created a
theoretically saturated sample, out of participants of several, consecutive rounds. All respondents signed an
informed consent form to participate in the research. At the beginning of the research, selected probands were
successful university students, despite the strains they carried from their primary families. Beforehand, probands
studied three types of secondary schools: grammar, technical or business schools.
The research was conducted with 2,031 probands. The sample contained 1,117 men and 914 women. The
youngest participant at the time of entering the research was 23 years old and the oldest was 31 years old.
However, the final research sample was reduced to only 303 probands, 180 men and 123 women. The
remaining probands had changed their residence over the course of the research and could not be easily
contacted due to large distance from the research team, or their workload had prohibited them from continuing,
or they had decided against further participation in the research for non-specified reasons.
Table 1
Probands of the Research Sample
Country Men Women All Research time in years
Czech Republic 53 44 97 10
Slovakia 14 13 27 10
Argentina 71 32 103 6
Chile 11 12 23 6
Spain 31 22 53 5
Total 180 123 303 10

Table 2
Study Field of the Probands
Faculty CZ SK Argentina Chile Spain Total
Technical 27 1 39 16 23 106
Arts 46 1 3 0 9 59
Economical 21 2 33 7 4 67
Law 3 4 23 0 3 33
Medicine 0 19 5 0 7 31
Fine Arts 0 0 0 0 7 7
Total 97 27 103 23 53 303
Results
Interview Results
The factors mentioned below were present in primary families of all probands.
Missing elements included family rituals, communication between family members, time spent together.
Parents had predominantly skeptical and even pessimistic views on life problems.
Hardly any mutual help was involved when family members solved life problems.
The family was not coping well with the stress of family development—when children entered compulsory
schooling, conflicts among parents/partners emerged about preparing children for school, selecting interest clubs
and hobbies, children care after school, later on about selecting secondary school, etc..
The emotional attachment between parents and probands was described as considerably cold.
Unaddressed relationship problems between parents started due to long-term residence of one of the parents
away from the family (employment farther away from the family).
Dominant behavior of the father towards children prevailed, without positive emotional approach.
Emotional support of parents to probands was missing (calming, caressing, explaining, reassuring). Parents
displayed little to no interest in the emotional well being of their children.
Probands would often supress and even hide their feelings. They were afraid to express negative feelings
as they had always been criticized for excessive complaining.
High demands by parents on probands on their performance, requiring excellent results (when the proband
did not reach the best possible results they were criticized; criticism was not constructive).
The upbringing had the form of orders, restrictions, instructions; when the child did not comply, punishment
followed. Parents, usually fathers, did not care why the children did not comply with the order (Lacková &
Sobotková, 2005).
Parents refusing dialogue between them and the child, refusing to hear out the opinions of the child (even
in adulthood). Conflicts solved through long-term silence, not answering the child’s questions, ignoring their
pleas (in extreme examples, silence lasted up to two months).
FAST Test Results
FAST Test: Typical representation. Hierarchy level. During the test, using pedestals, probands indicated a
high level of hierarchy. Probands emphasized parents had used an authoritarian approach. “Family has a high
hierarchy if the difference between the less dominant parent (lower parent figurine) and the most dominant
child (the highest children figurine) equals or is more than three small pedestals (small pedestal has the height
of 1.5 cm)” (Sobotková, 2005, p. 30). Specifically, 256 probands indicated that the father was more dominant.

In 47 cases, the mother was more dominant. Mother would find help for taking care of the family in the oldest
child in 11 cases; in five cases out of 47 dominant wives, there was a high level of dominance over the male
partner. It is unknown how the high level of dominance of one parent affected the subsequent development of
behavior of probands towards their siblings, and later classmates, colleagues, friends and partners.
Figure 1. Representing typical hierarchy and typical cohesion (FAST Hierarchy T, FAST Cohesion T) of primary
families according to the description by probands. Representing ideal hierarchy and cohesion (FAST Hierarchy I,
FAST Cohesion I) of primary families according to the description by probands.
F1 F4
F2 F2
F3 F3 F4 F6
F5
F5 F6
(a) (b)
Figure 2. Example of family cohesion representation by proband: (a) low level of cohesion (real situation in the
proband’s primary family); (b) medium level of cohesion (ideal situation as described by the proband).

Cohesion level. All probands showed low level of cohesion in their primary families. “A family has low
cohesion when one or more figures are placed outside the 3 × 3 square grid and the criteria for medium cohesion
are not met, i.e. all figures are in the 3 × 3 square grid, but not all of them are in adjacent squares” (Sobotková,
2005, p. 26). Perhaps it was due to high family hierarchy that family cohesion was low. There was a tendency of
the members to escape from the family home and find friendships outside the family.
FAST Test: Ideal representation. Hierarchy level. Probands felt low family hierarchy would be ideal in
their primary family. “Hierarchy is low when there is no difference between the less dominant parent and the most
dominant child or when the child is higher than any of the parents” (Sobotková, 2005, p. 30). They did not indicate
high hierarchy at all. It is difficult to assess why probands thought that way. It is possible that their childhood and
adolescent experiences with the dominant approach of their parents taught them this was not the best scenario.
They understood authority was necessary, but indicated that their upbringing had been only about orders and
dialogue had been completely missing; that might explain why they chose this extreme, i.e., low hierarchy.
Cohesion level. Probands consider middle level of cohesion to be ideal (middle level cohesion corresponds
with all figures in the 3 × 3 square grid, but not in adjacent squares), possibly because high cohesion could
negatively affect their free choice and low cohesion points to weak relationships between the family system
members, both when solving problems and when enjoying happy life moments.
Discussion
We wanted the probands to describe their lives in primary families. Specifically, we focused on
communication among family members, solving of difficult family situations, spending their free time together,
the upbringing style of their parents, the differences between approaches of each parent, etc.. At first, we
recruited probands through noticeboards at the universities, later we tried to acquire new probands from the
friends of our already active probands. We had to take into account that acquiring information on sensitive areas
could be complicated. Understandably, a person can present certain barriers when asked to trust an unknown
researcher and describe their experiences from the not-so-pleasant past (life with their primary family).
Respondents showed interest and willingness to help with clearing the research questions by participating in the
research. They were interested in the research process and in the findings and results of the research. In 2006 the
research sample was expanded by people from Argentina and Chile. These probands participated in our research
for six years. In 2007 (January) university students from Spain joined the research. The final interview with
probands from five states took place in November 2011. We do not disclose the results of each country
individually as our goal was to describe the whole research sample (furthermore the results were almost identical
for each country). Similar intercultural study has not been carried out yet, and our results also serve as pilot
results for further similar (and intercultural) research.
Part of the testing results has been published in the first Czech edition of Family System Test—FAST
(Sobotková, 2005, pp. 47-51). The actual FAST results served as complimentary information to the description of
primary families by probands, more specifically two characteristics: cohesion and hierarchy. This information
served as an important factor for selecting probands for the research.
Conclusions
Family System Test (FAST) has helped us assess the functionality of primary families of probands and
then carry out the interview about situations from the past life with their primary families. Some of the

figurine-based tests brought up noteworthy results. Some probands, who described their primary families as
highly functional, placed the figurines up to several fields further away from each other than is usual for
functional families. They also used more pedestals for the parent figurines than is characteristic for a healthily
functioning family system. We do not claim that parents should not be more dominant than their children, but if
one partner is overly dominant to the other partner, it may point to an authoritarian relation between the two.
(This could also point to a cross-generational coalition).
Above all, the test was used as a tool that can help portray the two basic characteristics used for describing
the family system—cohesion and hierarchy. It is also a method that helps facilitate the initial communication
with the probands, if they are not able to start talking about their families on their own. The family system
recreated with the figurines allows a psychologist or researcher as well as a clinician to use follow up questions
based on the position of figurines (based on their position on the “chessboard” and on the use of pedestals)
aimed to uncover the family functioning: methods of solving family problems, way of communication, solving
crises, resolving conflicts, measuring either the dominance of parents towards children or their democratic
approach to upbringing and also the parents’ relation to each other. We believe the method on its own is of
great significance for gathering insights into family systems. However these were not the only results on which
we base our findings about families (in this case primary families of probands), as test results are also
supported by interview results also mentioned in this article (in their shortened form).
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doi:10.17265/2159-5542/2016.05.004
D DAVID PUBLISHING
Inclusion in International Schools: Theoretical Principles,

Ethical Practices, and Consequentialist Theories*
Julie M. Lane, David R. Jones

Fresno Pacific University, Fresno, USA

International schools have the ability to create a global acceptance through inclusive special education school
settings while serving various cultures, races, and religions. But does the inclusion of children with disabilities
occur in international schools? And, if so, how do administrators’ perceptions predict whether or not the school
culture is inclusive? This study explores the relationship of inclusive practices, Connectedness (Frick & Frick,
2010), the Council of Exceptional Children (CEC) Ethical Principles and Practice Standards (2010), and
consequentialism. Fifty-seven participants representing 35 countries self-reported current practices and
self-perceptions regarding Connectedness (Frick & Frick, 2010), the CEC Ethical Principles and Practice Standards
(2010), and consequentialism.
Keywords: international schools, special education, inclusion, ethics, consequentialism, school administrator
Literature Review
International schools often serve temporarily displaced families who reside in foreign countries
(e.g., families in which one or both parents have been contracted for special employment opportunities). As of
May 2015, more than four million children attend English-speaking international schools with an anticipated
12,000 international schools by the year 2024 (Barnes, 2015, pp. 8-9). Due to the nature of international schools,
one would anticipate that international schools are heterogeneous communities reflecting multiple cultures,
races, religions, abilities, and expectations. This is not the case. Per Shaklee (2007), due to the competitive
climate of international schools and the cultural influences of the host country, international schools’ admission
process is selective. Nonetheless, international schools are serving a diverse population which includes children
with disabilities (Shaklee, 2007; Sperandio & Klerks, 2007). Bunnell (2006) and Haldimann (1998, 2004 as
cited in Shaklee, 2007) state there is a lack of research regarding children with disabilities in international
schools.
More than 3.2% of the world’s population is now living outside their country of origin (United Nations,
2013, p. 2). Nearly 93 million children or one in every ten children lives with some form of disability (Global
*
Acknowledgements: First and foremost, the researchers would like to acknowledge Mr. Gregg Pinick, Head of School, at
Concordia Shanghai, for the conversation which sparked the interest in international school research. The researchers would like
to thank the Association of American Schools in South America, Council of International British Schools, and the East Asian
Regional Council of Schools for their willingness to distribute the survey. Lastly, the researchers would like to acknowledge The
Next Frontier Inclusion, an international school educational initiative that seeks to empower international schools in serving
children with disabilities.
Julie M. Lane, Ed.D., School of Education, Fresno Pacific University.
David R. Jones, M.S., School of Education, Fresno Pacific University.

288 INCLUSION IN INTERNATIONAL SCHOOLS: THEORETICAL PRINCIPLES
Partnership for Education, 2015, para. 1; UNESCO, 2015, para. 1). The United Nations Educational, Scientific,
and Cultural Organization (UNESCO) “promotes inclusive education policies, programs, and practices to
ensure equal education opportunities for persons with disabilities” (UNESCO, 2015, para. 4). In 2006, the
United Nations’ (UN) Convention on the Rights of Persons with Disabilities formally recognized the need to
respect differences and accept those with disabilities as part of human diversity (UN, 2006, Article 3). The UN
(2006) convention also supports the need to (1) promote a positive perception of those with disabilities; (2)
acknowledge that those with disabilities have something to contribute to the greater good; and (3) include
individuals with disabilities into mainstreamed society.
The Office of Overseas Schools (A/OS) (2014/2015) report more than 500 international schools provide
disabilities programs (p. 2), however, A/OS is under the auspices of the U.S. Department of State and is not
comprehensive of all data regarding neither international schools nor their organizational associations. A/OS
states “Inclusion is a philosophy commitment that recognizes a right to a sense of welcome and belonging in
the education of all students” (Kusuma-Powell & Powell, 2004, para. 1). Despite Shaklee’s (2007) evidence
that children with disabilities are served in international schools, the number of children with disabilities in
international schools does not appear to be documented. With the recent establishment of Next Frontier
Inclusion, an international school service organization which promotes and protects the interest of children who
learn differently or at a different rate, it would appear that international schools are recognizing the need for
leadership and professional development in the disability field.
Inclusion
Educators must recognize that inclusion of children with disabilities is more than the integration of a child
with disabilities into the regular education classroom. It is the development of a school culture which embraces
diversity (Anderson, 2006, 2011; DiPaola, Tschannen-Moran, & Walther-Thomas, 2004; Fiedler & Van Haren,
2009; Hansen & Morrow, 2012; Frick, Faircloth, & Little; 2013; Kune, 1992). For the purposes of this paper,
inclusion is defined as not just the physical integration of a child with disability in the general education setting
but rather it is the establishment of a school cultural which practices acceptance. Inclusive environments reflect
patience, understanding, and compassion so that all children have the opportunity to learn. This requires school
administrators and educators to rethink how teaching and learning are intertwined and how all children have the
same opportunity to academically, socially, and behaviorally develop and interact alongside typical peers.
Bartlett (2014) states, “Rising to the greater challenge of meeting more diverse needs has raised our
(international schools) overall game, making us smarter thinkers, smarter problem solvers, and critically,
smarter teachers” (p. 18). Inclusion requires the re-envisioning of the classroom where the value of academics,
social development, friendships, behavior, and diversity are equal and understanding, patience, and compassion
are seen as traits that are essential for adult life (Anderson, 2006, 2011; DiPaola et al., 2004; Fiedler & Van
Haren, 2009; Hansen & Morrow, 2012; Frick et al., 2013). Lastly, inclusion provides a level playing field
where a disability explains why learning, socializing, and behaving may be challenging, and where disabilities
are not viewed as an excuse in which children do not have the opportunity to reach their full-potential.
School Administrators
School administrators are those who hold a top tier leadership role within their school, e.g., principal, head
of school, executive director. Frick and Frick (2010) identified six domains of connectedness that assist school
administrators in leading and creating school communities.

INCLUSION IN INTERNATIONAL SCHOOLS: THEORETICAL PRINCIPLES 289
(1) Justice is practiced regardless of a defining category in which one belongs, e.g., race, religion, ability, and
demonstrates the capacity to do what is good and just by placing the commitment above self to do what is right.
(2) Care is the capacity to act first for the well-being of others—especially those who are different than self.
(3) Critique requires administrators to reflect, question, and act upon the injustices of others regardless of current
norms while speaking up for those who are oppressed and discriminated against.
(4) (School) community is the moral agent. Administrators are to collaborate, communicate, and dialogue with the
community prior to making moral decisions.
(5) Profession is the ethical practice of placing the student’s best interest at the center of the conversation while
recognizing that personal values and beliefs shape our professional ethic.
(6) Virtue is a presence of openness to dialogue, to be responsibly authentic, and the practice of self-honesty and
relational sensitivity. (pp. 18-22)
Frick and Frick (2010) conclude that educational leaders must develop ways to connect all members of
the school community by creating effective and applicable professional development opportunities, advocating
and supporting needed programing, and fostering a learning environment which embraces acceptance and
awareness (p. 28). School administrators can create connected school communities by supporting all
members of the school community through curriculum, professional development, and instructional
strategies (Frick et al., 2013; Sergiovanni, 2007; Wendel, Hoke, & Joekel, 1996). Jabal (2013) stated that
school cultures and the needs of international schools are often imported by the vast array of cultures found
within faculty, staff, and families. If so, then the effectiveness of a school administrator in an international
school may depend on the administrator’s ability to connect with and understand the diverse cultures (Jabal,
2013).
The school culture rests in the vision and daily practices of the school administrator (Anderson, 2006,
2011; DiPaola et al., 2004; Fiedler & Van Haren, 2009; Hansen & Morrow, 2012; Frick et al., 2013; Frick &
Frick, 2010; Kune, 1992; Sperandio & Klerks, 2007). To create an inclusive school environment,
administrators must first create a vision that depicts the ability of every child to learn and find success
regardless of their limitations (Bakken & Smith, 2011; Conderman & Pedersen, 2005; DiPaola,
Tschannen-Moran, & Walther-Thomas, 2004; Frick et al., 2013). The vision must encompass the needs of the
child academically, socially, and behaviorally while respecting the child’s cultural background (Bakken &
Smith, 2011; DiPaola et al., 2004). Children with disabilities are more likely to find success when a school
culture acknowledges and reflects that all children can succeed and when the school creates pathways for
success (Hansen & Marrow, 2012; Smith & Leonard, 2005).
Council of Exceptional Children
The CEC Ethical Principles and Practice Standards (2010) emphasize ethics similar to those of
Connectedness (Frick & Frick, 2010). Fiedler and Van Haren (2009) concluded that school administrators must
not only hold “ethical codes of conduct and professional standards” (p. 162) but must also (1) be well-versed in
special education and its services in order to make ethical decisions; and (2) reflect an advocacy of concern and
commitment in their school communities regarding children with disabilities (p. 172). Helton and Ray (2009)
noted four types of special education ethical decisions errors made by school administrators: (1) decisions
resulting from administrative pressure to practice unethically; (2) placing one’s own beliefs before ethical codes
of practice; (3) following administrative directives regardless of practitioner ethical responsibilities; and (4)
teachers not receiving support from administrators when a child’s special education plan is not being
implemented (p. 115). To facilitate positive experiences for children with disabilities, school administrators

must serve, coach, facilitate, improve, respond, mediate, and nurture healthy environments (Sheldon, Angell,
Stoner, & Roseland, 2010).
Consequentialism
The consequentialist thought was defined by Jeremy Bentham (1748-1832) on the premise that “Morally
appropriate behavior will not harm others, but instead increase happiness or ‘unity’” (Driver, 2012, p. 7).
Increasing happiness or unity is not directed at the individual but rather towards the whole. Those who threaten
or act in a manner which may harm others do not foster a unity. Tasioulas (2010) indicates that when one
disrupts the happiness or unity of a group, then one should then be punished because they are capable of know
what they did was morally inappropriate (p. 688).
Consequentialism in its purest form is a moral value that reflects a decision that results in the best overall
outcome regardless of the situation (Driver, 2012; Hooker, 2010; Mill, 2003; Scheffler, 1988). Since Bentham’s
time, multiple philosophical variations of consequentialism have developed (Darwall, 2005; Driver, 2012;
Hooker, 2010; Mill, 2003; Scanlon, 1998) though all maintain a common thread that “moral value by
instrumental or extrinsic value” is assessed based upon one’s actions (Darwall, 2005, p. 27). For the purposes
of this study, Unitarianism consequentialism will be utilized.
Unitarianism consequentialism assess (1) the putting aside of personal preferences (Scheffler, 1988, p. 1);
and (2) the benefit of one’s actions by the value to the greater good (Darwall, 2005, p. 27). A school
administrator who embraces consequentialist thought may mandate a consequence for a child based solely on
the child’s actions rather than taking into account the rationale for the action, therefore, punishing someone
who may be unaware of their error or punishing disproportionately (Tasioulas, 2010). If we embrace the value
that a moral rule applies to all, then do we discriminate against the child with disabilities who may not know
that they have broken a moral rule? If so, do we then discriminate against the admission of children with
disabilities into international schools, lower our expectations as to their ability to learn, or punish them for
actions which may be manifested in their disability? Scanlon (1998) states one may even wish to consider that
equal and fairness are moral requirements and not moral goals (p. 81).
The Individuals with Disabilities Education Act in the United States requires a Manifestation
Determination Meeting to determine whether or not a child’s adverse behavior is manifested in the disability
rather than the child electing to break school rules. The meeting is designed to determine whether or not the
consequences for the child’s adverse actions should be determined based upon all students verses consequences
that take into account the child’s disabilities. Stike and Soltis (2009) state that equal value “means that they
(students) are entitled to the same basic rights and that their interests, though different, are of equal value” (p.
15). School administrators may have to exercise personal discretion (William, Pazey, Shelby, & Yates, 2013)
by stepping outside the rule or norm to make a determination (Driver, 2012, p. 1). An administrator who is a
consequentialist may be in conflict with special education-related legal mandates or disability cultural norms
(Brown, 2011). Scanlon (1988) states that one can build equality into the consequentialist theory if each
individual is given equal worth.
Methods
To determine international school administrators’ dispositions towards inclusive environments, a
quantitative correlational study was developed. Researchers developed an electronic survey which would be

distributed to international school administrators. Potential participants were identified by the researchers via an
internet search for international schools and international school organizations. Email addresses that reflected
school administrators via organizational websites were collected. If email addresses were not available, the
organization itself was contacted by the researchers via email. Three organizations agreed to distribute the
survey to their school administrators on behalf of the researchers via internal distribution lists. To encourage
participation, participants had the opportunity to be included in a drawing for a US $100 Amazon© Gift
Certificate. Participants who wished to be included in the drawing submitted their email via the survey. The
study sought to answer:
(1) What, if any, correlation exists between the total number of students enrolled in an international school
and the number of students with disabilities served?
(2) What, if any, correlation exists between tuition and the number of students with disabilities served?
(3) What, if any, correlation exists between teachers formally trained to serve children with disabilities and
the number of students with disabilities served?
(4) What, if any, correlation exists between the Ethics of Connectedness (Frick & Frick, 2010), CEC
(2010), and consequentialism, and inclusive practices?
(5) What, if any, correlations exists between each of the subscales-CEC (2010), Ethics of Connectedness
(Frick & Frick, 2010), and consequentialism?
Survey Development and Subscales

CEC Ethical Principles and Practice Standards
The researchers developed 16 statements based on the CEC Ethical Principles and Practice Standards
(2010). The statements represented a combination of forward and reverse-scored items. Researchers employed
a process of validation of the survey that approximated criterion reliability. There were 24 special education
professionals in the norming group. After norming the statements using a concurrent rater qualitative approach,
the researchers entertained the notion that respondents may have responded to one or more items from the
perspective that “these things ‘do’ or ‘do not’ happen” rather than “these things ‘should’ happen”. It is the
former perspective that may contribute to skewed results as the survey intended to assess individuals’ espousal
of ideals rather than appraisals of whether or not such ideals characterize current practice. However, researchers
employed the original design of the survey in the implementation of the current study.
Ethics of Connectedness
Frick and Frick’s (2010) discussion informed the development of the connectedness sub-portion of the
survey. Researchers generated 35 statements which included items that were reversed scored to control for
presenter bias and to gauge for consistency and authenticity in participant responses. There were 8 pre-service
school administrators in the norming group. The norming of the Connectedness scale utilized test-retest.
Following review of the reliability and variance of each item and subsequent omission of items that
demonstrated inverse (-) patterns, 26 items remained including six care-related, four community-related, three
critique-related, three justice-related, three professionalism-related, and seven virtue-related items.
Consequentialism
The researchers composed a scenario-based assessment of consequentialist versus non-consequentialist
tendencies. The development of scenarios was informed by Strike and Soltis (2009). Researchers adopted and

modified three scenarios and collected responses via three, six-point Likert scale responses ranging from
“Strongly Disagree” to “Strongly Agree” for each scenario. Two items measured tendencies toward a
consequentialist perspective. One item measured tendencies toward a non-consequentialist perspective.
Researchers provided one open-ended item (“What concerns you most about this situation?”). The names of
key characters were replaced by gender and English neutral pseudonyms (e.g., Chris or Alex).
Results
The survey was distributed once in spring 2014 by researchers or international school organizations. Since
the researchers were not able to discern how many distributed via international school organizations, it is
unclear as to the total number of potential participants and the number of individuals who viewed the solicited
request to participant in the study. Fifty-seven respondents completed the survey between March and April
2014. Twenty respondents initiated participation but did not complete the survey. One response set indicated a
clear pattern of disingenuous participation (i.e., no variance in the option selected as a response to all Likert
scale items). The number of total responses is discussed below in terms of the particular sub-portion of the
survey.
Demographics
The 57 participants represented 35 countries as indicated in Figure 1.
Figure 1. Geographical Dispersion of Respondents.
Fifty-six respondents indicated a nationality or nation of origin. Half (50%) of the respondents claimed
American nationality. Seven respondents (12.5%) claimed the United Kingdom (“English”) as the nation of
origin. Three respondents claimed dual nationality or origin (e.g., “Filipino-American” and “Canada-UK”).
Respondents included 31 males (54.39%) and 23 females (40.35%), not counting those respondents who
abbreviated or omitted this information. Table 1 reports the positions each respondent reported holding.

Table 1
Respondents’ Position
Position Frequency of responses Percent (%)
Head of school 16 28.07
Principal 14 24.56
Director 11 19.30
Coordinator 5 8.77
Superintendent 5 8.77
Counselor/Advisor 2 3.51
Teacher 1 1.75
Length of Service
Fifty-nine respondents identified the length of their service in the current role. More than half of
respondents (30 or 50.85%) indicated having served in the position between one and six years. The group
average ranged between three and six years; this is compatible to Benson’s (2011) findings of 3.7 years.
School Characteristics
Schools represented ranged in size from 25 to 2,200 enrolled students per respondent reports, averaging
approximately 682 (M = 585, σx = 488.71). The range of tuition fees in terms of U.S. dollars ranged
from $1,500 to $30,000 per annum (M = $10,938.40, σx = $7,711.57). One school reported that it received
funding through taxation and charged no tuition of attendees. Students enrolled in international schools
represented 70 different countries. Five respondents indicated that they served students from many other
countries but did not provide the identities of those countries. The United States was most often represented
(served by 42 of the 59 represented schools), followed distantly by Canada, China, and Korea (each represented
in 25 schools).
Thirty-five schools (59.32%) purportedly serve in an urban setting, and nearly a quarter (23.73% or 14)
schools serve in a suburban setting. Only ten percent (10.17% or six) schools serve in inner-city settings and
five percent (5.08% or three) schools serve in rural settings. One respondent indicated that the school served in
a “medium town”.
Most schools (53 or 91.38% of respondents) represented reported serving students with disabilities.
Enrollment of students with disabilities ranged from two to 180 (xҧ = 37.84, M = 22.5, σx = 41.88). Based on
respondent reports, 12% of the total population in international schools is comprised of students who have
disabilities.
Over 86% of respondents (51) claimed an affiliation between their school and at least one of 30
international school organizations. The most frequently claimed associations included the East Asian Regional
Council of Schools (11), the Council of International Schools (10), and the New England Association of
Schools and Colleges (8). Seven respondents reported an affiliation with either/both of the Association of
American Schools in South America and/or the European Council of International Schools. Five respondents
reported an affiliation with either/both of the Michigan Department of Education and/or the International
Baccalaureate. Four respondents reported an affiliation with the Association of American Schools in Mexico.
Three respondents reported an affiliation with the Council of British International Schools. Two respondents
reported an affiliation with either/all of the Center for International Education, Western Association of Schools and
Colleges, and/or the African International Schools Association. The following organizations were each

acknowledged as an affiliation by one respondent: Special Education Network in Asia, Japan Council of
International Schools, Academy for International School Heads, Swiss Group of International Schools, SACA
(researchers are not able to discern representation of acronym), Stamford American International School,
Association of International Schools in Africa, Southern Association of Colleges and Schools, Association for
Advancement of International Education, Association of China and Mongolia International Schools, Association
of Christian Schools International, International Childcare and Education Centre, Association of American
Schools of Central America, Colombia, Caribbean and Mexico, International Schools Association of Tanzania,
Middle States Association of Colleges and Schools, Central and Eastern European Schools Association,
Association to Advance Collegiate Schools of Business International, International Schools Association of
Thailand, Agency for French Education Abroad, EdExcel Pearson, and the Chiang Mai Circle of International
Schools.
Approximately 73% of schools reported no religious affiliation. Thirteen respondents reported a Christian
affiliation (22.03%). One respondent (1.69%) claimed either Buddhist or Islamic affiliation.
Correlations
School characteristics. School enrollment demonstrated a strong, positive correlation with enrollment of
students with disabilities (r(57) = 0.52, p = 0.0001, two-tailed). Researchers found no significant correlation
between per annum tuition and total enrollment (r = 0.18) or enrollment of students with disabilities (r = 0.02).
The correlation between the number of teachers with special education training on staff and enrollment figures
of students with disabilities (r = 0.38) and the number of teachers on staff and total enrollment (r = 0.90)
demonstrated a significant disparity. Table 2 compares the number of credentialed teachers purportedly serving
each group type.
Table 2
Number of Credentialed Teachers Purportedly Serving Each Group Type
Teaching credential Special education credential
Frequency of responses
0% 0 4
1-9% 0 8
10-19% 1 6
20-29% 0 5
30-39% 0 2
40-49% 1 2
50-59% 1 3
60-69% 2 0
70-79% 2 0
80-89% 9 1
90-99% 17 6
100% 25 18
Table 3 demonstrates correlations between subscales and the extent of inclusion as determined by the
number of enrolled students. Only combined scores on all three subscales and summative scores on the
connectedness sub-portion approached significance (r = 0.23 and r = 0.19, respectively).
Table 4 presents the correlations found among tests in relation to the ethics of connectedness
(Frick & Frick, 2010). Of note, significant correlations (p = 0.05) appeared between scores of care and

professionalism and espousal of the CEC ethics, as well as virtue and high scores of consequentialism as
indicated in responses to the vignettes. Care correlated significantly with combined scores with espousal of the
CEC ethics and consequentialism (r(60) = 0.27, p = 0.05, two-tailed) as did virtue (r(60) = 0.27, p = 0.05,
two-tailed). Justice indicated a strong inverse trend in relation to the CEC ethics but failed to achieve
significance. The trait of professionalism demonstrate a similar tendency but also failed to achieve significance
(r(60) = 0.19, p = 0.05, two-tailed). The trait of community barely missed significance (r(60) = 0.23, p = 0.05,
two-tailed).
Table 3
Correlations between Subscales and the Extent of Inclusion
Variables r
CEC Ethics & Special Education Inclusion +0.10
Consequentialism & Special Education Inclusion +0.09
Connectedness & Special Education Inclusion +0.19
Combined Subscales & Special Education Inclusion +0.23
Table 4
Correlations Found Among Tests in Relation to the Ethics of Connectedness (Frick & Frick, 2010)
CEC Ethics Consequentialism CEC & Consequentialism
Care +0.28* +0.02 +0.27*
Community +0.11 +0.13 +0.23
Critique +0.01 +0.09 +0.10
Justice -0.17 +0.05 -0.11
Professionalism +0.28* -0.07 +0.19
Virtue +0.02 +0.25* +0.27*
Note. * r(60) = x, p = 0.05, two-tailed.
Inclusion, connectedness, and CEC ideologues. Figure 2 demonstrates the relationship between
aggregate scores of the espousal of CEC ethics and the aggregate scores of consequentialism. Researchers
found a significant, inverse correlation between scores on espousals of the CEC ethics and high scores on
consequentialism (r(59) = -0.44, p = 0.001, two-tailed) but no significant relationship between either CEC
ethics espousal and connectedness (r = 0.215) or connectedness and consequentialism (r = 0.174). Removing
items that demonstrated weak statistical reliability during piloting had insignificant impact on the resulting
correlations.
The significance of the correlation between CEC ethics espousal and consequentialism lapsed when
responses to non-antagonistic scenarios were omitted. However, omitting responses to antagonistic scenarios
produced no significant change.
Table 5 provides summative item analysis of Likert scale items used in the consequentialism subscale.
Responses to scenarios one and three each demonstrated wide variance in at least one item. Responses to
scenarios two and four demonstrated overall moderate variance.
Table 6 demonstrates descriptive statistics for response patterns pertaining to each of the four scenarios
used in the consequentialist-non-consequentialist sub-section of the survey, where higher mean scores indicate
a tendency toward consequentialism. Patterns in responses suggest no overall allegiance to either a
consequentialist or non-consequentialist perspective (α = 0.53). However, a variation in subscription to one or

the other perspective appears when considering the nature of the infraction—specifically in regards to whether
the nature of the infraction involved antagonism or merely inconvenience. A t-test analysis for paired samples
for means indicated a statistically significant difference, for example, between response patterns between the
first and second scenarios (t-test, two-tailed p-level = 0.0001).
Figure 2. Relationship between aggregate scores of the espousal of CEC ethics and the aggregate scores of consequentialism.
Table 5
Correlations Found Among Tests in Relation to the Ethics of Connectedness (Frick & Frick, 2010)
CEC Ethics Consequentialism CEC & Consequentialism
Care +0.28* +0.02 +0.27*
Community +0.11 +0.13 +0.23
Critique +0.01 +0.09 +0.10
Justice -0.17 +0.05 -0.11
Professionalism +0.28* -0.07 +0.19
Virtue +0.02 +0.25* +0.27*
Note. * r(60) = x, p = 0.05, two-tailed.
Table 6
Descriptive Statistics for Response Patterns
Theme Mean Median Variance Standard Deviation
Parents complain about special
Scenario 1 accommodations interfering with 1.83 1.00 1.5 1.23
“abled” children’s learning
Student’s father threatens corporal
Scenario 2 3.45 2.00 2.81 1.68
punishment for involvement in altercation
Unauthorized search results in discovery
Scenario 3 2.46 2.00 2.10 1.45
of weapon
Academically struggling student requests
Scenario 4 2.30 2.00 1.43 1.20
employment reference
Discussion
Limitations
The limitations of this study are situated in the variables associated with each international school
(Sperandio & Klerks, 2007, p. 140). Countries vary as to what qualifies a child as having a disability.

Categories of disability that exist in one country, e.g., learning disabilities and attention deficit/hyperactive
disorder, may not be considered an area of disability in another country (Ferrari, 2014; Sperandio & Klerks,
2007). Furthermore, the types of disabilities served within an international school are not known. Cultural
backgrounds of the school administrator also impact survey responses. The Ethics of Connectedness (Frick &
Frick, 2010) and the CEC Ethics (2010) represent United States administrators and best practices, and the
alignment of these ethics to individual country’s cultural norms is unknown. In addition, no formal definition of
inclusion exists. How inclusion is implemented varies not only from country to country, but from school to
school. Finding a common definition of and experience in inclusive environments is challenging, if not
impossible. Special education professional training and the expectations of international school training for
special education teachers also varies.
Conclusions
This study was a quantitative correlational study regarding the Ethics of Connectedness (Frick & Frick,
2010), the CEC Ethical Principles and Practice Standards (2010), and consequentialism as it relates to
administrators’ dispositions towards inclusive practices. Participants overwhelmingly represented the United
States philosophy which necessitates further research to understand the influence of culture on the outcomes
reported herein. The correlation between total enrollment and enrollment of children with disabilities indicates
that the larger enrollment size of the school as is the larger number of children with disabilities served.
Conversely, responses also reflected a disproportionate number of appropriately credentialed teachers serving
as a function of the setting type. It is unclear, however, how school administrators determined whether or not
teachers were properly trained. Variables may include expectations of the host country, school administrators’
previous experiences in working with special education professionals, or the perception that children with
disabilities are not being properly supported within the school. Lastly, it may be concluded from the data that
tuition does not appear to impact total enrollment, enrollment of children with disabilities, nor enrollment of
typical peers.
The study also sought to determine, what, if any, correlation existed between the Ethics of Connectedness
(Frick & Frick, 2010), CEC (2010), and consequentialism, and inclusive practices. Aggregate data did reflect
an inverse correlation between CEC ethics and consequentialism. Services for children with disabilities are
designed to address the needs of each individual student as reflected in the United States Individuals with
Disabilities Education Act (2004) and do what is in the best moral value of the child. Therefore, one may seek
to conclude that there is a direct correlation between the CEC ethics and consequentialist theory. The data also
reflects that consequential subscale scenarios which were antagonistic v. merely inconveniences in nature may
reflect international school administrators’ willingness to be more open to conversations that support a child
with disabilities.
Correlations between Connectedness (Frick & Frick, 2010), CEC Ethics (2010) and consequentialism
subscales were noted in the data. Correlations were present in the Connectedness of care and professionalism
and the espousal of CEC ethics. As indicated by Frick and Frick (2010), care is the ability to act in a manner
which is for the well-being of others, and in particular, those who are different than one’s self and profession as
a means of placing students’ interest in the center of conversation. Therefore, it may be concluded that
international school administrators demonstrate that when serving children with disabilities, there is an effort to
meet the individual needs of the child. A correlation was also drawn between the Connectedness of virtue and

consequentialism. Frick and Frick (2010) define virtue as the ability to dialogue openly while being sensitive.
The correlation of care and virtue with the CEC Ethics and consequentialism may reflect an international
school administrator’s willingness to converse with others regarding a child with disabilities prior to making
decisions which will impact the child and/or the entire student body.
Recommendations
The current study did reflect a lack of teacher training for those serving children with disabilities. Insight
as to training expectations as related to host country special education practices, types of disabilities served
within a given international school, and school administrator expectations of special education professionals
may provide further insights.
In an effort to support special education services in international schools, further research is needed to
understand the cultural perspective that international school administrators bring with them to the host country
in which they will serve. Further disaggregation of the data from this study may allow the researchers to determine,
in particularly, if international school administrators from the United States correlate with Connectedness
(Frick & Frick, 2010) and the CEC ethics (2010) more so than those who indicated other nationalities.
Consequently, if a conclusion can be drawn that international school administrators first served as an
educator or administrator in their home country, a study regarding Connectedness (Frick & Frick, 2010) and the
CEC ethics (2010) with school administrator participants who currently serve in the United States may shed
further insight as to the special education perceptions that United States international school administrators
hold.
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doi:10.17265/2159-5542/2016.05.005
D DAVID PUBLISHING
Psychological Distress in Anorectic Women,

Their Fathers and Mothers
Elisabeth Bratt Neuberg Gerhard Andersson

Linköping University, Linköping University, Linköping; Karolinska Institutet,
Linköping, Sweden Stockholm, Sweden
Background: The aim of this study was to investigate self-reported psychological distress in anorectic women, their
father and mother. In addition, two other groups of young women and their parents were included. In total, there
were three groups consisting of women between 18-30 years with anorexia nervosa (AG), drug-dependency
problems (DG), students (SG) without significant problems and the parents of all three groups. The diagnoses of
anorexia were made according to DSM-IV. Methods: Several methods were used. The Karolinska Scale of
Personality (KSP) (Schalling, Åsberg, Edman, & Oreland, 1987) was the focus of this study. Results: Anorectic
women (AG) reported higher levels of psychological distress compared to the students (SG) but less than the
drug-dependent women (DG). The fathers of the anorexia nervosa women (AG) did not differ on the different
scales from the other fathers. This indicates that anorectic women do not have fathers with elevated psychological
distress. A significant effect on the scale of somatic anxiety (KPSA) was the only difference found between the
mothers, where AG was in the middle between SG with the highest scores and DG with the lowest scores.
Differences in psychological distress within families were also tested showing that anorectic women differed from
their mothers and fathers. We found an indication that mothers of anorectic women reported more anxiety than the
fathers. Conclusion: In conclusion, this study illustrates the importance of studying mothers and fathers of women
with anorexia.
Keywords: anorectic women, fathers, mothers, between families, within families
Introduction
Anorexia is a complex condition (Strober & Johnson, 2012). The role of the father in the life of the
anorectic women is a comparatively unexplored area (Phares, 1992; Bornstein, 1993; Phares, 2005). Research
on Anorexia Nervosa (AN) has mainly focused on the relation between the anorectic daughter and her mother,
on family pattern and the biological correlates. There are however a few papers on the father’s role. Jeammet,
Gorge, Zweifel, and Flavigny (1973) identified the anorectic girl’s father and identified four categories: the
“absent” father, the “blurred” father, the father with “contra oedipal orientation”, that is an erotized relation and
the father with “maternal orientation”. Engel and Stienen (1988) on the other hand identified four categories:
the “bonding”, the “brutal”, the “weak” and the “absent” father. The two first categories of fathers were
Elisabeth Bratt Neuberg, Licensed Psychologist, Licensed Psychotherapist, Department of Behavioral Sciences and Learning,
Linköping University.
Gerhard Andersson, Department of Behavioral Sciences and Learning, Linköping University; Department of Clinical
Neuroscience, Psychiatry section, Karolinska Institutet.

302 PSYCHOLOGICAL DISTRESS IN ANORECTIC WOMEN, THEIR FATHERS
overrepresented as fathers of anorectic daughters. Gale, Cluett, and Laver-Bradbury (2013) argued that there are
disproportionately fewer studies examining the role of the father in the development of child and adolescent
psychopathology, and in particular in the field of eating disorders. Botta and Dumlao (2002) focused on the
underlying patterns of father-child communication. They found that the communication patterns were
moderately linked to anorexia. The question of parental protection and psychological control has been the focus
of several studies paternal, among them has the overprotection been pointed out by Eme and Danielek (1995).
Thus, there is a need to further the understanding of the role of the father for his anorectic daughter. The
aim of this study was to investigate self-reported psychological distress in anorectic women and their fathers
and mothers.
Method
Participants and Procedure
The three groups investigated were: (1) The Anorectic Group (AG); (2) The Drug-Dependent Group (DG);
and (3) The Student Group (SG). The anorectic and the drug-dependent women were diagnosed according to
DSM-IV-TR (APA 2000) and ICD-10 (WHO 2007). All the young women and their families were recruited in
Stockholm. The AG from Stockholm Center for Anorexia Center (SCFA), previously called EMBLA, the DG
from the Center Therapy and Evaluation of Drugs and Medications (TUB), and the SG from Adult High School,
called ÅSÖ. In total 137 persons participated, with 52 daughters, 43 fathers and 42 mothers. The participants
were given the questionnaire in connection with the first or second interview and they had the choice to answer
it directly or return it at the following meeting. Most of the participants would fill it in directly following
informed consent (see Table 1 for further description).
Table l
Number and Mean Age of Years of Participants
Anorexia Group Drug-dependency Group Student Group
Age Age Age
N N N
(M)(SD) (M)(SD) (M)(SD)
Daughters 17 24 (3.2) 17 26 (2.5) 18 22 (3.2)
Fathers 17 55 (6.0) 13 55 (6.3) 13 52 (9.3)
Mothers 18 54 (5.2) 11 52 (6.4) 13 51 (7.01)
Notes. N: Number; M: Mean; SD: Standard deviation.
Instrument
The Karolinska scales of Personality (KSP) (af Klinteberg, Schalling, & Magnusson, 1986; Schalling &
Edman, 1987; Schalling et al., 1987), a personality inventory, was used to measure self-reported psychological
distress, as it explores and has the aim to understand complicated relations between individual differences in
behavior, affectivity and functioning and their physical correlates. KSP is built on 135 statements measuring 18
subscales (see Table 2). They are organized around four temperamental dimensions; Aggression/Hostility (i.e.,
guilt, indirect aggression, irritability, suspicion, and verbal aggression); Anxiety (i.e., inhibition of aggression,
muscular tension, psychasthenia, psychic anxiety, and somatic anxiety); Conformity versus non-conformity (i.e.,
socialization and social desirability); Introversion-Extraversion (i.e., detachment, impulsiveness, and
monotony-avoidance) (Dåderman, Hellström, Wennberg, & Törestad, 2005). The response format in the KSP is
a four-step scale, from ‘‘Does not apply at all’’ (scored 1) to ‘‘Applies completely’’ (scored 4). Nine of the

PSYCHOLOGICAL DISTRESS IN ANORECTIC WOMEN, THEIR FATHERS 303
KSP scales consist of 10 items, one scale (Socialization) includes 20 items and all hostility and
aggressiveness-related scales consist of five items each (Gustavsson, 1997). The scales have shown good
validity and reliability (Ahrén-Monga, Holmgren, Knorring, & Klinteberg, 2008).
Table 2
Descriptions of Highs Scores for Different Scales in Karolinska Scales of Personality (KSP) (Nielsen, 2015)
Personality scales Descriptions
1. Somatic Anxiety (SA) Autonomic disturbances, restless, panicky
2. Psychic Anxiety (PA) Worrying, lack of self-confidence, sensitive
3. Muscular Tension (MT) Tense, unable to relax
4. Multicomponent Anxiety (MCA) {1+2+3}
5. Social Desirability (SD) Social conformity, polite
6. Impulsiveness (I) Impulsive actions, acting on the spur of the moment
7. Monotony Avoidance (MA) Need for change and action, avoiding routine
8. Detachment (De) Avoiding close interactions with others, distanced
9. Psychastenia (Ps) Easily fatigued
10. Socialization (So) Positive childhood experiences, good adjustment
11. Indirect Aggression (IA) Showing anger indirectly, sulking,
12. Verbal Aggression (VA) Expressing anger verbally, getting into arguments
13. Irritability (IRR) Irritable, lack of patience
14. Suspicion (S) Suspicious, distrusting
15. Guilt (G) Remorseful, ashamed of bad thoughts.
16. Aggression (AGG) {11+12+13}/ IA + VA + IRR
17. Hostility (HOST) {14+15} /AGG + HOST
18. Inhibition of Aggression (Inh) Inability to speak up, non-assertive
Results
Comparison Between the Daughters
Analyses of variance with Bonferroni post hoc tests showed significant group effects for the daughters in
the three groups on the scales of muscular tension (KSPMT), multicomponent anxiety (KSPMCA), impulsivity
(KSPI), monotony avoidance (KSPMA), psychastenia (KSPPS) and socialization (KSPSO).
Bonferroni post hoc tests showed significant differences between the anorectic women (AG) and the drug
dependent women (DG) on the scales of impulsivity (KSPI) (p < 0.05). Significant differences were found
between the women with drug-dependency (DG) and the student (SG) on the scales of muscular tension
(KSPMT) (p < 0.01), multicomponent anxiety (KSPMCA), monotony avoidance (KSPMA), psychastenia
(KSPPS) at the level p < 0.05, socialization (KSPSO) at the level of p < 0.001.
Data are displayed in Figure 1 (in all figures only significant differences as displayed).
Comparisons Between the Fathers
There were no significant differences between the Fathers in the three groups. Data not shown.
Comparison Between the Mothers
There was a significant effect on the scale of somatic anxiety (KPSA). The scores for the mothers (AG) lie
in the middle (M = 18.17, SD = 5.17) in comparison with the mothers (DG) with the lowest scores (M = 17.36,

SD = 4.08) and the mothers (SG) with the highest scores (M = 22.38, SD = 5.87). The Bonferroni KSP T-scale
shows a significant effect on the scale of somatic anxiety (KSPSAT) between the mothers in the DG and the SG
at the level p < 0.05. Data are displayed in Figure 2.
Figure 1. Comparisons Between the Daughters—KSP ANOVA (only significant differences displayed).
Figure 2. Comparisons between the Mothers—KSP ANOVA (only significant differences displayed).
Comparison Within the Family

ANOVAs were also calculated for differences between family members in the three groups. Data are not
displayed.
The Anorectic Group
For the anorectic women there were significant effects on the scales of somatic anxiety (KSPSA), psychic
anxiety (KSPPA), muscular tension (KSPMT), multicomponent anxiety (KSPMCA), psychastenia (KSPPS) at
the level of p < 0.001, irritability (KSPIRR) at the level of p < 0.01, suspicion (KSPS) and hostility (KSPHOST)
at the level of p < 0.05.

Bonferroni post hoc tests showed significant differences between the daughter and the father on the scales
of somatic anxiety (KSPSA), psychic anxiety (KSPPA), muscular tension (KSPMT), multicomponent anxiety
(KSPMCA), and psychastenia (KSPPS) at the level of p < 0. 001, irritability at the level of p < 0.01, suspicion
(KSPS) hostility (KSPHOST) at the level of p < 0.05. All differences were in the direction of more problems
for the women.
Significant differences were also found between the daughter and the mother on the scales of somatic
anxiety (KSPSA), psychic anxiety (KSPPA) and multicomponent anxiety (KSPMCA) at the level of p < 0.01,
muscular tension (KSPMT) and irritability (KSPIRR) at the level p < 0.05.
A significant difference between the father and the mother on the scale of multicomponent anxiety
(KSPMCA) at the level p < 0.05 was also found with more anxiety reported by the mothers.
Bonferroni post hoc tests T-scores showed significant differences between daughter and the father on the
scale of impulsivity (KSPIT) at the level of p < 0.05, but nothing was found on the raw scores. For data see
Figure 3.
Figure 3. Comparison Within the Anorexia Family—KSP ANOVA (only significant differences displayed).
The Drug-Dependency Group

For the women with drug-dependency problems, their fathers and their mothers, there were significant
effects for the scales of somatic anxiety (KSPSA), psychic anxiety (KSPPA), muscular tension (KSPMT),
multicomponent anxiety (KSPMCA), psychastenia (KSPPS), socialization (KSPSO), and aggression
(KSPAGG), indirect aggression (KSPIA), verbal aggression (KSPVA), irritability (KSPIRR), guilt (KSPG) and
hostility (KSPHOST).
Post hoc tests showed differences for the scales of somatic anxiety (KSPSA), muscular tension (KSPMT),
multicomponent anxiety (KSPMCA), psychastenia (KSPPS) between daughter and father and daughter and
mother. All these differences were in the direction of more problems among the women.
Women reported higher scores than their mothers on the scales of socialization (KSPSO), guilt (KSPG)
and hostility (KSPHOST) (all p < 0.05 or less). Women reported higher scores than their fathers on the scales

of verbal aggression (KSPVA) and irritability (KSPIRR), and higher scores than their fathers and mothers on
the scales of indirect aggression (KSPIA) and aggression (KSPAGG) (all p < 0.05 or less). Data are displayed
in Figure 4.
The Student Group
Significant effects were found in the scales of somatic anxiety (KSPSA), muscular tension (KSPMT) and
multicomponent anxiety (KSPMCA) and psychic anxiety (KSPPA) (all p < 0.05 or less). Post hocs showed that
the women differed from the mothers on the scales of somatic anxiety (KSPSA), muscular tension (KSPMT)
and multicomponent anxiety (KSPMCA) (all p < 0.05 or less). Moreover, a difference was found between the
fathers and the mothers on the scale of psychic anxiety (KSPPA) at the level p < 0.05, with the mothers
reporting more anxiety. For data see Figure 5.
Figure 4. Comparison Within the Drug-Dependency Family—KSP ANOVA (only significant differences displayed).
Figure 5. Comparison Within the Student Family—KSP ANOVA (only significant differences displayed).

Discussion
The aim of this study was to investigate self-reported psychological distress in anorectic women, their
fathers and mothers. Two additional groups of young women (drug-dependence respectively student group) and
their parents were also included. The largest differences of the psychological distress were found in the three
groups of young women. The study shows that anorectic women reported higher level of psychological distress
compared to the student group, but lower level compared to the drug-dependence group.
No differences in psychological distress were found among the three groups of fathers, but minor
differences were found among the three groups of mothers. The mothers of the anorectic women reported
higher degree of somatic anxiety compared to the mothers of the drug-dependency women but lower than the
mothers of the students.
Differences in psychological distress within families were also tested. The anorectic women were more
distressed, in comparison to their mothers and fathers. The mothers in all three groups showed more anxiety
than the fathers.
Interpretation
Several studies confirm that anorectic women have higher level of psychological distress. The biological
aspects of KSP in the study of Ahrén-Moonga et al. (2011) showed that the biological responses to stress,
anxiety states and starvation include, for example, elevations of interleukins as an immunological response.
Ahrén-Moonga et al. (2011) showed that the anorectic women had significantly higher scores than the controls
on scales measuring Somatic Anxiety, Muscular Tension and Psychic Anxiety. Also the women with eating
disorders scored higher in the study by Ravi, Forsberg, Fitzpatrick, and Lock (2009), than women without
eating disorders on the scales of anxiety. Augestad, Saether, and Götestam (1999), showed in her study that
high school students with AN and BN scored higher on anxiety than those without eating disorder.
Compared with the AG and the SG with no significant effects on the aggression scales, the DG had
elevated scores on them. Östlund, Spak, and Sundh (2004) found in her study comparing women with alcohol
dependence, that they reported higher irritability and impulsiveness with more extreme scores than the general
population.
An interesting fact was that no differences were found among all the variables of the fathers in all three
groups. This result could indicate that the anorectic women do not have fathers with elevated psychological
distress, but it could also be due to a small sample size and only self-report measures and a selected sample.
Two studies in China showed that the fathers, being more rational in their coping style, were less disturbed and
distressed than the mothers (Ma, 2015).
The mothers’ in all the groups had similar scores on the somatic anxiety scale. The finding in this study of
comparison within the group was that the mothers in all three groups had more anxiety than the fathers.
According to a private communication with family therapists, they found that mothers with non-problematic
children had more anxiety and the problems with the other mothers were that they showed a lack of anxiety for
their children
When comparing within the families we found hostility and irritability between the anorectic women and
their fathers. Horesh, Sommerfeld, Wolf, Zubery, and Zalsman (2015) found that “fathers’ negative attributes
were significantly associated with ED and depressive symptom”. Nielsen (2015) pointed in her research that the

quality of the father-daughter relationship was associated with young women’s rates of clinical depression
and eating disorders—the highest rates seen in the daughter’s early adult years. In opposition to the above,
Fäldt Ciccolo (2008) when looking at the varieties of qualities within family functioning found the patient
group (AN and BN) did not significantly express more hostility and criticism than the control group.
Demidenko et al. (2014) found that there were more negative feelings in the description of the father by the
depressed than by the non-depressed woman in their relation to their fathers when comparing adolescent girls
13-19 and their fathers.
The consequences of starvation with the obsessive thoughts are well known as the Minnesota Starvation
Experiment showed (Kalm & Semba, 2005). The question of what is predisposing and what is actually a
consequence of the eating disorder, is brought up by several authors (Ahrén-Moonga et al., 2008; Strober &
Johnson, 2012). Augusted et al. (1999) found that the length of time of the anorectic state was closely related to
the hostility scores in fathers. Increasing rates of hostility scores in parents with increased duration of AN, this
could be viewed as a response to the presence of the disorder or as maintaining factor. The research by Ravi et
al. (2009) found that the parents with a child with AN would have higher levels of psychopathology but
significantly lower than outpatient psychiatric norms. She also brings up the question whether a family
psychopathology is playing a role in the development or if it may represent familial response to AN. Mental
illness over an extended period of time introduces numerous stressors into parents’ lives.
The ability to be conscious about both own and others affects is a state or trait in subgroups of patients
diagnosed with eating disorders (AN, BN). The findings of Lech, Holmqvist, and Andersson (2012) showed
that the levels of observer-rated affect consciousness were not correlated with self-reported eating pathology or
psychopathology. The quality study by Sibeoni et al. (2014) of the process of differentiation among families
with anorectic daughters in comparison with families with normal daughters found that in the anorectic group
concentrated only on the relation among the family member and did not address the question of the peer group.
Limitations
The study has several limitations. First, the sample size was small rendering limited statistical power to
detect differences. Second, we had a selected sample and only self-report measures. Third, we only studied the
women and their fathers and mothers. It would have been interesting to have data on siblings, friends and
grandparents who also may be important for women with AN. Fourth the response options are fixed and
therefore has to fit into the response alternatives.
Conclusions
In spite of these limitations the study has its importance as its results gives some directions of the
experiences of individuals in close relation and touches the role of the father, a less researched subject. It can
then be used for further studies on the father and daughter relation.
This study may contribute to help clarifying the awareness of psychological distress as experienced by
each participant and also in relation to the others in the same family as well as to the same gender group. The
results could also help to distinguish the similarity and the differences between the three groups and within
each group. In conclusion, the study illustrates the importance of studying the mothers and fathers of women
with anorexia. Larger studies are needed to further investigate the role of the family relations in AN.

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Livingstone.

doi:10.17265/2159-5542/2016.05.006
D DAVID PUBLISHING
Representation of Youth Generation in the Mobile Phone and

Internet Media in Sri Lanka
Manoj Jinadasa
University of Kelaniya, Sri Lanka
This study explores the differences in behavioral patterns in youth generation that is affected by mobile phones and
internet in Sri Lanka. Yet, culture and society of Sri Lanka has profoundly rooted by its traditional religious
cultures, their behaviors have been shifted into a different phase as a result of the enormous usage of mobile phone
and internet media. Penetration of mobile phone is substantially high (101%), which is bigger with other
developing countries in South-Asia from the very beginning in 2012. The use of internet is also gradually being
increased comparing with other developing countries in South-Asia. Recent statistical reports reveal that nearly
21.9% of total population use internet in their daily use (2013). In this study, from 2011 up to 2015, rural and urban
societies were explored using random sampling. This study conducted in mixed approach, as quantitative; survey
(100 questionnaires) and qualitative; 20 in-depth interviews and participatory observation in some of the places
where youth were highly assembled for their socio-cultural functions. Sri Lankan youth have sharply been changed
in their behaviors by the new media culture. Youth’s behaviors are inter-relationship, sexuality, learning modes and
behaviors, socialization, taste of entertainment, imagination of aesthetic creativity, attitudinal development, use of
information, social systems and life values have been dramatically changed by gradual development of the use of
new media tools and equipment. Key social issue in youth in this is the lack of critical understanding. However, this
study suggests a need of critical and innovative knowledge in use of mobile phone and internet so that they are
enabling with use them for their personal and professional developmental purposes.
Keywords: representation, youth generation, mobile phone, internet, behavior
Background
In Sri Lanka, covering a large diversity of ethnic and cultural patterns, media circulation has rapidly
expanded over the country with nearly sixty (60) Radio channels, fourteen (40) television channels and more
than 60 printed media including newspapers, periodicals, and journals in all three languages of Sinhala, Tamil
and English. Currently, Sri Lanka shows the highest penetration of mobile phone in developing countries in
South-Asia (101%). There is a tendency in the growth of use and circulation of internet.
Total population of Sri Lanka has reached to a maximum of 20,277,597 as at March, 2012 in terms of the
preliminary report prepared by the department of Census and Statistics of Sri Lanka (preliminary report
(provisional)—1,2012 ). Population growth is 0.7. Maximum of population represents by rural sector is 72.2%,
while urban sector is 21.5% and state sector is 6.3% (2011). Growth of GDP is 8.3% by 2011 as presented in
Economic and Social Statistics of Sri Lanka—2012 (Central Bank of Sri Lanka, 2012:01).
Manoj Jinadasa, MSSc., Senior Lecturer in Mass Communication, Department of Mass Communication, University of Kelaniya.
312 REPRESENTATION OF YOUTH GENERATION IN THE MOBILE PHONE
In the expansion of telecommunication as presented in above report, number of the wire-line telephone is
941,781 and the number of the cellular phones is 18,319,447. Number of wireless telephone loop is 2,666,612.
Telephone density (telephones for 1,000 persons, including cellular phones) is 1,051. Number of the Internet
and email subscribers is 844,000 billion (Central Bank of Sri Lanka, 2012:08).
On the other hand, there is a clear picture provided by the statistical report—2012 March of
telecommunication regulatory board of Sri Lanka.
Table 1
Statistical Overview of the Telecommunication Sector as at End of 2012
Number of System Licenses 64
Total number of Fixed phones 3,616,411
Teledensity (Fixed Phones per 100 inhabitants) 17.5*
Number of Cellular Mobile Subscribers 18,866,134
Mobile Subscription per 100 people 91.3*
Internet & Email Subscribers―Fixed 375,000*
M Internet & Email Subscribers (Mobile ) 711,000*
Number of Public Pay Phone Booths 6145
Trunk Mobile Radio Subscribers 206*
Note. * Provisional.
In reference to these statistics and surveys in Table 1, it is apparently clear that the high growth in both
internet and mobile phone including other related technologies of new media is possible with contemporary
society of Sri Lanka.
As Figure 1 shows, from 1990 to 2012, there is a growing increase in the use of fixed access telephone in
Sri Lanka, while from 2005 to 2008, it shows a considerable steep up. However, at the end of March 2012,
when it comes to the provincial distribution of fixed telephone, Figure 2 indicates a significant difference
between western province (40%) and other provinces in the use of fixed access telephone.
Moreover, for years some efforts have been taken to develop high speed of broadband internet by TRC
(Telecommunication regulatory Board). Some of the telecommunication cooperation like Dialog, SLT, Lanka
bell and Suntel have been modified to gain sufficient speed in the broadband internet facility under certain
issues immerged in geographical and technological sectors. From 2015, government has been taking some
efforts to bring internet to the entire country using Google balloon.
Along with this, some studies and pilot tests are conducting currently in mounting internet protocol
version-04 (IPV4) into internet protocol version-06 (IPV6) in Sri Lanka. Steps have been taking to enhance the
quality of the internet and new media technology, so that its fundamental objective is to cater with national
development.
But the mismatch comes with the quality of human life in their social and cultural life with the circulation
of the forms of new media. It is understood that the lessons are inadequate to use the new forms of media, yet
there is growing development of the tools of internet based communications (Jinadasa, 2006; 2008). In this, my
attention has drawn to the cultural behaviors of youth generation which has been dramatically changed by the
network society. In other words, even there is a substantial growth and utility of mobile phone with the internet,
it is obscure why that of media use is impossible in advancing human quality that leads to improve national
development leading to youth generation.
REPRESENTATION OF YOUTH GENERATION IN THE MOBILE PHONE 313
Year Cumulative
1990 121,388
1991 125,834
1992 135,504
1993 157,774
1994 180,724
1995 204,350
1996 255,049
1997 341,622
1998 523,529
1999 669,113
2000 767,411
2001 827,195
2002 883,108
2003 939,013
2004 991,239
2005 1,243,994
2006 1,884,076
2007 2,742,059
2008 3,446,411
2009 3,435,958
2010 3,578,463
2011 3,608,392
2012
3,616,411
March
Figure 1. Performance of fixed access telephone operators.
Provincial Fixed
Province Phones as at
2012 March
Central 408,113
East 155,569
North 110,149
North Central 229,515
North West 342,331
Sabaragamuwa 295,841
Southern 408,113
Uva 248,599
Western 1,443,664
Total 3,616,411
Figure 2. Performance distribution of fixed access telephone operators.
Fundamentally, for many years, there is a continuous dialogue and emphasis in the use and necessity of IT
(Information Technology), Internet, and Mobile phone in the capacity to develop national education, health,
cultural values and other planning in social development. At present, this is highly demanding as Sri Lanka is
one of the middle range developing countries in the world.
One of the possible reasons for this nature is even we have an immense growth in internet and mobile
phone; we are inefficient in implementation them in the capacity of social development as new media
technology and tools are not being properly taught by the education system. This has been correct in the current
social incidents such as decreasing in the quality and standard of the national education which is unfit for
handling existing local issues. Rate of crime and sexual harassments related to new media, wrongly interpreted
political interference through social media which cause to destruct the pillars of democracy are some of the
important changes in this venture. This situation signifies the overall massive collapse in culture and politics as
the circulation of new media injecting new forms of cultural sophistications into the youth in Sri Lanka.
Extreme use of mobile phone and internet in network society in digital age for many needs and wants has
been the fact in shaping and reshaping teen cultures (Castells, 2004; 2009; 2010). However, when it comes to
the behavioral changes with this new media, specially teen and youth cultures are plugged in the rate of crime
(Jinadasa, 2015) and sexual liberation that dance with their implicit clandestine relations (Jinadasa, 2015; 2010).
Methodology
This study conducted using mixed approach. Rural and urban societies were studied using convenient
sampling. For the data gathering, Quantitative and qualitative methods as survey (100 questionnaires), 20
in-depth interviews and participatory observation in some places where youth was highly gathered for their
socio-cultural functions were utilized.
For this sample, districts of Colombo, Kandy, Galle, Anuradhapura, and Kurunagala were used for
selecting urban population. Districts of Ampara, Monaragala, Rathnapura, Jaffna, and Batticlaw were used for
selecting rural population. 100 questionnaires were comprised by ten questionnaires from each district. Answer
rate of this sample was 87%.
For the qualitative analysis, 20 in-depth interviews were conducted from the districts by representing two
subjects from each district. Participatory Observation was also used to justify some of the gathered data from
interviews and questionnaires.
Data Analysis
All the subjects use mobile phone by 100%, while some of them having extra phone for their interpersonal
communication with others for clandestine relationships. And use of internet is not familiar like the use of
mobile phone is only 58%. This amount is largely represented by the rural and mid-urban sectors.
The use of mobile phone has shown diverse interests and needs. Primarily, it was used for interpersonal
communication. In this, it is highlighted some of them use extra phone for covert relations specially leading to
sexual bahaviors. Love affairs among teens have been dramatically changed into an intolerable type of
affections, so that they are possible with releasing their instant feeling to one another from which it could be a
disastrous for their life.
In the use of internet, a large number of subjects use it as a mode of entertainment rather than a form of
educational mode is 95%. Use of the Internet as a medium of entertainment is narrowed down for only listening
songs, watching new movies, chatting and more on social media dialogues. Face book is the major and most
commonly use social media in youth societies. Internet has been used as a motivation of sex instincts in many
ways such as chatting, using internet camera, blogging, social media, and particularly the use of internet
pornography.
There is an increasing expansion of Compact Disk (CD) pornography prepared by the source of internet
pornography as a big business among the teens and youth. This is highly being leaked into rural areas through
the urban sectors. In addition, there are some places called internet cafes, specially made for the pornography
over rural community in youth and teen. This is much ingrained in school children and university
undergraduates. Type of Compact Disk (CD) pornography has created other cases in marital sexual
relationships.
One of the resent case revealed from district of Monaragala far remote area in Sri Lanka is very important
for this study. Her husband having seen a sexual intercourse of long duration in CD, he has many times
quarreled with his spouse and finally in the face of her inability of such a long course of sex she climbed to a
jack tree for the protection from her husband and fallen down with severe back damage.
And several other interesting cases have been found in the expansion of homosexuality in remote and
urban areas as an impact of CD circulation which emanated from internet sex clips and video movies. This has
more peculiar in Ampara and Rathnapura as far remote rural areas and Colombo and Kandy as urban areas in
Sri Lanka in the same manner. In addition, there is a dramatic change in school and teen cultures more
particularly in urban and very popular collages, in organizing homosexual groups as an adopted cultural
behavior created on the increase of internet and mobile phone. In this, it is something an extreme imitation of
being westernization by receiving their sexual relationship in the bless of internet and mobile phone.
Moreover, it is seen such a big expansion of same sex, especially in gay in both urban and rural areas in
Sri Lanka as an impact of internet via the mobile phone (Jinadasa, 2015). In this, social media is innovatively
being utilized for the sexuality, interestingly among youth and teen cultures.
Even such a big expansion in internet, youth is not interested in using it for their educational events. In
school level education, it is highly minimal in the use of internet as a form of informal mode of education;
while in undergraduates’ use, it is not for thorough awareness but for the preparation of their course
assignments using only for copy and paste style. No critical and creative writing in their studies. Many youth
engage in e-mail, blogging and social media for their interrelations of personal affairs (Ziththrin, 2008;
Wittcower, 2010). They do not use it for searching new knowledge and professional development. However,
there is a minimal use of social media for advertising their image and retaining their market of some of the teen
members such as commercial models, actors, businessmen.
In a holistic perspective, the technology of both the tools of mobile phone and internet has not sufficiently
spread out in rural sectors while some expansion is in the areas of urban. One of the reasons behind this is as
the subjects see it is the lack of IT education in rural schools in Sri Lanka. Eighty-four percent (84%) schools in
Sri Lanka have no at least single computer in their education. However, there is a growing development in the
use of smart phone in the youth generations as a result of the presentation new brands attractively in the popular
markets.
New generation of youth and teen is much confident with consuming the latest version of highly expensive
mobile phones at any price (Winston, 2003; Katz, 2008). In general, they used to change their phones with the
introduction of new versions of the same. But they do no change their awareness or rationality with the
grasping of latest mode of technology. They do not use it for their critical knowledge. And with this rapid
circulation of mobile phone, there is no such a rapid growth in productivity in their daily works or studies. This
is very peculiar among in the societies of adults. Consequently, the use of mobile phone also, has been a part
and parcel of high consumerism prevailed in contemporary society in Sri Lanka as a result of capital economy.
Conclusions and Recommendations

There is a considerable difference in the use of mobile phone and internet in the youth society in Sri Lanka.
While it takes an expansion of new media, there is a considerable destruction of youth society behaviors in Sri
Lanka. New media literacy is law irrespective of the high rate of language literacy in Sri Lanka. Concerning the
studies of new media in the curricula of Mass communication, albeit some inclusion of new media for curricula,
it is not sufficient with the rapid expansion of the use of mobile phone and internet with its tremendous
socio-cultural issues. Thus, psychological and Philosophical analysis into the use of new media remains much
applicability to this situation.
Rate of crime and murder has been increased with the circulation of the forms of new media is also
significant in the new media society in Sri Lanka. Rate of divorce is also increasing dramatically by 40 to 50
cases as reported monthly in district courts. It is noteworthy to recommend for a thorough study of the
relevance and relation of the rate of divorce and the use of new media. Many clandestine relations, that happens
in the mobile phone has been the fact for such immediate divorce cases soon after their marriage.
Despite the fact that, having an immense understanding on the necessity of IT and new technology in
communication, most updated versions of the communication technology of new media are being slowly
adopted by the local audiences.
Two of the major misuses in the use of new media in youth are high interference of politics and
malpractice in traditional media of TV, Radio and newspaper. The high consumer behavior and modern social
competition that were engulfed to the Sri Lankan society have been interrelated with the misuse of new media
within the generation of youth.
Education system is still in the course of traditional norms and policies of teaching and learning. However,
some of the higher education institutions have been trying to adopt new electronic systems of education such as
e-learning and online education system (LMS) refers with open, external and distance modes of education.
One of the crucial reasons behind the misuse of new media in the youth generation is the inadequacy of
the learning in philosophy and aesthetic of human sciences of the use of new media. It is urgent to concern on
the ethics and morals of human culture under the curricula of education, when there is a high exercise and
growth of new communication technologies that transform world into efficient in the digital age. In the
education system of Sri Lanka, nevertheless it is fundamentally emphasized the relevance and the importance
of philosophy and psychology of the process of human mechanism, it has been decreased by the face of
competition and extreme consumerism in modern capital economy.
In brief, New media has not relevantly been used for the critical understanding, so that the traditional
interpretation for the concepts like democracy, human rights, rule of law, good governance, ethics and
aesthetics, have been in both great sophistication and no of their pragmatic sense in the third world countries
after the colonial period. Lack of innovative interpretation and critical understanding have been two factors that
needs to project on the increase of high circulation of internet and mobile phone in Sri Lanka.
With this deficiency of critical knowledge in new media, it is crucially important to search for a new
policy and regulation to govern the practice and use of the new media for decreasing their ill-effects towards
youth generation.
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Call for Papers
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Psychology Research

Volume 6, Number 5, May 2016 (Serial Number 59)

David Publishing Company

David Publishing Company

Identifying Conceptual Differences Between Psychiatric Disorders and Neurological

The Influence of the Family on the Development of Psychosomatic Disorders in Preschool

Developmental and Educational Psychology

Inclusion in International Schools: Theoretical Principles, Ethical Practices, and

Psychological Distress in Anorectic Women, Their Fathers and Mothers 301

Identifying Conceptual Differences Between Psychiatric

Shrirang S. Bakhle, M.B., Director, Dr. Bakhle Clinics.

Different Viewpoints about the Differences Between Psychiatric

Psychiatric Disorders Are “Mental” Disorders

What Is the Meaning of “Mental”?

Understanding the Inclusion and Exclusion Criteria of the DSM-5

“Mind and Brain! Here We Go Again!”

Mind: The Central Key Piece of this Entire Puzzle

The Importance of Understanding the Difference Between Physical Parts,

The Properties of a “Functional Organization”

Mind and the “Mental” Disorders

Are “Mental” Disorders, Disorders of Mind or Brain?

What Is the Difference Between Psychiatric Disorders and Neurological

After the Clinical Examination of a Patient, Does a Psychiatrist Conclude

Is It Correct to Use the Term “Behavioral Disorders” Instead of “Mental Disorders”?

The Influence of the Family on the Development of

Svetlana Aleksandrovna Mugal

Keywords: family, psychosomatic disorders, mental retardation, mental trauma

Arina, N. A. Kovalenko, J. Klammer, G. P. Mozgova), especially among the preschool children.

Using FAST Test for Diagnosing of Cohesion and Hierarchy of

Lucia Lackova Martin Malcik

Lucia Lackova, Department of Pedagogical and School Psychology, University of Ostrava.

Material and Methods

Inclusion in International Schools: Theoretical Principles,

Julie M. Lane, David R. Jones

Survey Development and Subscales

Figure 1. Geographical Dispersion of Respondents.

Psychological Distress in Anorectic Women,

Elisabeth Bratt Neuberg Gerhard Andersson

Keywords: anorectic women, fathers, mothers, between families, within families

Comparison Within the Family

The Drug-Dependency Group

Representation of Youth Generation in the Mobile Phone and

Keywords: representation, youth generation, mobile phone, internet, behavior

Conclusions and Recommendations

★ Database of EBSCO, ★ Excellent papers in ERIC ★ Scientific Indexing Services

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