[Downloaded free from http://www.indjsp.org on Friday, October 2, 2020, IP: 183.83.46.

169]

Original Article

A Comparative Study of Half‑Orphan and Double‑Orphan Adolescents to

Explore the Psychological Well‑Being in Orphanage of District Srinagar,
Kashmir

Abstract Tabasum Dilawar

Introduction: The impact of orphanhood on the mental health of adolescents is an inevitable Malla,
phenomenon. This impact is raised when an adolescent loses both of his/her parents. Hence, Ifshana Iliyas
the present study was aimed to compare the level of psychological well‑being  (PWB) and
its dimensions  (autonomy, environmental mastery, positive relations with others, purpose Rather,
in life, personal growth, and self‑acceptance) between half‑orphans and double‑orphans. Nusrat Yousuf1
Materials and Methods: The present study was conducted from June 2015 to June 2016 in selected Department of Psychiatry,
orphanages of district Srinagar, Kashmir. The sample size consists of 115 adolescent orphans, and Government Medical College,
among those, 70  (61%) were half‑orphans and 45  (39%) were double‑orphans. Level of PWB was
1
Department of Anesthesia, 
Sher I Kashmir Institute of
assessed using standardized scale  –  Ryff’s PWB scale. t‑test was used to compare the PWB and its
Medical Sciences, Srinagar,
dimensions between half‑orphans and double‑orphans. Results: Using t‑test, it was found that there Jammu and Kashmir, India
is significant difference between half‑orphans and double‑orphans only in case of positive relations
with others  (t  =  2.034, P <  0.05) and self‑acceptance  (t  =  2.325, P <  0.05) dimensions of PWB,
while there is insignificant difference of autonomy  (t  =  0.126), environmental mastery  (t  =  1.013),
personal growth  (t  =  0.377), purpose in life  (t  =  0.355) dimensions of PWB, and overall
PWB (t = 1.788). Conclusion: Mean difference was found between half‑orphans and double‑orphans
in every dimension while there was statistically significant difference between the two groups in only
two dimensions  (positive relationship with others and self‑acceptance dimension of PWB) where
half‑orphans dominate. It is therefore recommended that the orphanages may have to consider the
possibility of recruiting qualified counselors, psychiatric nurses, or child psychologists.

Keywords: Double‑orphan, half‑orphan, orphanage, psychological well‑being

Introduction in the mid‑1990s as the AIDS pandemic

Globally, an orphan is defined by
international organizations based on age
and parental status. The UNICEF, UNAIDS,
and USAID joint report on orphan
estimates and program strategies, children
on the brink, defines an orphan as a child
aged 0–17  years whose mother  (maternal
orphans) or father  (paternal orphans) or
both (double orphans) are dead.[1]
The UNICEF and global partners define
an orphan as a child who has lost one or
both parents. By this definition, there were
over  132 million orphans in Sub‑Saharan
Africa, Asia, Latin America, and the
Caribbean in 2005. Of the more than 132
million children classified as orphans, only 13
million have lost both parents. The UNICEF
and numerous international organizations
adopted the broader definition of an orphan
began leading to the death of millions of
parents worldwide, leaving an ever‑increasing
number of children growing up without one
or more parents. Hence, the terminology of
a “single‑orphan and half‑orphan”  –  the loss
of one parent  –  and a “double‑orphan”  –  the
loss of both parents  –  was born to convey
this growing crisis.[2]
A new study by an international charity for
orphaned and abandoned children found
Address for correspondence:
that India is home to 20 million orphans, a
Tabasum Dilawar Malla,
figure projected to increase by 2021.[3] Kathi‑Maidan, Alamgari‑Bazar,
Srinagar, Jammu and Kashmir,
Orphans frequently lack sufficient food, India.
shelter, schooling, and medical care E‑mail: tabuji786@gmail.com
and are at risk of abuse and economic
exploitation  (Afework T, 2013).[4] Most
research work on orphan concentrates on Access this article online
basic need. There is little available research, Website: www.indjsp.org
DOI: 10.4103/ijsp.ijsp_99_18

This is an open access journal, and articles are
distributed under the terms of the Creative Commons
Attribution‑NonCommercial‑ShareAlike 4.0 License, which
allows others to remix, tweak, and build upon the work
non‑commercially, as long as appropriate credit is given and
the new creations are licensed under the identical terms.
For reprints contact: reprints@medknow.com
How to cite this article: Malla TD, Rather II, Yousuf N. Quick Response Code:
A Comparative study of half-orphan and double-orphan
adolescents to explore the psychological well-being in
orphanage of district Srinagar, Kashmir. Indian J Soc
Psychiatry 2019;35:188-92.
Received: 14-11-2018, Revised: 19-02-2019,
Accepted: 26-04-2019, Web Publication: 30-09-2019

188 © 2019 Indian Journal of Social Psychiatry | Published by Wolters Kluwer - Medknow
[Downloaded free from http://www.indjsp.org on Friday, October 2, 2020, IP: 183.83.46.169]
Malla, et al.: Psychological well-being of half and double orphan adolescents of district Srinagar
but increasing concern, regarding the psychological
well‑being (PWB) of orphans in Kashmir.
An estimate by a UK based charity “Save the Children;”
Kashmir valley has 215,000 orphans out of which  >37%
have lost one or both parents to the prevailing conflict. More
than 15% of these children live in orphanages.[5] A report
available on the website of Save the Children organization
reveals that 37% of the orphans lost one or both parents
due to the conflicts while 55% were orphaned due to the
natural death of parents and remaining 8% due to other
reasons.[6]
Consequences/effects of orphanhood
• Loss of affection and nurturing
• Depression
• Inadequate hygiene
• Loss of guidance and discipline
• Risk of prostitution and other risky behavior
• Loss of regular primary health care
• Increased economic distress
• Child labor
• School dropout[7]
• Inhibited physical development[8]
• Increased susceptibility to psychological risks and
emotional problems[8]
• Inhibited social development and connectivity.[8]
The literature on PWB has progressed rapidly since the
emergence of the field over five decades ago. PWB refers
to how people evaluate their lives. As summarized by
Huppert  (2009, P.  137)[9] “PWB is about lives going well.
It is the combination of feeling good and functioning
effectively.” By definition, therefore, people with high PWB
report feeling happy, capable, well supported, satisfied with
life, and so on.
Carol Ryff has worked on the study of PWB. When she
thought of well‑being, she thought about it more in terms
of optimal psychological functioning rather than happiness.
She has identified six broad facets associated with optimal
psychological functioning as follows:
• Autonomy: This means being self‑determining,
independent, and regulating behavior internally;
resisting social pressures to think and act in certain
ways; evaluating oneself by personal standards[10]
• Environmental mastery: This means feeling competent
and able to manage a complex environment; choosing
or creating personally suitable contexts[10]
• Sense of personal growth: This means having feelings
of continued development and being open to new
experiences[10]
• Positive relations with others: This means having warm,
satisfying, trusting relationships. It also means being
concerned about other welfare and being capable of
strong empathy, affection, and intimacy; understanding
give‑and‑take of human relationships[10]
Indian Journal of Social Psychiatry | Volume 35 | Issue 3 | July-September 2019
• Purpose in life: This means having goals and a sense of
direction in life. It means feeling that both the present
and past experiences are meaningful; holding beliefs
that give a purpose to life[10]
• Self‑acceptance: This means having a positive attitude
toward yourself; acknowledging and accepting multiple
aspects of self; feeling positive about one’s past life.[10]
In 1988, a study of preschool children admitted to New
Orleans Hospitals as psychiatric patients over  34  months
found that nearly 80% came from fatherless homes,
according to Photius.com.[11] One more study done by
Jyotika and Tankha[12] found that male students of science
faculty were significantly higher on four factors of PWB
namely environmental mastery, positive relations with
others, purpose in life, and self‑acceptance than the
commerce students. There was no significant difference
found on other two factors of PWB using Ryff’s PWB
scale. Female gender, suspected HIV infection, experiences
of potentially traumatic events, including the loss of both
parents, urban residence, eating fewer than three meals
per day, and low caregiver involvement have been found
to be associated with poorer child health outcomes as
per   Thielman et al.[13]
As per the study conducted by   Zhou in 2012, the mean
of the “child bereavement” scores of double orphans was
found significantly higher than that of paternal orphans.[14]
There is little available research, but increasing concern,
regarding the PWB of orphans in Kashmir.
Unfortunately, in Kashmir, mental health is a neglected area
as it is in most of India. The need for psychological health
and psychiatry is yet to be recognized, and consequently,
a very small percentage of the orphans have received any
sort of counseling and treatment.[15]
Based on the above descriptions, the researcher felt the
need to address the special needs of this vulnerable group.
Hence, the present study was undertaken to find out the
extent of well‑being of the orphans.
Materials and Methods
The present study was carried out at Madre‑E‑Meharban
Institute of Nursing Sciences and Research, SKIMS,
Soura, conducted from June 2015 to June 2016 in selected
orphanages of district Srinagar, Kashmir. This research was
initiated following approval by the Institutional Ethical
Committee and Board of Research Studies of Sher‑I‑Kashmir
Institute of Medical Sciences, Soura, Srinagar. Permission
was taken from the Chairman of Raahat Manzil, Jammu
and Kashmir Yateem Trust, and Al‑Noor Yateem Trust, and
consent was taken from adolescent orphans before data
collection. Setting was selected for the study on the basis
of feasibility of conducting the study and availability of the
required sample. These areas were selected based on the fact
that there is large number of orphan children in these areas.
189
[Downloaded free from http://www.indjsp.org on Friday, October 2, 2020, IP: 183.83.46.169]

Malla, et al.: Psychological well-being of half and double orphan adolescents of district Srinagar

The study is descriptive in its nature since it attempts Observations

to assess the level of PWB in orphans, which involves
Table  1 represents the distribution of study subjects
comparative survey since it compares the status of PWB of
according to their sociodemographic variables. The
half‑orphans and double‑orphans.
data obtained are described in terms of gender, habitat,
In the present study, the population consists of all the educational status, type of orphan, and time spent in
adolescent orphans falling in the age range of 12–18  years orphanage.
and residing in orphanage of Srinagar district during the
Table  2 represents that “t” value of 2.034  (P  <  0.05) and
period of data collection.
higher mean on positive relations with others suggests
The sample size consists of 115 adolescent orphans from better PWB of half‑orphan than double‑orphan adolescents.
the selected orphanages of Srinagar district. As regards self‑acceptance, “t” value 2.325  (P  <  0.05) and
Stratified proportionate simple random sampling technique
Table 1: Frequency and percentage distribution of
is used. The population of selected orphanages was divided
subjects according to demographic variables
into five strata (7th, 8th, 9th, 10th, and 11th class). The students
Variables Frequency (%)
were selected from each of these strata by simple random
Single orphan Double orphan Total
sampling with the lottery method.
Gender
All the cases were assessed for sociodemographic variables Male 54 (77) 36 (80) 90 (78)
such as gender, habitat, educational qualification, type of Female 16 (23) 09 (20) 25 (22)
orphan, and time spent in orphanage. To assess the PWB Total 70 (61) 45 (39) 115 (100)
of the respondents, the researcher employed the Ryff’s Habitat
PWB scale[16] – a self‑report inventory, in English and Urdu Rural 47 (67) 33 (73) 80 (70)
language. Urban 23 (33) 12 (27) 35 (30)
Total 70 (61) 45 (39) 115 (100)
The scale consists of a series of statements reflecting the Educational status
six areas of PWB: autonomy, environmental mastery, 7th 16 (23) 9 (20) 25 (22)
personal growth, positive relations with others, purpose in 8th 22 (32) 13 (29) 35 (30)
life, and self‑acceptance. Subscale consists of 9, 9, 6, 9, 6, 9th 19 (27) 11 (24) 30 (26)
and 7 items, respectively. Respondents rate statements on a 10th 10 (14) 10 (22) 20 (18)
scale of 1–6, with 1 indicating strong disagreement and 6 11th 3 (4) 2 (5) 5 (4)
indicating strong agreement. Total 70 (61) 45 (39) 115 (100)
Individual indicated their response on 6‑point liker‑type Time spent in
orphanage
scale, which higher scores on each scale indicating greater
<6 months 12 (17) 12 (27) 24 (21)
wellbeing on each dimension. The number of responses
>6 months 58 (83) 33 (73) 91 (79)
made by the subject on each question depends on whether
Total 70 (61) 45 (39) 115 (100)
the question is positive or negative. If it is a positive
question, responses are rated from 1 to 6, where a score
of 6 indicates strong agreement. If it is a negative question Table 2: Independent sample t‑test for assessing the level
scoring done is in reverse order which is from 6 to 1, of psychological well‑being according to dimensions
where 6 indicated strong disagreement. For each category, between half‑orphans and double‑orphans
a high score indicates that a respondent has a mastery of Dimension Variable Mean (SD) t P
that area in his/her life. Conversely, a low score shows Autonomy Half‑orphan 34.80 (4.877) 0.126 0.90
that the respondent struggles to feel comfortable with that Double‑orphan 34.69 (4.171)
particular concept. Environmental Half‑orphan 37.36 (3.679) 1.013 0.31
mastery Double‑orphan 36.60 (4.239)
Statistical analysis
Personal growth Half‑orphan 25.10 (3.359) 0.377 0.70
Data were organized in Microsoft Excel Sheet Double‑orphan 24.84 (3.831)
and was analyzed using   SPSS version  20.0 and Positive relations Half‑orphan 35.37 (4.846) 2.034 0.04
SYSTAT‑13.  Frequency and percentage distribution were with others Double‑orphan 33.49 (4.818)
used to describe the demographic variables. Quartile Purpose in life Half‑orphan 25.56 (3.713) 0.355 0.72
deviation was used to assess the level of PWB and its Double‑orphan 25.82 (4.201)
dimensions in adolescent orphans. Chi‑square test was used Self‑acceptance Half‑orphan 30.07 (3.804) 2.325 0.02
to analyze the association of PWB and its dimensions with Double‑orphan 28.33 (4.051)
selected demographic variables. t‑test was used to compare Psychological Half‑orphan 188.26 (12.428) 1.788 0.07
the PWB and its dimensions between half‑orphans and well‑being Double‑orphan 183.78 (14.071)
double‑orphans. SD=Standard deviation

190 Indian Journal of Social Psychiatry | Volume 35 | Issue 3 | July-September 2019

[Downloaded free from http://www.indjsp.org on Friday, October 2, 2020, IP: 183.83.46.169]
Malla, et al.: Psychological well-being of half and double orphan adolescents of district Srinagar
higher mean score of half‑orphan adolescents indicates
greater PWB than double‑orphan adolescents. The
mean scores on other four variables namely autonomy,
environmental mastery, personal growth, and purpose
in life as well as overall PWB of half‑orphans indicate
better PWB than double‑orphan adolescents although the
difference was statistically insignificant.
Independent‑sample t‑test for assessing the level of PWB
according to the dimensions between half‑orphans and
double‑orphans.
Discussion
In Kashmir, there is growing concern about the
consequences of the epidemic for orphaned children and
adolescents.[6] According to a 2014 study conducted by
Save the Children, a London‑based charity organization,
the estimated population of orphans in Jammu and Kashmir
due to conflict and natural death of parents is around
215,000, 15% of whom live in orphanage homes across the
territory.
In a humanistic expansion formula, society is the
preponderant parameter that germinates human values,
beliefs, and their acceptance. The stakeholders of
humankind are the pillars upon which society thrive its
existence and children are the base in this construction.
Further, in an attempt to reduce a just and equitable future,
one has to start with its base. That, in fact, reflects the
role of children in the futurity of society, state, and its
development. Children are like dividends that are returns
to its stakeholders in the future. It is an investment in
building the edifice of humanity. If not properly invested
and taken care, they, perhaps, will give bad results and
losses.[17,18]
Our study results reveal that two‑third of the adolescents
were half‑orphans, nearly four‑fifth of them were males,
almost three‑fourth of the adolescent orphans were from
rural area, about one‑third of them were belonging to the
8th‑standard. Furthermore, the maximum of respondents had
spent more than 6 months in orphanage.
In our study, it was found that there is significant difference
between half‑orphans and double‑orphans only in case
of positive relations with others  (t  =  2.034, P <  0.05)
and self‑acceptance  (t  =  2.325, P <  0.05) dimension
of PWB, while as there is insignificant difference of
autonomy  (t  =  0.126), environmental mastery  (t  =  1.013),
personal growth  (t  =  0.377), purpose in life  (t  =  0.355)
dimension of PWB, and overall PWB  (t  =  1.788). The
results are consistent with the studies carried out at Kashmir
by Khan and Jahan[19] on 80 adolescents where nonorphans
scored higher on PWB than orphan adolescents. Certain
dimensions of PWB namely personal growth, positive
relations, purpose in life, and self‑acceptance also differ
significantly in orphans and nonorphans. The study was
also in conformity with the findings of a study conducted
Indian Journal of Social Psychiatry | Volume 35 | Issue 3 | July-September 2019
by Tsige[20] where the results revealed that institutional
orphan children are relatively not psychologically well
compared to the noninstitutional children.
Limitations
The sample size is limited to 115 adolescent orphans
of selected orphanage in Srinagar which limits the
generalization of research findings. The sample size
difference between comparable group is wide (half‑orphans:
double‑orphans = 70:45).
Conclusion
In view of difference between the comparable groups, the
orphans need to be treated and taken care of accordingly.
Qualified counselors and trained psychiatric nurses need to
be posted in the orphanages for the overall well‑being of
orphans.
Acknowledgment
We would like to thank Dr.  Shabir Ahmad Dar, Senior
Resident, for his continuous support and valuable
suggestions.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. World Bank. The OVC Toolkit in SSA  –  A Toolkit on how to
Support Orphans and Other Vulnerable Children  (OVC) in
Sub‑Saharan Africa  (SSA)  (English). Washington, DC: World
Bank; 2005. Available from: http://documents.worldbank.org/
curated/en/131531468135020637/The-OVC-toolkit-in-SSA-
a-toolkit-on-how-to-support-orphans-and-other-vulnerable-
children-OVC-in-Sub-Saharan-Africa-SSA. [Last accessed on
2015 Jul 13].
2. UNICEF‑for Every Child. Orphans: Press Centre; 2015.
Available from: http://www.unicef.org/media/media_45279.
html. [Last accessed on 2015 Mar 06].
3. Available from: http://www.soschildrensvillages.ca/
india‑now‑home‑20‑million‑orphans‑study‑finds. [Last accessed
on 2015 Apr 20].
4. Afework  T. A  Comparative Study of Psychological Wellbeing
between Orphan and Non‑Orphan Children in Addis Ababa: The
Case of Three Selected Schools in Yeka Sub‑city. Addis Ababa.
Unknown Publisher; 2013.
5. Firdosi  M. Orphans of Conflict: Forgotten by Society and
the State. Greater Kashmir; 08  December, 2015. p.  6.
Available from: https://m.greaterkashmir.com/news/opinion/
orphans‑of‑conflict‑forgotten‑by‑society‑and‑the‑state/194021.
html. [Last accessed on 2016 Feb 07].
6. Kashmir Global‑News and Research on Kashmir.
Kashmir has over  2 Lakhs Orphans: Report; 2014.
Available from: http://kashmirglobal.com/2014/08/06/
kashmir‑has‑over‑2‑lakhs‑orphans‑report.html. [Last accessed on
2015 Oct 14].
7. World Bank. Factors that Contribute to and the Consequences
191
[Downloaded free from http://www.indjsp.org on Friday, October 2, 2020, IP: 183.83.46.169]

Malla, et al.: Psychological well-being of half and double orphan adolescents of district Srinagar

of Orphanhood. World‑Bank; 2015. Available from: http://info. PLoS One 2012;7:e38109.

worldbank.org/etools/docs/library/164047/Sector/factorstable.
html. [Last accessed on 2015 Nov 17].
8. Johnson WD. The Effects of Being an Orphan. UK: eHow; 2015.
9. Huppert FA. Psychological Well - being: Evidence Regarding
its Causes and Consequences. Appl Psychol Health Well Being
2009;1:137-64.
10. Ryff CD, Keyes CL. The structure of psychological well-being
revisited. J Pers Soc Psychol 1995;69:719-27.
11. Statistics of a fatherless America. Available from: https://photius.
com/feminocracy/facts_on_fatherless_kids.html. [Last accessed
on 2019 Sep 15].
12. Jyotika  S, Tankha  G. Psychological wellbeing of first year male
students of science and commerce faculty. Int J Res Publ Res J
Soc Sci Manage 2014;4:62‑70.
13. Thielman  N, Ostermann  J, Whetten  K, Whetten  R,
O’Donnell K; Positive Outcomes for Orphans Research Team.
Correlates of poor health among orphans and abandoned children
in less wealthy countries: The importance of caregiver health.
14. Zhou  G. Understanding the Psychosocial Wellbeing of Orphans
and Vulnerable Children  (OVC): The Intersection of Research
and Policy. Durham NC; 2012.
15. The Effects of a Single‑Parent Family on Society. Florence:
eHow Demand Media Inc.; 1999‑2015.
16. Available from: http://sparqtools.org/mobility‑measure/
psychological‑wellbeing‑scale/. [Last accessed on 2016 Jan 10].
17. Available from: https://m.rediff.com/news/2001/dec/13child.html.
[Last accessed on 2016 Jun 13].
18. Karkera  R. Generation  –  The Story of the Children in Kashmir;
2001. p.  3. Available from: http://Thelost.rediff.com. [Last
accessed on 2015 Sep 26].
19. Khan  TF, Jahan  M. Psychological wellbeing and achievement
motivation among orphan and non‑orphan adolescents of
Kashmir. Indian J Health Wellbeing 2015;6:769.
20. Tsige  W. Psychological Wellbeing between Institutional and
Non‑Institutional Orphan Children in Gulele sub‑city, Addis
Ababa. Ethiopia; June, 2015.

192 Indian Journal of Social Psychiatry | Volume 35 | Issue 3 | July-September 2019