Social stressors, mental health, and physiological stress in an urban elite of young Afghans in Kabul

Abstract

Afghanistan provides a unique setting in which to appraise psychosocial stress, given the context of persistent insecurity and widening economic inequality. In Kabul, people experience widespread frustrations, hinging on restricted opportunities for social advancement, education, and employment. We appraised social aspirations, every-day stressors, psychosocial distress, and mental health problems for a random sample of 161 male and female students at Kabul University. The survey featured both existing and newly-developed instruments (Self-Reported Questionnaire SRQ-20; Afghan Symptom Checklist; Afghan Daily Stressor Scale; and Social Aspirations and Frustrations), implementing both internationally-used and culturally-grounded measures of mental health assessment. We also included indicators of physical health (blood pressure, immune responses to Epstein-Barr virus (EBV), C-reactive protein, and body mass index), to map physiological function with reported psychosocial distress. This young, urban elite expressed major feelings of frustrations, related to physical, economic, social, and political stressors of day-to-day life in Kabul. There were striking gender differences for psychosocial and physiological markers of wellbeing; specifically, women showed poorer mental health (SRQ-20, P = 0.01) and elevated EBV antibody titers (P = 0.003). Both diastolic blood pressure (P = 0.018) and EBV (P = 0.038) were associated with a subscale of family stressors among women, but not among men, consistent with women's social vulnerabilities to stressful family dynamics. This is the first study to integrate approaches from anthropology, cross-cultural psychiatry, and human biology to document social stressors, psychosocial distress, and physiological wellbeing in the challenging setting of present-day Afghanistan.

Discrimination-Related Stress, Blood Pressure and Epstein-Barr Virus Antibodies Among Latin American Immigrants in Oregon, Us

“…Researchers have found elevations in EBV antibody levels among individuals in poor quality marriages (Kiecolt-Glaser et al, 1993, caregivers for a family member with Alzheimer's disease (Kiecolt-Glaser et al, 1987), and Samoan adolescents and indigenous Siberian adults exposed to Westernizing influences (McDade et al, 2000b;Sorensen et al, 2009). Research in the US and internationally also indicates important gender differences, with higher levels of psychosocial stress and depression corresponding with elevated EBV antibody levels among women and adolescent girls (Kiecolt-Glaser et al, 1993;McDade & Worthman, 2004;Panter-Brick, et al, 2008).…”

“…A trend finding provides preliminary support for an association between discrimination-related stress and family support: the greater the stress women reported feeling because of negative things said to them, the more they agreed with the statement, 'when there are problems, you can count on family ' (r=0.26; p=0.07). Other plausible alternatives for these apparent gender differences are that women have different outlets for stress responses than men, such as depression or changes in eating behaviour (Flores et al, 2008), or that women's biology may moderate stress responses differently than men's (Panter-Brick et al, 2008).…”

“…Over the past two decades, EBV antibody levels have been applied as a biomarker of chronic psychosocial stress (McDade et al, 2000a;Panter-Brick et al, 2008). The Epstein-Barr virus is a ubiquitous herpes virus for which 80-90% of adults in the US test positive by the age of 40 (Jones & Straus, 1987), with even higher prevalence rates estimated in the developing world (McDade et al, 2000a).…”

Young Ischemic Stroke in South Asia: A review

“…48,69 Another study in Kabul showed the significant hypertensive cases (14.33%) among university students. 70 Risk factors like hypertension, diabetes and coronary artery diseases were also found to be highly prevalent in Afghani population. 71 According to WHO data 2011, age adjusted stroke death rate in Afghanistan was estimated to be 109.47 per 100,000 of population.…”

Staying Behind and Looking Forward: Characteristics of Urban Afghan Youth with No Intent to Seek Asylum

“…Anecdotal evidence suggests that Afghanistan is headed down this path with young people pushed into drug trafficking or joining the insurgency, solely to earn an income [11] or others giving up and deciding to leave the country in search of better opportunities. Many educated, urban youth are disillusioned and distressed as a result limited opportunities for social advancement and upward mobility [12], a consequence of a broken economy and a culture of pervasive nepotism instituted by those in positions of power [13]. Maley [14] contends that changing this situation and challenging the elites currently in positions of power can only occur by engaging with young people who remain committed to building a better future for themselves and their country.…”