A cross-country psychiatric screening of ICD-11 disorders specifically associated with stress in Kenya, Nigeria and Ghana

Background The Global Forum for Health Research, with the support of the World Health Organization, highlighted the need to prioritize mental health research in Africa. The introduction of revised descriptions of Posttraumatic Stress Disorder (PTSD) and Adjustment Disorder, along with new diagnoses of Complex PTSD and Prolonged Grief Disorder, in the ICD-11 creates a need for additional national level epidemiological studies on the prevalence of stress-related disorders.Methods The prevalence rates of these four ICD-11 stress disorders were assessed in three African countries including Nigeria (N = 1006), Kenya (N = 1018), and Ghana (N = 500). Participants completed disorder-specific measures for each disorder.Findings Across the entire sample, the current prevalence rate of probable Adjustment Disorder was 8.4% (95% C.I. = 7.4%, 9.6%), probable PTSD was 18.6% (95% C.I. = 17.2, 20.2%), probable Complex PTSD was 15.9% (95% C.I. = 14.5%, 17.4%) and probable Prolonged Grief Disorder was 3.7% (95% C.I. = 3.1%, 4.5%).Interpretation The results are applicable primarily to well-educated urban and suburban adults in these African countries. Results indicated that Adjustment Disorder, PTSD, and CPTSD are highly prevalent in these three African countries. There is now a pressing need to develop culturally sensitive interventions to enable recovery from these conditions

Psychological distress during the COVID-19 pandemic: An integrative perspective.

Informed by socio-ecological psychology and the conservation of resources model, the present study proposes an integrative perspective on the association between psychological distress and a constellation of factors, during the COVID-19 outbreak in Israel. Our sample, comprised of 991 adult participants, was measured for psychological distress, locus of control (internal/ external), resilience, loneliness, social support, dimensions of citizens' trust in government organizations (perceived competence, benevolence, and integrity), and demographic characteristics. The findings showed that women, non-religious people, and the unemployed reported higher levels of psychological distress. Internal locus of control, resilience, social support, and the extent to which citizens perceive government organizations as benevolent were negatively associated with psychological distress. Self-reported loneliness and external locus of control positively predicted the level of respondent psychological distress. No association was detected between age, competence and integrity and psychological distress. An overview of the research findings indicates that individuals with greater resources were less likely to suffer from psychological distress during the COVID-19 outbreak. These findings call upon mental health care practitioners to help as well as to enable clients to attain resources in order to lower their levels of psychological distress. Policies developed by policymakers during periods of acute crisis should consider the specific needs and vulnerabilities of certain population groups, including women and the unemployed who may be more susceptible to psychological distress. It is also important for policymakers to be aware that the perception of democratic governments as benevolent can serve as a buffer against psychological distress during times of crisis

Integrating creativity and systematic methodology in teaching qualitative research

Qualitative research is both a wide and deep field of study. It is difficult for the beginning researcher to navigate the various approaches within the qualitative paradigm to which s/he is introduced. This involves reading the maps of the territory, i.e. understanding the underlying philosophy and principles of the different approaches, choosing a route, and of course the journey itself—collecting and analyzing data. In many B.A. or M.A. programs in the social and behavioral sciences, students enroll in a one semester course in qualitative research, and some may embark on a one to two year supervised qualitative research project. In this presentation I will share my experiences as a teacher and supervisor of qualitative research with an emphasis on the dilemma of whether to emphasize developing skills in creative free-flowing interpretation or in structured systematic analysis. I will suggest a way of integrating these two approaches by using Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2009). I will explain the principles and practices of IPA and will demonstrate the techniques I use to guide beginning students through what some initially experience as the quagmire of qualitative research

Gadamer\u27s philosophy of interpretation: Creative dialogue among researchers of diverse professional and personal backgrounds

Hans-Georg Gadamer’s (1976) primary focus was on the concept of understanding, which he posited could be achieved through four key philosophical constructs: prejudice, the hermeneutic circle, dialogue, and fusion of horizons (Koch, 1996; Matheson, 2009). The hermeneutic experience, according to Gadamer, takes place within a framework of multiple voices. This presentation will consist of a dialogue among three researchers of very diverse backgrounds (cultural, academic, professional) who collaborated on a research project about the experiences of adults whose fathers died prior to their birth. We attempted to expand the boundaries of the interpretative framework during the various stages of the textual analysis to incorporate our very different interpretive stances. It is the questions, says Gadamer (1981), that are of crucial importance, not the answers, which are only a resting place on the way. Since every interpretive endeavor is limited and raises questions that spur further investigations, we will describe the simultaneous entrances and exits in a number of interpretive circles: researchers-text, colleague-supervisor-student, interviewer-research participants. Different research partnership positionings, contracts, dialogues, and deadlocks that we experienced will be illustrated and conceptualized

Screening of adjustment disorder: Scale based on the ICD-11 and the Adjustment Disorder New Module

In line with ICD-11 new conceptualization of Adjustment disorder (AjD), a self-report Adjustment Disorder-New Module (ADNM) was developed and validated. Nevertheless, the ADNM-20 is a long research tool and potentially problematic in the use in epidemiological and clinical studies. The present study introduces the brief ADNM-8 and the ultra-brief ADNM-4, examines their validity and establishes cut-off scores for their clinical use. The study used a representative national sample of 1003 Israelis who reported on the ICD-11 stress spectrum ranging from AjD, PTSD, complex PTSD and complicated grief. Construct validity was assessed via confirmatory factor analysis and cut-off scores were established through ROC analysis. The original and brief instruments were highly correlated (r > 0.918 or better). Cronbach's Alpha for the Brief ADNM-8 and the Ultra-Brief ADNM-4 were above 0.800. Correlations with stress related conditions indicated a good convergent and construct validity for both instruments as well. The ultra-brief ADNM-4 was found to have a very good fit with the data. These findings indicate that the brief ADNM-8 and the ultra-brief ADNM-4 can serve as a brief screening tools for assessing AjD symptoms according to the ICD-11 definition

Prolonged grief disorder: Its co-occurrence with adjustment disorder and post-traumatic stress disorder in a bereaved Israeli general-population sample

BACKGROUND: Prolonged grief disorder (PGD) is a new disorder included in the WHO International Classification of Diseases 11th version (ICD-11). This study is the first to use these new ICD-11 PGD guidelines to examine prevalence rates, predictors of PGD and disorder co-occurrence with other stress-related disorders in a survey of 544 bereaved Israelis. METHODS: Descriptive statistics, correlation, linear regression and mediation analysis examined the validity of the ICD-11 diagnostic algorithm. RESULTS: Prevalence of PGD in the Israeli population sample is low (2%). The prevalence rate of post-traumatic stress disorder (PTSD) was 7.2% and for adjustment disorder (AjD) was 17.8%. A significant positive correlation found between scores on these measures indicates concurrent validity. Mediation analysis found that symptoms of PGD were predicted by serious life events, and significantly mediated by symptoms of PTSD and AjD. A regression analysis found significant predictors of PGD symptom severity, including socio-demographic and person-specific predictors. LIMITATIONS: This study did not assess the index-death of the grief questionnaire. No conclusions could be made regarding the relationship between the type of loss and grief severity. Furthermore, the time since loss (time criterion) was not assessed. CONCLUSIONS: This study is the first to examine prevalence rates of ICD-11 PGD in a population-based survey. The mediation relationship between serious life events, AjD, PTSD and PGD supports a vulnerability model of stress related disorders whereby the number of stressful life events may predict symptoms of stress related disorders