Guided Act and Feel Indonesia (GAF-ID) – Internet-based behavioral activation intervention for depression in Indonesia: study protocol for a randomized controlled trial

Background: Depression is a leading cause of disease burden across the world. However, in low-middle income countries (LMICs), access to mental health services is severely limited because of the insufficient number of mental health professionals available. The WHO initiated the Mental Health Gap Action Program (mhGAP) aiming to provide a coherent strategy for closing the gap between what is urgently needed and what is available in LMICs. Internet-based treatment is a promising strategy that can be made available to a large number of people now that Internet access is increasing rapidly throughout the world. The present study will investigate whether such an Internet-based treatment for depression is effective in Indonesia.  Methods: An Internet-based behavioral activation treatment, with support by lay counselors who will provide online feedback on the assignments and supportive phone contact to encourage participants to work in the program (Guided Act and Feel Indonesia/GAF-ID), is compared to an online-delivered minimal psychoeducation without any support (psychoeducation/PE). Initial assessment for inclusion is based on a Patient Health Questionnaire-9 (PHQ-9) score of at least 10 and meeting criteria for major depressive disorder or persistent depressive disorder as assessed using the Structured Clinical Interview for DSM-5 (SCID-5). Participants with depression (N=312) will be recruited and randomly assigned to GAF-ID or PE. Overall assessments will be done at baseline, post intervention (10 weeks from baseline) and follow-ups (3 months and 6 months from baseline). The primary outcome is the reduction of depression symptoms as measured by the PHQ-9 after 10 weeks from baseline.  Discussion: To our knowledge, this is the first study in Indonesia that examines the effectiveness of an Internet-based intervention for depression in a randomized controlled trial. The hope is that it can serve as a starting point for bridging the mental health gap in Indonesia and other LMICs. Trial registration: Nederlands Trial Register ( www.trialregister.nl ): NTR5920 , registered on 1 July 2016

A Construction of Entrepreneurial Personality Tests: Testing Archetype Personality Inventory in Entrepreneurship

VUCA is about a hyper-competitive and unpredictable environment. It stands for volatility, uncertainty, complexity, and ambiguity. Personal attributes are necessary to navigate the VUCA environment. Studies in entrepreneurship show that narratives help people to connect different experiences. Literature shows that a narrative journey can be described through archetypes and relate to entrepreneurial behavior. This study aims to construct and validate measurements of entrepreneurial personality by adapting Pearson & Marr's archetype inventory test within the entrepreneurial context. This study was conducted as an assessment of the measurement psychometric attributes consisting of 12 archetypes. Explanatory Factor Analysis (EFA) was carried out by Oblimin rotation resulting in 60 final items. This study involved 154 small and medium entrepreneurs in Jakarta and West Java

Guided Act and Feel Indonesia - Internet-based Behavioral Activation Intervention for Depression in Indonesia:A Systematic Cultural Adaptation

Depression is one of the leading causes of the global disease burden, affecting millions of people worldwide. The availability of mental health treatment, however, remains very limited in many low-middle income countries, including Indonesia. Internet-based interventions are known to have the potential to deliver mental health treatment economically and appropriately according to numerous studies conducted in high-income countries. In the current study, we describe a systematic cultural adaptation of an internet-based behavioral activation intervention for depression in Indonesia, named Guided Act and Feel Indonesia. During the adaptation, relevant stakeholders were involved, including licensed clinical psychologists, mental health communities, lay counselors, and patients. The adaptation used the formative method for adapting psychotherapy (FMAP) to adapt eight important cultural elements (language, persons, metaphors, content, concepts, goals, methods, and context). The intervention was adapted from the original Dutch version called Doe en Voel, consisting of 8 structured modules that are offered in a secure online environment. The adapted version is being delivered during an ongoing randomized controlled trial with non-face-to-face support from lay counselors who work under the supervision of licensed clinical psychologists. The challenges that were faced during the cultural adaptation are discussed

Indonesian leadership styles: a mixed-methods approach

Indonesian leadership characteristics were examined in three studies, using mixed methods. In the first, qualitative study 127 indigenous characteristics of Indonesian leadership were identified from interviews and focus group discussions with Indonesian managers and staff. In the second study, a questionnaire based on the characteristics found in the first study was administered to Indonesian managers to identify Indonesian leadership styles. Using factor analysis, two highly correlated dimensions were extracted, labelled benevolent paternalism and transformational leadership. In the third study, a questionnaire consisting of leadership characteristics from the GLOBE study, supplemented with a selection of 49 items from the Indonesian questionnaire, was administered to another sample of Indonesian managers. We found that Indonesian leadership has two components; the first involves a more local modernization dimension that ranges from (traditional) benevolent paternalism to (modern) transformational leadership, the second is a more universal person- versus team-oriented leadership dimension. We conclude that Indonesian leadership has both emic and etic aspects.http://dx.doi.org/10.1111/j.1467-839X.2012.01384.

Internet-based behavioural activation with lay counsellor support versus online minimal psychoeducation without support for treatment of depression : a randomised controlled trial in Indonesia

Background: Depression is one of the leading contributors to the global burden of disease. However, treatment availability is often very poor in low-income and middle-income countries. In a randomised clinical trial, we investigated the efficacy of internet-based behavioural activation with lay counsellor support compared with online minimal psychoeducation without support for depression in Indonesia (a middle-income country). Methods: We did a community-based, two-group, randomised controlled trial in Indonesia. Eligible participants were aged 16 years or older, scored 10 or above on the Patient Health Questionnaire 9 (PHQ-9), met the criteria for major depressive disorder or persistent depressive disorder based on the Structured Clinical Interview for DSM-5, were proficient in Bahasa Indonesia, and could use the internet. Participants were randomly allocated (1:1) by a research assistant using a web-based randomisation program to online behavioural activation with lay support (termed Guided Act and Feel Indonesia [GAF-ID]) or online psychoeducation without further support. Randomisation was done within a random permuted block design and was stratified by sex and depression severity (ie, PHQ-9 10–14 vs ≥15). The primary outcome was self-reported PHQ-9 score at 10 weeks from baseline. Research assistants were masked to group allocation until after the assessment of the primary outcome. Interventions were described to participants during the consent procedure and after randomisation, but no indication was given as to which was the intervention of interest and which was the control. Analysis was by intention to treat. The trial was registered in the Netherlands Trial Register, number NTR5920. It is closed to new particpants, and follow-up has been completed. Findings: Between Sept 6, 2016, and May 1, 2017, 313 participants were enrolled and randomly assigned, 159 to the GAF-ID group and 154 to the online psychoeducation group. At 10 weeks, PHQ-9 scores were significantly lower in the GAF-ID group than in the online psychoeducation group (mean difference −1·26 points [95% CI −2·29 to −0·23]; p=0·017), and participants in the GAF-ID group had a 50% higher chance of remission at 10 weeks (relative risk 1·50 [95% CI 1·19 to 1·88]; p<0·0001). An effect size of 0·24 for the GAF-ID group compared with the control group at 10 weeks was sustained over time (effect size 0·24 at 3 months, and 0·27 at 6 months). No adverse events were reported in either group. Interpretation: To our knowledge, ours is the first adequately powered randomised clinical trial of an internet-based intervention for depression in a low-income or middle-income country. Online behavioural activation with lay counsellor support efficaciously reduced symptoms of depression, and could help to bridge the mental health gap in low-income and middle-income countries. Funding: Indonesia Endowment Fund for Education, University of Groningen

Internet-based behavioural activation with lay counsellor support versus online minimal psychoeducation without support for treatment of depression: a randomised controlled trial in Indonesia

Background Depression is one of the leading contributors to the global burden of disease. However, treatment availability is often very poor in low-income and middle-income countries. In a randomised clinical trial, we investigated the efficacy of internet-based behavioural activation with lay counsellor support compared with online minimal psychoeducation without support for depression in Indonesia (a middle-income country). Methods We did a community-based, two-group, randomised controlled trial in Indonesia. Eligible participants were aged 16 years or older, scored 10 or above on the Patient Health Questionnaire 9 (PHQ-9), met the criteria for major depressive disorder or persistent depressive disorder based on the Structured Clinical Interview for DSM-5, were proficient in Bahasa Indonesia, and could use the internet. Participants were randomly allocated (1:1) by a research assistant using a web-based randomisation program to online behavioural activation with lay support (termed Guided Act and Feel Indonesia [GAF-ID]) or online psychoeducation without further support. Randomisation was done within a random permuted block design and was stratified by sex and depression severity (ie, PHQ-9 10-14 vs >= 15). The primary outcome was self-reported PHQ-9 score at 10 weeks from baseline. Research assistants were masked to group allocation until after the assessment of the primary outcome. Interventions were described to participants during the consent procedure and after randomisation, but no indication was given as to which was the intervention of interest and which was the control. Analysis was by intention to treat. The trial was registered in the Netherlands Trial Register, number NTR5920. It is closed to new particpants, and follow-up has been completed. Findings Between Sept 6, 2016, and May 1, 2017, 313 participants were enrolled and randomly assigned, 159 to the GAF-ID group and 154 to the online psychoeducation group. At 10 weeks, PHQ-9 scores were significantly lower in the GAF-ID group than in the online psychoeducation group (mean difference -1.26 points [95% CI -2.29 to -0.23]; p=0.017), and participants in the GAF-ID group had a 50% higher chance of remission at 10 weeks (relative risk 1.50 [95% CI 1.19 to 1.88]; p Interpretation To our knowledge, ours is the first adequately powered randomised clinical trial of an internet-based intervention for depression in a low-income or middle-income country. Online behavioural activation with lay counsellor support efficaciously reduced symptoms of depression, and could help to bridge the mental health gap in low-income and middle-income countries. Copyright (c) 2018 Elsevier Ltd. All rights reserved

Assessing sense of school belonging across cultural contexts using the PSSM: Measurement and functional invariance

Abstract: Despite its popularity, the factorial structure of the Psychological Sense of School Membership (PSSM) Questionnaire remains controversial. The current study set out to clarify its structure across different cultural contexts. The study was carried out among 1,928 adolescents aged 11 to 20 years in the Netherlands, Kenya, Indonesia, and Spain. Item-based measurement models with a single factor did not show a good fit. A bifactor method (defining a method factor for negatively worded items) did not show a good fit either. However, when items were combined per target to be rated (school, student, teacher, other people, and self), measurement invariance of a one-factorial model was found. Internal consistencies observed across the cultural groups studied were high. In addition, an evaluation of functional equivalence indicated that the relationship between PSSM and life satisfaction was invariant across countries. Implications for assessment and future directions are discussed

Socially desirable responding: Enhancement and denial in 20 countries

Abstract: This article investigated the dimensionality, measurement invariance, and cross-cultural variations of social desirability. A total of 3,471 university students from 20 countries completed an adapted version of the Marlowe–Crowne scale. A two-dimensional structure was revealed in the pooled sample, distinguishing enhancement (endorsement of positive self-description) and denial (rejection of negative self-description). The factor structure was supported in most countries; medium-sized item bias was found in two denial items. In a multilevel analysis, we found that (a) there was more cross-cultural variation in denial than enhancement; (b) females tended to score higher on enhancement whereas males tended to score higher on denial; (c) the Human Development Index, an indicator of country socioeconomic development, was the best (negative) predictor of denial; and (d) both enhancement and denial seemed to be associated with country-level values and personality pertinent to “fitting in.” We conclude that social desirability has a positive and a negative impression management dimension that are meaningfully associated with country-level characteristics, and we argue that social desirability is better interpreted as culturally regulated response amplification

Perceptions of parenting styles and their associations with mental health and life satisfaction among urban Indonesian adolescents

The study aimed at investigating the association between maternal and paternal parenting styles and psychological well-being among Indonesian adolescents. The Parental Authority Questionnaire (PAQ), General Health Questionnaire-12 (GHQ-12), and the Brief Multidimensional Students’ Life Satisfaction Scale, were administered to 500 adolescents. We were unable to replicate the three-factor solution of the PAQ using confirmatory factor analysis. The permissive subscale demonstrated poor psychometric properties; it was therefore not included in any further analysis. Mothers were perceived to be more authoritative than fathers; on the other hand, fathers were perceived to be more authoritarian than mothers. Both maternal and paternal authoritative parenting styles were positively associated with outcomes. Authoritarian parenting was not associated with any outcome. Scores computed to represent perceived differences between maternal and paternal use of various parenting styles were associated with reported GHQ-12 and life satisfaction scores. Our results confirm Western findings on the positive effects of authoritative parenting, but do not replicate the negative associations of authoritarian parenting. Future studies that examine different parenting styles at the construct level are needed to elucidate the association between parenting styles and adolescent psychological functioning in the Indonesian and other similar contexts