Gaithri A. Fernando

Growing Pains: The Impact of Disaster-Related and Daily Stressors on the Psychological and Psychosocial Functioning of Youth in Sri Lanka.

Daily stressors may mediate the relation between exposure to disaster-related stressors and psychological and psychosocial distress among youth in disaster-affected countries. A sample of 427 Sri Lankan Sinhalese, Tamil, and Muslim youth (mean age = 14.5) completed a survey with measures of exposure to disaster-related stressors and daily stressors, psychological distress (posttraumatic stress, depression, and anxiety), and psychosocial distress. The results indicated that daily stressors significantly mediated relations between war- and tsunami-related stressors and psychological and psychosocial distress. Some daily stressors not directly related to disaster also predicted functioning. These results point to the need for policies and interventions that focus on reducing proximal daily stressors that are salient to Sri Lankan youth exposed to disasters.

The roads less traveled: Mapping some pathways on the global mental health research roadmap

The global mental health (GMH) research agenda should include both culture-general and culture-specific perspectives to ensure ecological validity of findings. Despite its title, the current GMH research agenda appears to be using a monocultural model that is individualistic, illness-oriented, and focused on intrapsychic processes. Ironically, issues of culture are prominently absent in many discussions of global mental health. This paper highlights some issues and concerns considered key to conducting ecologically valid and socially responsible GMH research. The concerns are particularly directed at researchers from dominant cultures who are working in low-income countries. Central to these issues is the balance between etic and emic perspectives in assessment, diagnosis, and intervention, as well as language, engagement of stakeholders and their agendas, and evaluation of the benefit of interventions to the community. New terminology is proposed that identifies broad cultural groups, and recommendations provided for a research agenda to encourage both basic and applied research that mutually benefits all stakeholders in the GMH research endeavor.

Assessing mental health and psychosocial status in communities exposed to traumatic events: Sri Lanka as an example.

The purpose of this study was to develop a measure of psychosocial status that could reliably and accurately assess psychosocial functioning in Sinhalese Sri Lankans impacted by traumatic events. A culturally grounded methodology using qualitative data was used to develop and validate the Sri Lankan Index of Psychosocial Status--Adult Version (SLIPSS-A). The SLIPPS-A is a 26-item measure assessing local indicators of distress, with items placed on a frequency scale from 0 (never) to 4 (6-7 days per week). The instrument was administered to 170 Sinhalese Sri Lankans (72% women) between the ages of 21 and 71 years with differing types of trauma exposure. The measure demonstrated excellent reliability (alpha = .92) and was significantly correlated with the Postraumatic Stress Disorder (PTSD) Checklist. Scores on the SLIPSS-A significantly predicted exposure to the tsunami. Factor analysis resulted in the extraction of five factors. The results suggest that the SLIPSS-A could be used as a general measure to assess psychosocial functioning in Sri Lankan rural Sinhalese adults impacted by trauma.

The role of religion in youth exposed to disasters in Sri Lanka

ABSTRACT Little research is available on the role of religious coping among youth exposed to disasters. This study examined the role of general and religious coping in a sample of 669 Sri Lankan Buddhist, Hindu, Muslim, and Christian youth (mean age = 14). Youth completed a survey with measures of exposure to disaster-related stressors, psychological and psychosocial functioning, and general and religious coping. Exposure to stressors was the most consistent predictor of negative outcomes, while approach-related coping predicted better outcomes for Buddhist and Hindu youth. Religious coping was the highest reported type of coping for all four religious groups, but was not significantly associated with any of the measured outcomes. The results suggest that Sri Lankan youth of different religious backgrounds are probably more similar than different in the ways they cope with adversity.

Development and Initial Validation of a Multidimensional Scale Assessing Subjective Well-Being: The Well-Being Scale (WeBS):

Numerous scales currently exist that assess well-being, but research on measures of well-being is still advancing. Conceptualization and measurement of subjective well-being have emphasized intrapsychic over psychosocial domains of optimal functioning, and disparate research on hedonic, eudaimonic, and psychological well-being lacks a unifying theoretical model. Lack of systematic investigations on the impact of culture on subjective well-being has also limited advancement of this field. The goals of this investigation were to (1) develop and validate a self-report measure, the Well-Being Scale (WeBS), that simultaneously assesses overall well-being and physical, financial, social, hedonic, and eudaimonic domains of this construct; (2) evaluate factor structures that underlie subjective well-being; and (3) examine the measure’s psychometric properties. Three empirical studies were conducted to develop and validate the 29-item scale. The WeBS demonstrated an adequate five-factor structure in an exploratory structural equation model in Study 1. Confirmatory factor analyses showed that a bifactor structure best fit the WeBS data in Study 2 and Study 3. Overall WeBS scores and five domain-specific subscale scores demonstrated adequate to excellent internal consistency reliability and construct validity. Mean differences in overall well-being and its five subdomains are presented for different ethnic groups. The WeBS is a reliable and valid measure of multiple aspects of well-being that are considered important to different ethnocultural groups.

Attempting to bridge the 10/90 divide: special issue on South Asian mental health

It gives me great pleasure to bring this special issue of the International Review of Psychiatry to those interested in the mental health of South Asian communities. This project has been almost fi ve years in the making, in that the idea for the special issue began in October 2010. The papers in this issue represent only a portion of the kind of work that is being carried out in that part of the world, and it is hoped that collections such as these will lead to a greater understanding of the mental health issues relevant to those communities. In turn, this may inspire researchers in high-income countries (from high-power individualistic or HPI cultures; see Fernando, 2012, and footnote in Fernando & Wilkins, this issue) to reach across the 10 – 90 divide (Patel, 2006), and collaborate with researchers engaged in community-focused projects and programmes in middle-income or lowincome countries working in low-power collectivistic (LPC) cultures, to make them more accessible to the international research community.

Barriers to recovery in communities exposed to disasters: Sri Lankan voices speak

Abstract Disasters experienced by a community place all members at risk for physical and psychological harm. While natural resilience may help many to recover, there may be barriers that hinder the recovery process. This qualitative study was conducted to examine barriers to recovery in a community impacted by both war and the tsunami. A group of 43 ethnically diverse Sri Lankans (F = 63%) participated in six focus groups and provided their perspectives on barriers they perceived to impede their recovery from traumatic events. Grounded-theory-based data analysis revealed culture-general and culture-specific socio-economic, environmental, sociocultural, and individual barriers that participants identified as impeding their recovery. Interventions and health policies targeting these groups could focus on helping communities to overcome these barriers as a means of facilitating recovery in these beleaguered communities.