Mohamad Avicenna

Self-reported mental health problems among adolescents in developing countries: results from an international pilot sample.

Objective: To evaluate the prevalence, pattern, and sociodemographic correlates of self-reported mental health problems among a pilot sample of adolescents from 5 developing countries and to speculate the methodology and design of a larger scale study. Methods: The sociodemographic questionnaire was developed based on extant literature on the sociodemographic correlates of mental health problems among adolescents. Additional information about the socioeconomic status of parents/caregivers of the participants was obtained using the Family Affluence Scale (FAS). Mental health problems were evaluated using the Strength and Difficulty Questionnaire (SDQ). Logistic regression analysis was done to determine independent sociodemographic correlates of mental health problems. Results: A total of 1894 adolescents sampled from 5 countries completed the study. The prevalence of self-reported mental health problems was 10.5% (range, 5.8–15) with conduct and emotional problems being the most prevalent. When the raw total-SDQ scores were adjusted for age, gender, and FAS scores, there was a statistically significant difference in the mean scores among the adolescents from different countries (F = 17.23, p < .001). After controlling for all potential sociodemographic confounders, living with single parents or other nonparent care givers, having a chronic disabling physical condition, lower maternal education, and coming from a family in the lower FAS-score category were all independently associated with higher odds of mental health problems. Conclusions: Study has added to the currently limited data on prevalence of mental health problems among adolescents in developing countries. It further established that socioeconomic and family factors still play a major role in the mental health of children irrespective of region of the world. Significant but surmountable methodological issues for a larger scale study were raised.

Does the Strengths and Difficulties Questionnaire - self report yield invariant measurements across different nations? Data from the International Child Mental Health Study Group

AIMS This study evaluated the measurement invariance of the strengths and difficulties questionnaire (SDQ) self-report among adolescents from seven different nations. METHODS Data for 2367 adolescents, aged 13-18 years, from India, Indonesia, Nigeria, Serbia, Turkey, Bulgaria and Croatia were available for a series of factor analyses. RESULTS The five-factor model including original SDQ scales emotional symptoms, conduct problems, hyperactivity-inattention problems, peer problems and prosocial behaviour generated inadequate fit degree in all countries. A bifactor model with three factors (i.e., externalising, internalising and prosocial) and one general problem factor yielded adequate degree of fit in India, Nigeria, Turkey and Croatia. The prosocial behaviour, emotional symptoms and conduct problems factor were found to be common for all nations. However, originally proposed items loaded saliently on other factors besides the proposed ones or only some of them corresponded to proposed factors in all seven countries. CONCLUSIONS Due to the lack of a common acceptable model across all countries, namely the same numbers of factors (i.e., dimensional invariance), it was not possible to perform the metric and scalar invariance test, what indicates that the SDQ self-report models tested lack appropriate measurement invariance across adolescents from these seven nations and it needs to be revised for cross-country comparisons.

Role of personal and family factors in alcohol and substance use among adolescents: an international study with focus on developing countries

Most studies examining adolescent alcohol and substance use or abuse hardly include samples from developing countries. To bridge some gap, the prevalence and associated social correlates of alcohol and substance use and abuse was examined among a cohort of school-going adolescents sampled from seven developing countries. Alcohol and substance abuse was measured using the CRAFFT instrument, independent socio-demographic correlates were determined using regression models. A total of 2454 adolescents completed the study, among which 40.9% reported using either alcohol or at least one other substance during the previous 12 months. This was mostly alcohol (37.8%), followed by marijuana/hashish (8.6%) and other substances (8.1%). Among the adolescents who reported using at least one substance, 45% (18.3% of total sample) had CRAFFT scores indicative of problematic or hazardous substance use. Several personal and family factors were independently associated with use/abuse, and the modifiable nature of these factors calls for appropriate intervention strategies.

Cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale across 11 world-wide societies

BACKGROUND In order to compare estimates by one assessment scale across various cultures/ethnic groups, an important aspect that needs to be demonstrated is that its construct across these groups is invariant when measured using a similar and simultaneous approach (i.e., demonstrated cross-cultural measurement invariance). One of the methods for evaluating measurement invariance is testing for differential item functioning (DIF), which assesses whether different groups respond differently to particular items. The aim of this study was to evaluate the cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale (RCADS) in societies with different socioeconomic, cultural, and religious backgrounds. METHODS The study was organised by the International Child Mental Health Study Group. Self-reported data were collected from adolescents residing in 11 countries: Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestinian Territories, the Philippines, Portugal, Romania and Serbia. The multiple-indicators multiple-causes model was used to test the RCADS items for DIF across the countries. RESULTS Ten items exhibited DIF considering all cross-country comparisons. Only one or two items were flagged with DIF in the head-to-head comparisons, while there were three to five items flagged with DIF, when one country was compared with the others. Even with all cross-culturally non-invariant items removed from nine language versions tested, the original factor model representing six anxiety and depressive symptoms subscales was not significantly violated. CONCLUSIONS There is clear evidence that relatively small number of the RCADS items is non-invariant, especially when comparing two different cultural/ethnic groups, which indicates on its sound cross-cultural validity and suitability for cross-cultural comparisons in adolescent anxiety and depressive symptoms.

The Relationships Between Alcohol/Drug Use and Quality of Life Among Adolescents: An International, Cross-Sectional Study

Although a major public health and social concern globally, limited data exist on substance use and their effects among adolescents living in low- and middle-income countries. This study evaluated the relationships between alcohol/drug use and quality of life (QOL) among adolescents in general populations from India, Indonesia, Nigeria, Serbia, Turkey, Bulgaria, and Croatia. The sample included 2,393 adolescents. The Pediatric Quality of Life Inventory (PedsQL) was used for QOL assessments, the Strengths and Difficulties Questionnaire (SDQ) was used for mental health problems, and the CRAFFT self-report questionnaire was administered for eliciting alcohol/drug use. Alcohol/drug use was significantly associated with lower levels of QOL. In particular, substance use among older male adolescents, adolescents with overt psychopathology, or adolescents in lower socioeconomic status was associated with greater reductions in levels of QOL.

Cross-Cultural Measurement Invariance of Adolescent Self-Report on the Pediatric Quality of Life Inventory™ 4.0

This study evaluated the cross-cultural measurement invariance of the Pediatric Quality of Life Inventory version 4.0 (PedsQL™) among adolescents sampled from Bulgaria, Croatia, India, Indonesia, Nigeria, Serbia, and Turkey. The multiple-indicator multiple-cause (MIMIC) model was used, which allowed controlling of demographic variables (i.e., age, gender, and socioeconomic status). Significant effects of country on scores within the PedsQL™ domains were observed, with up to 17 items showing differential item functioning (DIF) across the countries. We did not find support for cross-cultural measurement invariance hypotheses for scores on the PedsQL™ adolescent self-report in this study. Researchers should use caution in making cross-cultural quality of life comparisons while using the PedsQL.

Cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale across eleven world-wide societies – ERRATUM

Stevanovic D, Bagheri Z, Atilola O, Vostanis P, Stupar D, Moreira P, Franic T, Davidovic N, Knez R, Nikšić A, Dodig-Ćurković K, Avicenna M, Multazam Noor I, Nussbaum L, Deljkovic A, Aziz Thabet A, Petrov P, Ubalde D, Monteiro LA and Ribas R. Cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale across 11 world-wide societies. Epidemiology and Psychiatric Sciences, available on CJO2016. doi:10.1017/S204579601600038X. Epidemiology and Psychiatric Sciences (2017), 26, 441.

Role of personal and family factors in alcohol and substance use among adolescents: an international study with focus on developing countries: Alcohol and substance use among adolescents

Most studies examining adolescent alcohol and substance use or abuse hardly include samples from developing countries. To bridge some gap, the prevalence and associated social correlates of alcohol and substance use and abuse was examined among a cohort of school-going adolescents sampled from seven developing countries. Alcohol and substance abuse was measured using the CRAFFT instrument, independent socio-demographic correlates were determined using regression models. A total of 2454 adolescents completed the study, among which 40.9% reported using either alcohol or at least one other substance during the previous 12 months. This was mostly alcohol (37.8%), followed by marijuana/hashish (8.6%) and other substances (8.1%). Among the adolescents who reported using at least one substance, 45% (18.3% of total sample) had CRAFFT scores indicative of problematic or hazardous substance use. Several personal and family factors were independently associated with use/abuse, and the modifiable nature of these factors calls for appropriate intervention strategies.

Role of Personal and Family factors in Alcohol and Substance Use among Adolescents : An international study with focus on undeveloped and developing countries

Most studies examining adolescent alcohol and substance use or abuse hardly include samples from developing countries. To bridge some gap, the prevalence and associated social correlates of alcohol and substance use and abuse was examined among a cohort of school-going adolescents sampled from seven developing countries. Alcohol and substance abuse was measured using the CRAFFT instrument, independent socio-demographic correlates were determined using regression models. A total of 2454 adolescents completed the study, among which 40.9% reported using either alcohol or at least one other substance during the previous 12 months. This was mostly alcohol (37.8%), followed by marijuana/hashish (8.6%) and other substances (8.1%). Among the adolescents who reported using at least one substance, 45% (18.3% of total sample) had CRAFFT scores indicative of problematic or hazardous substance use. Several personal and family factors were independently associated with use/abuse, and the modifiable nature of these factors calls for appropriate intervention strategies.