How does culture impact psychopathology? A quantitative and qualitative examination of trauma-related anxiety and depression in a non-Western, war-affected population [electronic resource].

Jayawickreme, Nuwan.
114 p.
Contained In:
Dissertation Abstracts International 72-05B.

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South Asia -- Research.
Clinical psychology.
Local subjects:
0326. (search)
0622. (search)
0638. (search)
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Mode of access: World Wide Web.
My program of research identifies the manner in which the presentation and experience of trauma-related anxiety (e.g., posttraumatic stress disorder [PTSD]) and depression varies in different cultures. In studies 1 and 2, I examined the factor structure of PTSD and depression in a war-affected non-Western country (Sri Lanka). This was done through confirmatory factor analysis of the Tamil-language versions of the PTSD Symptom Scale (PSS) and the Beck Depression Inventory (BDI) collected from a sample of 197 war-affected Tamil individuals living in North-Eastern Sri Lanka. Neither the PSS-SR nor the BDI fit any established models. Exploratory factor analyses revealed factor structures similar to established models, but with a number of items either loading on different factors or not loading on any factor. In study 3, I developed a self-report measure of general war problems for a Sri Lankan Tamil population - the Penn/RESIST/Peradeniya War Problems Questionnaire (PRPWPQ) - which includes a psychiatric symptoms subscale consisting of local idioms of distress. This measure was developed through the coding of qualitative data (604 individual interviews asking people about war problems) from a Tamil population in Northern and Eastern Sri Lanka. In study 4, the PRPWPQ was administered along with established self-report measures of depression and PTSD (namely the Posttraumatic Symptoms Inventory [PSS] and the Beck Depression Inventory [BDI]) to a sample of 197 war-affected Sri Lankan Tamil individuals. Exploratory factor analysis of the items in the psychiatric symptom section of the PRPWPQ revealed 3 factors: anxiety, depression and negative perception. Regression analyses were conducted to examine whether these 3 factors from the new measure better predicted functional impairment (as measured by the World Health Organization Disability Assessment Scale) than the established measures (the PSS and BDI). I hypothesized that instruments containing local idioms of distress would better predict functional impairment than translated versions of measures developed for other cultures. This hypothesis was confirmed, with the anxiety and depression factors significantly predicting functional impairment after controlling for demographic variables and the PSS and BDI. Implications of these studies and directions for future research are discussed.
Source: Dissertation Abstracts International, Volume: 72-05, Section: B, page: 3097.
Adviser: Edna B. Foa.
Thesis (Ph.D.)--University of Pennsylvania, 2010.
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School code: 0175.
University of Pennsylvania.
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Restricted for use by site license.