Adaptation and testing of an assessment for mental health and alcohol use problems among conflict-affected adults in Ukraine

Abstract

BackgroundIn Ukraine, a large number of internally displaced persons (IDPs) and veterans experience social and psychological problems as a result of the ongoing conflict between Ukraine and Russia. Our purpose was to develop reliable and valid instruments to screen for common mental health and alcohol use problems in these populations.MethodsWe used a three-step process of instrument adaptation and testing. The instrument—the Mental Health Assessment Inventory (MHAI)—combines adapted standard screeners with items derived locally in Ukraine. A validity study was conducted using a sample of 153 adults (54% male) ages 18 years and older. All participants in the sample were IDPs or veterans living in or near the major urban areas of Kyiv and Zaporizhia. Reliability testing (internal consistency, test-retest) and validity testing (construct, criterion) of the MHAI were conducted using classical test theory. After initial testing, we used Item Response Theory (IRT) to shorten and further refine the instrument.ResultsThe MHAI showed good internal consistency and test-retest reliability for the main outcomes: depression (α = 0.94; r = .84), post-traumatic stress (PTS; α = 0.97; r = 0.87), anxiety (α = 0.90; r = 0.80), and alcohol use (α = 0.86; r = 0.91). There was good evidence of convergent construct validity among the scales for depression, PTS, and anxiety, but not for alcohol use. Item Response Theory (IRT) analysis supported use of shortened versions of the scales for depression, PTS, and anxiety, as they retained comparable psychometric properties to the full scales of the MHAI.ConclusionThe findings support the reliability and validity of the assessment—the MHAI—for screening of common mental health problems among Ukrainian IDPs and veterans. Use of IRT shortened the instrument to improve practicality and potential sustainability.Electronic supplementary materialThe online version of this article (10.1186/s13031-018-0169-6) contains supplementary material, which is available to authorized users.

Desenvolvimento de um banco de itens para avaliar o transtorno depressivo maior

“…Alguns estudos, tanto na literatura internacional (Doty et al, 2018;Uher et al, 2008;Yan & Kao, 2014) quanto nacional (Andrade, 2008;Castro, Trentini, & Riboldi, 2010), têm considerado as vantagens da TRI para investigar aspectos que não poderiam ser testados apenas por meio da TCT. Por exemplo, Uher et al (2008) Descobertas desse tipo só são possíveis porque a TRI utiliza o item como unidade de análise e não o teste como ocorre na TCT.…”

Introduction to the special collection: developing valid psychological measures for populations impacted by humanitarian disasters

“…The six papers contained within this special collection span a wide range of populations impacted by humanitarian disasters, a wide range of tools measuring a variety of psychological constructs, and a wide range of psychometric approaches used to evaluate the use of these tools within these populations. Samples include young adult secondary school students in Haiti [12], internally displaced adults and veterans from Ukraine [13], Eritrean refugees living in Ethiopia [14], refugees from the Darfur region of Sudan living in Chad [15], refugees from Iraq, Iran, Sri Lanka and other countries currently residing in Australia [16] and a national, representative sample of Sri Lankan adults affected by civil war [17]. Psychological constructs measured include the psychopathological constructs most common to the psychosocial aid literature, posttraumatic stress disorder (PTSD), major depression, and anxiety [12,16,17], but also substance abuse [13], cultural concepts of distress [15] and broader phenomena related to wellbeing [14].…”

“…Samples include young adult secondary school students in Haiti [12], internally displaced adults and veterans from Ukraine [13], Eritrean refugees living in Ethiopia [14], refugees from the Darfur region of Sudan living in Chad [15], refugees from Iraq, Iran, Sri Lanka and other countries currently residing in Australia [16] and a national, representative sample of Sri Lankan adults affected by civil war [17]. Psychological constructs measured include the psychopathological constructs most common to the psychosocial aid literature, posttraumatic stress disorder (PTSD), major depression, and anxiety [12,16,17], but also substance abuse [13], cultural concepts of distress [15] and broader phenomena related to wellbeing [14]. Psychometric approaches include confirmatory factor analysis (CFA) [14,16,17], receiver operating characteristics (ROC) [12], item response theory (IRT) [13], and dynamic network analysis [15]; one study even shows how qualitative methods can be integrated to develop and validate tools [13].…”

“…Psychological constructs measured include the psychopathological constructs most common to the psychosocial aid literature, posttraumatic stress disorder (PTSD), major depression, and anxiety [12,16,17], but also substance abuse [13], cultural concepts of distress [15] and broader phenomena related to wellbeing [14]. Psychometric approaches include confirmatory factor analysis (CFA) [14,16,17], receiver operating characteristics (ROC) [12], item response theory (IRT) [13], and dynamic network analysis [15]; one study even shows how qualitative methods can be integrated to develop and validate tools [13].…”

“…In many cases, psychosocial practitioners entering a new post-disaster context have to quickly assess the salient psychosocial problems facing those populations and develop accurate assessments of those problems that are brief and not too burdensome on respondents. Doty and colleagues [13] provided an impressive showcase of how to efficiently engage in this practice. They first conducted quick ethnography [17] to gain information about salient mental health problems and indicators of functional impairment in internally displaced individuals and veterans in Ukraine.…”