Concurrent and convergent validity of culture-specific psychopathology syndromes among Cambodian adolescents.

Psychopathology is defined in part by its impacts on life functioning (e.g., fulfillment of daily responsibilities at work or school, in family relationships). Relations to life functioning are particularly important in the validation of culture-specific syndromes (patterns of mental health symptoms specific to a particular culture), to demonstrate that culture-specific symptom patterns do in fact represent pathology. The current study's goal was to assess the construct validity of the Cambodian Somatic Symptom and Syndrome Inventory (CSSI). The study focused on the statistically unique effects of the CSSI on life functioning (i.e., effects of the CSSI on life functioning, controlling for Western psychopathology syndromes), to determine whether the CSSI contributes information beyond standard Western measures, which would support CSSI culture-specific convergent validity. Because adolescence is a key period when psychopathology often develops, study participants were 391 high-school students in one urban and one rural area of Cambodia. Participants completed the CSSI, the Western psychopathology surveys Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder questionnaire (GAD-7), and life functioning measures assessing functional impairment, quality of life, and help-seeking. Results indicated strong CSSI concurrent validity (canonical correlation = 0.75) with the PHQ-9 and GAD-7, and CSSI total effects convergent validity on life functioning indicators. All CSSI statistically unique effects (controlling for the PHQ-9 and GAD-7) on life functioning measures were non-significant indicating that the CSSI, shown to be a valid assessment measure in the current study, does not add predictive information beyond standard Western measures. A key limitation that should be considered in interpretation of these results is that the life functioning measures, although reviewed by Khmer psychologists, were Western-based, thus potentially inflating relations with Western psychopathology measures.

Does supportive parenting mitigate the longitudinal effects of peer victimization on depressive thoughts and symptoms in children?

Cohen and Wills (Cohen, S., & Wills, T. A., 1985, Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310-357) described two broad models whereby social support could mitigate the deleterious effects of stress on health: a main effect model and stress-buffering model. A specific application of these models was tested in a three-wave, multimethod study of 1888 children to assess ways parental support (social support) mitigates the effects of peer victimization (stress) on children's depressive symptoms and depression-related cognitions (health-related outcomes). Results revealed that (a) both supportive parenting and peer victimization had main effects on depressive symptoms and cognitions; (b) supportive parenting and peer victimization did not interact in the prediction of depressive thoughts and symptoms; (c) these results generalized across age and gender; and (d) increases in depressive symptoms were related to later reduction of supportive parenting and later increase in peer victimization. Although supportive parenting did not moderate the adverse outcomes associated with peer victimization, results show that its main effect can counterbalance or offset these effects to some degree. Implications for practice and future research are discussed.

Testing reciprocal longitudinal relations between peer victimization and depressive symptoms in young adolescents.

A 2-wave longitudinal study of young adolescents was used to test whether peer victimization predicts depressive symptoms, depressive symptoms predict peer victimization, or the 2 constructs show reciprocal relations. Participants were 598 youths in Grades 3 through 6, ages 8 to 14 (M = 10.9, SD = 1.2) at Wave 1. The sample was 50.7% female and 90.3% Caucasian. Participants completed self-reports of depressive symptoms, and self-reports and peer nomination measures of physical and relational peer victimization at 2 time points separated by 1 year. The results were as follows: (a) depressive symptoms predicted change in both physical and relational victimization, but neither type of peer victimization predicted change in depressive symptoms; (b) depressive symptoms were more predictive of physical victimization for boys than for girls; and (c) boys experienced more physical victimization, and girls experienced more relational victimization. Expression of some depressive symptoms may represent signs of vulnerability. For boys, they may also represent a violation of gender stereotypes. Both factors could be responsible for these effects. Implications for intervention include the possibility that treatment of depression in young adolescents may reduce the likelihood of peer victimization.

A Model for Sustainable Development of Child Mental Health Infrastructure in the LMIC World: Vietnam as a Case Example.

Children and adolescents are among the highest need populations in regards to mental health support, especially in low and middle income countries (LMIC). Yet resources in LMIC for prevention and treatment of mental health problems are limited, in particular for children and adolescents. In this paper, we discuss a model for development of child and adolescent mental health (CAMH) resources in LMIC that has guided a ten year initiative focused on development of CAMH treatment and research infrastructure in Vietnam. We first review the need for development of mental health resources for children and adolescents in general, and then in Vietnam. We next present the model that guided our program as it developed, focused on the twin Capacity Development Goals of efficacy and sustainability, and the Capacity Development Targets used to move towards these goals. Finally we discuss our CAMH development initiative in Vietnam, the center of which has been development of a graduate program in clinical psychology at Vietnam National University, linking program activities to this model.