The ICD-11 and DSM-5-TR prolonged grief criteria: Validation of the Traumatic Grief Inventory-Self Report Plus using exploratory factor analysis and item response theory

More recently, the prolonged grief disorder (PGD) has been recognized as a mental health disorder following bereavement, which is distinct from depression and PTSD. However, the number and proposed symptom items vary across the ICD-11 and the DSM-5-TR criteria for PG. The Traumatic Grief Inventory-Self Report Plus (TGI-SR+), which is an updated version of the TGI-SR, is currently the only robust instrument that assesses PG according to the ICD-11 and DSM-5-TR criteria. For research and clinical use among French-speaking countries, the forward-backward procedure was applied to translate the TGI-SR+ into French language. Exploratory factor analysis and parallel analysis converged towards a two-dimensional structure for the TGI-SR+, representing adaptation difficulties and traumatic separation distress. However, items mapping onto ICD-11 and DSM-5-TR criteria for PG represented a one-dimensional structure. Findings based on item response theory method provided strong evidence for discriminative characteristics of the items The internal reliability was excellent for the TGI-SR+ (McDonald's ω = .97) and ICD-11 and DSM-5-TR criteria for PGD (McDonald's ω = .95, respectively). We also demonstrated a very high temporal stability for the TGI-SR+ total score (ICC = .91, p < .0001) and ICD-11 PGD and DSM-5-TR PGD (ICC = .90, and ICC =.88, ps < .0001, respectively). The concurrent validity of the instrument was also demonstrated, such that the TGI-SR+ total score and all combinations were positively and significantly associated with the levels of depression, anxiety, and post-traumatic stress symptoms. However, the effect sizes were moderate. We conclude that for research and clinical use among French bereaved populations, the TGI-SR+ is a sound tool with very good psychometric properties.

Sexual satisfaction and sexual behaviors during the COVID-19 pandemic: results from the International Sexual Health And REproductive (I-SHARE) health survey in Luxembourg

AIM

To identify the impact of COVID-19 measures on sexual behaviors and sexual satisfaction in Luxembourg residents.

METHODS

We conducted a cross-sectional online survey of adults (> 18 years of age) residing in Luxembourg, while COVID-19 restrictions were in place. The survey was available from January 15 to February 12, 2021 in four languages (French, German, English and Portuguese). Survey questions focused on masturbation, cuddling, condom use, sex frequency, sexting, cybersex, watching porn, and sexual satisfaction.

RESULTS

557 volunteers completed the survey (35.5% men, 64.3% women). Sexual satisfaction and sexual problems variables were assessed on 4-point Likert scales (0 = not at all/never to 3 = very/often). Sexual problems increased during the COVID-19 measures while sexual satisfaction decreased compared to before the introduction of COVID-19 restrictions (assessed retrospectively). Factors associated with increased odds of sexual satisfaction included having a steady relationship before COVID-19 restrictions, engaging in sexting, reporting good mental health and not altering alcohol intake.

CONCLUSIONS

The context of the COVID-19 pandemic and the measures implemented in Luxembourg affected sexual behaviors and sexual satisfaction. Sexual and reproductive health care centers and health professionals in general should take these results into consideration when providing care. Recommendations on the importance of sexual health for general wellbeing and behaviors associated with sexual satisfaction should be offered and possibilities to experience sexuality while reducing contamination risks be discussed.

Migration experience and mental health: A qualitative study in France and Brazil

BACKGROUND

The relationship between migration and mental health is complex and involves factors at different levels, as the individual history of the migrant, the collective history of their home country, the host society's and their mutual past history. Even though the migratory scenario of France and Brazil has changed over the years, both countries currently host an important number of immigrants.

AIM

The main objective of the present study was to describe and analyze the impacts of the migratory experience on mental health of migrants with different migration experiences and living in two countries: France and Brazil.

METHOD

Semi-structured interviews were conducted with 13 participants, six in France and seven in Brazil. A thematic qualitative analysis of the data was performed using the ATLAS.TI software. Three themes were created based on the different times of the migration experience: before migration, during migration and after migration. All codes of these three bigger themes were organized in sub-themes for the samples in France and Brazil.

RESULTS

Participants in France described an important exposure to traumatic events before and during migration. In Brazil, the migration experiences were multiple, in some cases presenting a traumatic history, but in most cases migration was seen as an opportunity to have access to better life conditions. In both countries, participants reported a great level of psychological distress associated to post-migratory difficulties (e.g. unemployment, learning a new language, or facing a new cultural environment).

CONCLUSIONS

Our results suggest that multidisciplinary interventions, with focus on skills development, such as language and work-related skills, and on access to basic needs may be essential for both voluntary and involuntary migrants. In addition to these interventions, some individuals may need specialized mental health intervention, focusing in past traumatic exposure and in the current acculturation process.

Migrations, trauma and mental health: A literature update on psychological assessment

INTRODUCTION

Migrants and refugees often face potentially traumatic events and post-migratory stressors. Upon arrival in the host country, they can be referred to mental health services to assess the impact of their previous experiences. These cross-cultural clinical encounters may raise questions, particularly regarding the assessment of mental health using models based on Western conceptions of psychopathology.

OBJECTIVES AND METHOD

The objective of the present non-systematic review of the literature is to discuss the psychological evaluation of post-traumatic reactions in migrants and refugees. More specifically, we present current research on psychopathology, resilience and post-traumatic development (PTG) among the migrant and refugee population. We also examine the cross-cultural validity of concepts such as Post-Traumatic Stress Disorder, resilience and PTG. Finally, we describe the most frequently used tools in cross-cultural psychological assessment and briefly reflect on the question of cultural sensitivity of mental health professionals. A bibliographic search was carried out using the databases: PILOTS, Pubmed, APA PsycNET, and Google Scholar using the following keywords: "migrants", "refugees", "posttraumatic stress disorder", "mental health", "Psychopathology", "risk factors", "protection factors", "posttraumatic growth" and "resilience". We have also reviewed the reference lists of articles encountered from database searches.

RESULTS

Responses to a potentially traumatic situation are multiple. Regarding the migrant and refugee population, the reviewed articles studied different post-traumatic reactions such as resilience, post-traumatic development, and psychopathologies. The most studied psychopathological responses were depression, anxiety and Post-traumatic Stress Disorder. After reviewing these studies, we asked the following question: considering the complexity of the migration process, what are the factors associated with the development of these different post-traumatic responses? Indeed, several individual and social factors before, during and after migration influence the mental health of individuals in a migration situation. Among the most cited risk factors identified were: to be a victim of or witness to violence in the country of origin and, after migration, to face post-migration difficulties such as asylum denial, to be in a precarious situation with regard to housing and work, as well as the difficulties linked to adaptation to the new culture. We have also described protective factors for the mental health of this population, such as: social support, psychological support, and a good quality of life in the host country. The reviewed articles also describe an important influence of cultural aspects on mental health, such as the perception of an event as traumatic. Although the authors of the reviewed articles accept this influence of culture on post-traumatic responses, most of the tools used to assess the mental health of migrants and refugees were created in a Western context. Studies show a growing concern with these cultural aspects, and certain tools that allow a more culturally sensitive evaluation, such as the "Cultural Formulation Interview", are being developed.

DISCUSSION AND CONCLUSION

Even if the concern with the sensitivity of the tools used in cross-cultural assessment seems to be more present in the international literature, researchers seem to encounter difficulties in better understanding the effects of culture on the mental health of individuals. With increasingly diverse societies, new research should not be based on participants' geographic or ethnic origins, but rather try to "unpack" culture with, for example, the exploration of the relationships between certain values or orientations and the different expressions of psychological distress. Finally, given the still lacking development in the field of cross-cultural research, certain practices, such as the participation of interpreters, the supervision of cultural mediators or the use of culturally sensitive tools, can help the clinician to maintain good practices with patients from different cultures in the diagnostic and psychotherapeutical processes.

Imigração Haitiana no Rio Grande do Sul: Aspectos Psicossociais, Aculturação, Preconceito e Qualidade de Vida

Resumo Este estudo traça um panorama da imigração haitiana no Rio Grande do Sul, quanto a aspectos psicossociais, perfil sociodemográfico e socioeconômico, orientações aculturativas, preconceito e qualidade de vida. A pesquisa, de delineamento quantitativo transversal, contou com a participação de 67 imigrantes haitianos, com idades entre 19 e 58 anos (M = 33,87; DP = 5,47). A amostra é predominantemente composta por homens (77,6%), com alta escolaridade (M = 10,5; DP = 4,53) e que falam o idioma português (56,7%). A orientação aculturativa mais frequente é a de integração, que é mais presente entre homens, quem acessou o sistema brasileiro de assistência social; os mais jovens, os com maior fluência em outros idiomas e os que chegaram há mais tempo no Brasil. Além disso, o preconceito percebido e a qualidade de vida obtiveram resultados mais significativos em comparação a estudos com imigrantes haitianos realizados em outros países.

Reações Pós-Traumáticas em Crianças: Como, Por Que e Quais Aspectos Avaliar?

A vivência de eventos traumáticos nos primeiros anos de vida impacta o desenvolvimento infanto-juvenilem diferentes níveis, com repercussões psicológicas, neurobiológicas e sociais. Este artigo discutiu aavaliação clínica das reações pós-traumáticas em crianças e adolescentes, incluindo questões relacionadasà manifestação dos sintomas, às consequências a longo prazo e aos instrumentos de avaliaçãodisponíveis. Foi apresentado um modelo ilustrativo dos fatores de risco para o Transtorno de EstressePós-Traumático em crianças. Concluiu-se que a avaliação precoce é fundamental para a detecção defatores de risco e indicação de diferentes intervenções, servindo como fonte de prevenção secundária.

Translation and adaptation of the Child Posttraumatic Cognitions Inventory (cPTCI) to Brazilian Portuguese

INTRODUCTION

Experiencing a traumatic event is a risk factor for the development of mental illness, especially posttraumatic stress disorder. A child's appraisals of a traumatic event may play a prominent role in the development or maintenance of the disorder. Therefore, subjective responses should be evaluated to understand the impact of a traumatic event on a child's life. This study translated and adapted the Child Posttraumatic Cognitions Inventory (cPTCI) for use in linguistic and cultural contexts in Brazil.

METHODS

The process included translation, back-translation, language expert evaluation and expert committee's evaluation.

RESULTS

Content validity index scores were good for all dimensions after evaluation by two judges and one reformulation. The back-translation of the final version also showed that the cPTCI items in Brazilian Portuguese maintained the same meanings of the original in English. This version was tested in a sample of the target population, and all the items were above the cut-off point (minimum = 3.6; maximum = 4.0).

CONCLUSIONS

This study was successful in producing a Brazilian version of the cPTCI. Further studies are underway to examine the reliability and the factorial and concurrent validity of cPTCI subscales.