Individual-level factors associated with mental health in Rwandan youth affected by HIV/AIDS
- 232 Downloads
Prevention of mental disorders worldwide requires a greater understanding of protective processes associated with lower levels of mental health problems in children who face pervasive life stressors. This study aimed to identify culturally appropriate indicators of individual-level protective factors in Rwandan adolescents where risk factors, namely poverty and a history of trauma, have dramatically shaped youth mental health.
The sample included 367 youth aged 10–17 in rural Rwanda. An earlier qualitative study of the same population identified the constructs “kwihangana” (patience/perseverance) and “kwigirira ikizere” (self-esteem) as capturing local perceptions of individual-level characteristics that helped reduce risks of mental health problems in youth. Nine items from the locally derived constructs were combined with 25 items from an existing scale that aligned well with local constructs—the Connor-Davidson Resilience Scale (CD-RISC). We assessed the factor structure of the CD-RISC expanded scale using exploratory factor analysis and determined the correlation of the expanded CD-RISC with depression and functional impairment.
The CD-RISC expanded scale displayed high internal consistency (α = 0.93). Six factors emerged, which we labeled: perseverance, adaptability, strength/sociability, active engagement, self-assuredness, and sense of self-worth. Protective factor scale scores were significantly and inversely correlated with depression and functional impairment (r = −0.49 and r = − 0.38, respectively).
An adapted scale displayed solid psychometric properties for measuring protective factors in Rwandan youth. Identifying culturally appropriate protective factors is a key component of research associated with the prevention of mental health problems and critical to the development of cross-cultural strength-based interventions for children and families.
KeywordsProtective factors Youth Rwanda Mental health Resilience
This work would not have been possible without the enormous contributions of the Rwandan families that participated in this study, the research team who carried out this work in the field: Charles Ingabire, Sharon Teta, Josee Mukandanga, and Valentine Tuyishime, the collaboration of Partners in Health/Inshuti Mu Buzima, and the Rwandan Ministry of Health. This study was funded by Grant K01MH077246 and T32MH096724 from the National Institute of Mental Health, the Harvard Center for the Developing Child, the Julie Henry Junior Faculty Development Fund, the Peter C. Alderman Foundation, and Fogarty D43TW009335. The authors have no conflicts of interest to report.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 3.Lester P, Stein JA, Bursch B, Rice E, Green S, Penniman T, Rotheram-Borus MJ (2010) Family-based processes associated with adolescent distress, substance use and risky sexual behavior in families affected by maternal HIV. J Clin Child Adolesc Psychol 39(3):328–340. doi: 10.1080/15374411003691677 CrossRefPubMedPubMedCentralGoogle Scholar
- 7.Van Rensburg A, Theron L, Rothmann S (2015) A review of quantitative studies of South African youth resilience: some gaps. S Afr J Sci 111(7–8):1–9Google Scholar
- 8.Theron LC, Theron A (2010) A critical review of studies of South African youth resilience, 1990–2008. S Afr J Sci 106(7–8):1–8Google Scholar
- 10.Betancourt TS, Meyers-Ohki S, Stulac SN, Barrera AE, Mushashi C, Beardslee WR (2011) Nothing can defeat combined hands (Abashize hamwe ntakibananira): protective processes and resilience in Rwandan children and families affected by HIV/AIDS. Soc Sci Med 73(5):693–701. doi: 10.1016/j.socscimed.2011.06.053 CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Betancourt T, Scorza P, Meyers-Ohki S, Mushashi C, Kayiteshonga Y, Binagwaho A, Stulac S, Beardslee WR (2012) Validating the center for epidemiological studies depression scale for children in Rwanda. J Am Acad Child Adolesc Psychiatry 51(12):1284–1292. doi: 10.1016/j.jaac.2012.09.003 CrossRefPubMedGoogle Scholar
- 13.Scorza P, Stevenson A, Canino G, Mushashi C, Kanyanganzi F, Munyanah M, Betancourt T (2013) Validation of the “world health organization disability assessment schedule for children, WHODAS-Child” in Rwanda. PLoS One 8(3):e57725. doi: 10.1371/journal.pone.0057725 CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Notario-Pacheco B, Solera-Martinez M, Serrano-Parra MD, Bartolome-Gutierrez R, Garcia-Campayo J, Martinez-Vizcaino V (2011) Reliability and validity of the Spanish version of the 10-item Connor-Davidson Resilience Scale (10-item CD-RISC) in young adults. Health Qual Life Outcomes 9:63. doi: 10.1186/1477-7525-9-63 CrossRefPubMedPubMedCentralGoogle Scholar
- 23.StataCorp (2009) Stata statistical software, 11 edn. StataCorp LP, College StationGoogle Scholar
- 24.Muthen LK MB (1998–2010) Mplus User’s Guide, 6th edn. Muthen & Muthen, Los AngelesGoogle Scholar
- 26.The World Health Report 2001 (2001): Mental health: new understanding, new hope (2001). World Health OrganizationGoogle Scholar