Abstract
This chapter examines the integration of qualitative and quantitative research methods in the development of culturally grounded mental health, and psychosocial assessment tools for use with populations displaced by armed conflict or natural disaster. After first arguing for the importance of grounding our assessment tools in local cultural contexts, the author then describes the unique and complementary contributions that qualitative and quantitative methods can make to the creation of contextually and empirically sound instruments. Of particular importance is the capacity of blended or mixed-methods approaches to identify and assess locally salient expressions of wellbeing and distress, as well as factors that influence mental health in specific contexts. Drawing on examples from research on the mental health of adults in Afghanistan and on the psychosocial wellbeing of youth in Sri Lanka, the author illustrates an easily replicable, sequenced approach to culturally anchored development of measures. First, qualitative methods such as free-listing and key informant interviews are used to identify relevant constructs and key indicators of those constructs; those indicators are then used as items in newly-developed measures of the target constructs. The measures are then pilot tested in community surveys and assessed for reliability and validity using traditional quantitative scale development procedures. The chapter includes a detailed discussion of the development and validation of the Afghan Symptom Checklist and the Sri Lankan Index of Psychosocial Status – Child Version.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- ADSS:
-
Afghan Daily Stressor Scale
- ASCL:
-
Afghan Symptom Checklist
- AWES:
-
Afghan War Experiences Scales
- PTSD:
-
Post-traumatic Stress Disorder
- SLIPSS-A:
-
Sri Lankan Index of Psychosocial Status for Adults
- SLIPSS-C:
-
Sri Lankan Index of Psychosocial Status for Children
- UNHCR:
-
United Nations High Commissioner for Refugees
- UNDP:
-
United Nations Development Programme
References
ABC News Online. (2004). 1 Million People Displaced by Tsunamis: Red Cross.
http://www.abc.net.au/news/newsitems/200412/s1272890.htm Accessed June 22 2009.
Afghanistan Conflict Monitor (2009, May 28). Crackdown urged on druglords, corrupt officials http://www.afghanconflictmonitor.org/2009/05/crackdown-urged-on-afghan-drug-lords-corrupt-officials-.html Accessed June 20 2009.
Al-Krenawi, A., Lev-Wiesel, R., & Sehwail, M. (2007). Psychological symptomatology among Palestinian children living with political violence. Child and Adolescent Mental Health, 12, 27–31.
Birman, D., Ho., J., Pulley, E., Batia, K., Everson, M. L., Ellis, H., et al. (2005). Mental health interventions for refugee children in resettlement: White Paper II. National Child Traumatic Stress Network. http://www.nctsnet.org/nctsn_assets/pdfs/promising_practices/MH_Interventions_for_Refugee_Children.pdf. Accessed 1 March 2009.
Bolton, P., & Tang, A. (2002). An alternative approach to cross-cultural function assessment. Social psychiatry and psychiatric epidemiology, 37, 537–543.
Boothby, N., Strang, A., & Wessells, M. (2006). A world turned upside down. Bloomfield, CT: Kumarian Press.
Bracken, P. J., Giller, J. E., & Summerfield, D. (1995). Psychological responses to war and atrocity: The limitations of current concepts. Social Science & Medicine, 40, 1073–1082.
CARE (2004). Prevalence of self-reported depression symptoms among the beneficiaries of the Kabul widows humanitarian assistance program. Kabul, Afghanistan: CARE International Afghanistan.
CARITAS (2004). Women in Kabul: A needs assessment. Germany: CARITAS Germany.
de Jong, J. (2002). Public mental health, traumatic stress and human rights violations in low-income countries. In J. de Jong (Ed.), Trauma, war, and violence: Public mental health in socio-cultural context (pp. 1–91). New York: Kluwer.
de Jong, J., & van Ommeren, M. (2002). Toward a culture-informed epidemiology: Combining qualitative and quantitative research in transcultural contexts. Transcultural Psychiatry, 39(4), 422–433.
Farhood, L., Zurayk, H., Chaya, M., Saadeh, F., Meshefedjian, G., & Sedani, T. (1993). The impact of war on the physical and mental health of the family: The Lebanese experience. Social Science and Medicine, 36, 1555–1567.
Fernando, G.A. (2008). Assessing mental health and psychosocial status in communities exposed to traumatic events: Sri Lanka as an example. American Journal of Orthopsychiatry, 78, 229–239.
Fernando, G., Miller, K., & Berger, D. (In press). Growing pains: The impact of disaster-related and daily stressors on the psychological and psychosocial functioning of youth in Sri Lanka. Child Development.
Fox, S., & Tang, S. (2000). The Sierra Leonean refugee experience: Traumatic events and psychiatric sequelae. Journal of Nervous and Mental Disease, 188, 490–495.
Goodson, L. (2001). Afghanistan’s endless war. Seattle: University of Washington Press.
Handwerker, W. P. (2001). Quick ethnography. Walnut Creek, CA: AltaMira Press.
Hubbard, J., & Pearson, N. (2004). Sierra Leonean refugees in Guinea: Addressing the mental health effects of massive community violence. In K. E. Miller & L. M. Rasco (Eds.), The mental health of refugees: Ecological approaches to healing and adaptation (pp. 95–132). Mah Wah, NJ: Lawrence Erlbaum Associates, Inc.
International Crisis Group (2007). Conflict history: Afghanistan.
http://www.crisisgroup.org/home/index.cfm?action=conflict_search&l=1&t=1&c_country=1. Accessed 22 June 2009.
Hart, J., Galappatti, A., Boyden, J., & Armstrong, M. (2007). Participatory tools for evaluating psychosocial work with children in areas of armed conflict: A pilot in eastern Sri Lanka. Intervention, 5, 41–60.
Jenkins, J. (1996). Culture, emotion, and PTSD. In A. Marsella, M. Friedman, E. Gerrity, & R. Scurfield (Eds.), Ethnocultural aspects of post-traumatic stress disorder (pp. 165–182). Washington, DC: American Psychological Association.
Lopes Cardozo, B., Bilukha, O., Gotway Crawford, C., Shaikh, I., Wolfe, M., Gerber, M., et al. (2004). Mental health, social functioning, and disability in postwar Afghanistan. JAMA, 292, 575–584.
Miller, K. E., & Rasco, L. M. (Eds.). (2004). The mental health of refugees: Ecological approaches to healing and adaptation. Mah Wah, NJ: Lawrence Erlbaum Associates, Inc.
Miller, K.E., & Rasmussen, A. (2010). War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks. Social Science and Medicine, 70, 7–16.
Miller, K.E., Omidian, P., Qurashy, A.S., Nasiry, M.N., Quarshy, N., Nasiry, S., et al. (2006). The Afghan Symptom Checklist: A culturally grounded approach to mental health assessment in a conflict zone. American Journal of Orthopsychiatry, 76, 423–33.
Miller, K. E., Omidian, P., Rasmussen, A., Yaqubi, A., Daudzai, H., Nasiri, M., et al., (2008). Daily stressors, war experiences, and mental health in Afghanistan. Transcultural Psychiatry, 45, 611–639.
Miller, K. E., Omidian P., Kulkarni, M., Yaqubi, A., & Rasmussen, A. (2009). The validity and clinical utility of post-traumatic stress disorder in Afghanistan. Transcultural Psychiatry, 46, 219–237.
Miller, K. E., Kulkarni, M., & Kushner, H. (2006). Beyond trauma-focused psychiatric epidemiology: Bridging research and practice with war-affected populations. American Journal of Orthopsychiatry, 76, 409–422.
Mollica, R., McInnes, K., Pham, T., Fawzi, M., Smith, C., Murphy, E., et al. (1998). The dose-effect relationships between torture and psychiatric symptoms in Vietnamese ex-political detainees and a comparison group. Journal of Nervous & Mental Disease, 186, 543–553.
Neuner, F., Schauer, E., Catani, C., Ruf, M., & Elbert, T. (2006). Post-tsunami stress: A study of post-traumatic stress disorder in children living in three severely affected regions in Sri Lanka. Journal of Traumatic Stress, 19, 339–347.
Omidian, P., & Miller, K.E. (2006). Addressing the psychosocial wellbeing of women in Afghanistan. Critical Half, 4, 16–21.
Panter-Brick, C., Eggerman, M., Mojadidi, A., & McDade, T. (2008). Social stressors, mental health, and physiological stress in an urban elite of young Afghans in Kabul. American Journal of Human Biology, 20, 627–641.
Rashid, A. (2000). Taliban: Militant Islam, oil, and fundamentalism in Central Asia. New Haven: Yale University Press.
Rasmussen, A., Nguyen, L., Wilkinson, J., Vundla, S., Raghavan, S., Miller, K. E., et al. (2010). Rates and impact of trauma and current stressors among Darfuri refugees in Eastern Chad. American Journal of Orthopsychiatry, 80, 227–236.
UNDP. (2005). Security with a human face: Challenges and responsibilities. http://www.mindfully.org/Reform/2005/Afghanistan-Human-Development21feb05.htm Accessed 23 June 2009.
UNHCR. (2006). Global report 2005: UNHCR and the Pakistan earthquake. http://www.unhcr.org/4487e91e0.html Accessed 22 June 2009.
US Committee for Refugees and Immigrants. (1997). USCRI World Refugee Survey 1997. http://www.unhcr.org/cgibin/texis/vtx/refworld/rwmain?page=search&docid=3ae6a8b220&skip=0&query=bosnia%201997. Accessed 22 June 2009.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Miller, K.E. (2010). Mixed-Methods Approaches to Contextually Grounded Research in Settings of Armed Conflict and Natural Disaster. In: Carr, S. (eds) The Psychology of Global Mobility. International and Cultural Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6208-9_3
Download citation
DOI: https://doi.org/10.1007/978-1-4419-6208-9_3
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-6207-2
Online ISBN: 978-1-4419-6208-9
eBook Packages: Behavioral ScienceBehavioral Science and Psychology (R0)