Screening for emotional problems: Diagnostic accuracy of the Strength and Difficulties Questionnaire Indonesian version.

PURPOSE: Screening and intervention of emotional problems in Indonesia can be quite challenging given the large gap between available resources in Indonesia. Strength and Difficulties Questionnaire (SDQ) emotional problem subscale is a simple screening tool often used to detect mental health issues in adolescents. This study examined the accuracy of the SDQ emotional problem subscale Indonesian version. METHODS: Accuracy has been examined by comparing the SDQ with diagnostic interviews based on DSM-5 as a gold standard. A double-blind study has been utilized with the assistance of the research team. Interviews have been conducted with 40 adolescents acquired from high schools located in Jakarta. Data has been analyzed with crosstabs and Receiver Operating Characteristic (ROC). RESULTS: SDQ emotional problem subscale has a sensitivity of 94.4% and specificity of 86.4%. ROC plot shows that the cutoff score of 6 is ideal to identify adolescents with emotional problems. CONCLUSIONS: The Indonesian version of the SDQ emotional problem subscale showed high diagnostic accuracy for emotional problem screening based on the DSM-5, therefore it is an accurate tool to screen for emotional problems in adolescents.

Prevalence of psychotic-like experiences and its predictors among early adolescents from rural areas in Indonesia.

Background: Psychotic symptoms are present in a wide range of both clinical and non-clinical populations. Psychotic symptoms in adolescents often take the form of psychotic-like experiences (PLEs), which are considered a risk factor for numerous serious mental illnesses. Socioeconomic disadvantages are across rural areas, and poverty is known as the third most important risk factor of PLEs. However, there have been limited studies on PLEs which focus on populations in rural areas.Objective: The aim of this study was to assess the prevalence of PLEs and investigate their predictors among early adolescents living in rural areas.Method: Data from 629 early adolescents from two rural areas in Indonesia were analysed using descriptive statistics to determine the prevalence of PLEs. Multiple logistic regression analysis was used to assess the predictors of PLEs. This was a school-based cross-sectional study, and data were collected using a paper questionnaire.Results: The results showed that the prevalence of PLEs among early adolescents in rural areas is 24.5%. Four significant predictors of PLEs were identified after controlling for sex: emotional problems, age, the number of caregivers in daily life, and psychological well-being.

Gender differences and the correlates of violent behaviors among high school students in a post-conflict area in Indonesia.

INTRODUCTION: Adolescent violence is a public health problem worldwide. Studies show that challenging environments, such as poverty and war, increase the risk of adolescent violence. This paper aims to assess gender differences in violent behaviors among adolescents in a post-conflict area in Indonesia. The other aim of this study is to investigate the correlates of adolescents' violent behaviors using the socio-ecological framework. METHODS: This is a school-based study involving 511 students from six randomly selected high schools in Kotamadya Ambon. Active and verbal violent behaviors and the potential correlates were measured and assessed using backward linear regression analyses. RESULTS: Boys were involved in more violent behaviors than girls. However, some of the boys and girls reported being involved in all types of violent behaviors. The most significant correlates of violent behaviors across genders were community violence exposure and some types of behavioral problems. DISCUSSION: This study highlighted the interconnectedness between community violence exposure and violent behaviors among adolescents living in a post-conflict area. The study also emphasizes the association between problem behaviors and violent behaviors. The results demonstrate the importance of both reducing community violence exposure and identifying adolescents with behavioral problems in the prevention of violent behaviors.

Community violence exposure and determinants of adolescent mental health: A school-based study of a post-conflict area in Indonesia.

INTRODUCTION: Studies have shown the adverse impact of exposure to community violence on adolescent health. However, most of the studies were conducted in high-income countries. This study aimed at assessing the community violence exposure and the determinants of mental health problems among adolescents in Ambon, a post-conflict area in Indonesia. MATERIAL AND METHODS: We conducted a cross-sectional, school-based study involving 511 of 10th-graders from six randomly selected high schools in Kotamadya Ambon. Our participants were assessed using a set of questionnaires including the Strength Difficulties Questionnaire (SDQ) to measure mental health problems, and the child version of the Screen for Adolescent Violence Exposure (KID-SAVE) to measure community violence exposure. The hierarchical regression analyses were used to explore the determinants of mental health problems. RESULTS: In this study, boys reported more exposure to community violence (both in frequency and severity) than girls. Meanwhile, the girls reported higher emotional problems than boys. The hierarchical regression analyses revealed that in the total sample and among boys, the community violence exposure was associated with mental health problems. However, it was the perceived impact of community violence exposure which showed an association with mental health problems among girls. CONCLUSIONS: This study revealed the high community violence exposure among adolescents living in a post-conflict setting in Indonesia. The study also found gender differences in the determinants of mental health problems among adolescents who were exposed to CVE.

The prevalence and psychosocial risk factors for psychotic-like experiences (PLE) among high school students in Jakarta.

INTRODUCTION: The prevalence of psychotic-like experiences (PLE) in general population is moderately high (5%-8%), although the prevalence of psychotic disorder is considerably low (˂1%). Amid the urgency to understand the underlying factors of psychotic disorder and PLE, most research tend to focus on genetic factors. However, numerous recent works suggested increasing importance of non-genetic factors. This study aims to investigate the prevalence of PLE and any psychosocial variables that contribute to any occurrence of PLE among adolescent in Jakarta. METHODS: This is a school based cross-sectional study that was carried out in early 2017. A total sample of 623 high school students from five schools in Jakarta were selected by using multistage random sampling. Psychotic experience was measured using Psychotic-Like Experiences Questionnaire. Multiple psychosocial variables proposed as predictor model for PLE were examined using multivariate regression. RESULTS: Our final result showed 20.6% prevalence of PLE among high school students in Jakarta. The proposed psychosocial risk model (consisting of violence exposure, parental communication pattern, peer and conduct problems, social comparison, parental attachment, loneliness, and bullying) contributed to explain 16.3% of the occurrence of PLE (R square: .163). DISCUSSION: The prevalence of PLE in this population was considerably high. Cultural factors such as paranormal beliefs are assumed to contribute to the high prevalence of PLE among high school students. The quite low contribution score of psychosocial model proposed in predicting the phenomenon of PLE shows that further research is needed to explore more variables that can be better predictors of PLE.

Prevalence of psychotic-like experiences and their correlations with internalizing problems: A study of early adolescents in rural area in Karawang, Indonesia.

INTRODUCTION: Adolescents who live in rural areas have been found to experience more mental health problems than those who live in urban areas. In Indonesia, adolescents who live in rural areas have limited facilities to access mental health services. On the other hand, there is still a strong belief in the rural communities that mental health problems are the consequence of demonic possession, having committed a sin, lack of faith, etc. Rural communities tend to seek traditional remedies such as advice from traditional healers or witchdoctors. Unfortunately, previous studies have indicated that the onset of most mental health problems is during adolescence, and this includes psychotic symptoms that are often manifested as psychotic-like experiences (PLEs). METHODS: The Strength and Difficulties Questionnaire was used to examine internalizing problems. PLEs were used to examine psychotic symptoms. Data were collected in 3 junior high schools in Karawang. A total of 270 adolescents (aged between 11 and 16 years old) who live in the rural area in Karawang participated in this research. RESULTS: The study found that the prevalence of adolescents with at least 2 symptoms of PLEs was 7%. The result of the study indicated that there is no significant correlation between psychotic-like experiences and internalizing problems (r = .075, P = .22). DISCUSSION: PLEs significantly correlated with peer-relationship problems rather than with internalizing problems. Further investigation is needed to examine the factors that contribute to PLEs in rural settings.

Household roles, poverty and psychological distress in internally displaced persons affected by violent conflicts in Indonesia.

BACKGROUND: Some of the possible reasons for deteriorating mental health among forced migrants have been identified as poverty, traumatic experiences before migration and postmigration negative life events. Previous studies suggest that the prevalence of psychological distress of forced migrants is higher among women than men. However, there is a lack of studies of internally displaced persons (IDP) that assess the relationship between psychological distress and selected variables in low income countries. OBJECTIVES: This study aims to assess the association between poverty, household roles and psychological distress among IDP in Ambon, Indonesia, and to identify different risk factors of psychological distress across household roles. METHODS: In a cross-sectional study carried out in Ambon from July to September 2005, 460 adults were recruited from 200 households in 10 camp locations on Ambon Island. The Hopkins Symptom Check List-25 was used as a dichotomous variable ("case" score >/= 1.75) to measure psychological distress, and questionnaires were used to measure socioeconomic level, trauma experiences related to conflict and current health conditions. Data were collected through face-to-face structured interviews. RESULTS: The overall prevalence of psychological distress was 47%. Prevalence was highest among women, regardless of their household roles (55%), and lowest among men (37%). Different risk factors for psychological distress were identified for each household role. Poverty-related risk factors were only significant among "mothers". An important risk factor for "fathers" was long-term illness (lasting more than three months), and for "mothers" was witnessed murder. CONCLUSION: Different risk factors were identified for each household role of IDP, indicating that their mental health care requirements may be different.