Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD-SUD, 35–62% of individuals drop out of trauma-focused exposure treatments. Thus, it is important to identify predictors of PTSD treatment dropout among substance abusers with PTSD in order to gain information about adapting treatment strategies to enhance retention and outcomes. The current study explored pre-treatment predictors of early termination from PE treatment in a sample of 85 individuals receiving concurrent treatment for PTSD and a SUD in a residential treatment facility as part of a randomized controlled trial. The results indicated that less education and more anxiety sensitivity uniquely predicted PE treatment dropout. Demographic variables, PTSD severity, SUD severity, mental health comorbidities, and emotion regulation difficulties did not predict treatment dropout. These results suggest that adding pre-treatment interventions that address anxiety sensitivity, and promote social adjustment and cognitive flexibility, could possibly improve PE retention rates in clients with high anxiety or low education.

Ugandan youth face a number of threats to their healthy development including poverty, high rates of disease, civil conflict, and environmental degradation. Cultivating developmental competencies is critical, not only for youth, but also for the future of Ugandan communities and civil society. In this article, we highlight contextual challenges facing Ugandan youth, report exploratory results on “standard” measures of developmental assets, and discuss the utility of a positive youth development (PYD) framework in Uganda. Despite difficult circumstances, our results indicated high levels of internal and external assets as assessed with the Developmental Assets Profile (DAP). The DAP demonstrated acceptable internal consistencies and was correlated with two other measures of youth assets, self-efficacy, and civic action. Although researchers should proceed with caution when using psychometric measures in new cultural contexts, our results provide preliminary support for the use of the DAP and a PYD framework for advancing adolescent research and programming in Uganda.

The 21-item Depression, Anxiety, and Stress Scales (DASS-21) is a self-report measure that is easy to administer, quick to score, and is freely available. Widely used in diverse settings and populations, confirmatory factor analytic evidence has accumulated for a bifactor model underlying this multidimensional measure. Studies employing an exploratory bifactor approach to more closely examine its underlying structure and inter-relations of factors, however, have been scarce. This is unfortunate because confirmatory techniques often employ indirect ways of handling model misspecification, whereas exploratory methods enable more direct approaches. Moreover, more precise approaches to modeling an exploratory bifactor structure have not been examined with the DASS-21. Based on several large samples of undergraduate students in the United States, the first two parts of the paper (Studies 1 and 2) utilized both exploratory ( M = 19.7 years of age) and confirmatory factor analytic methods ( M = 19.7 years of age) following those presented by contemporary multidimensional modeling theorists. Building upon these results, the third part of the paper (Study 3; M = 20.0 years of age) examined sensitivity-/specificity-related indices to provide cut-off score recommendations for a revised DASS-21 instrument based on a newly identified and supported bifactor structure. Implications of these results are discussed in terms of taxonomy, challenges inherent in multidimensional modeling, and potential use of the revised DASS-21 measure as a component of an actuarial decision-making strategy to inform clinical referrals.

In Uganda, depression is a growing concern, yet mental health professionals are in short supply, and help is often sought from traditional healers. To develop an integrated system of care, we must understand sociocultural aspects of depression including beliefs about help seeking and treatment. In a mixed methods study, we used semi-structured interviews and self-report measures to assess depressed patients (N = 30) seeking treatment in traditional healing (n = 15) and psychiatry clinics (n = 15) near Kampala, Uganda. We assessed demographics, symptoms, treatment characteristics, and explanatory models (EMs) of depression (e.g., labeling the problem, cause, impact on life, best type of treatment). We predicted differences across treatment settings. To further explore EMs, we assessed differences in EMs of patients and their providers by interviewing patient–provider dyads (n = 8 dyads). Patients in both settings were similar in demographics, symptoms, perceived cause, seriousness, and impact of depression. However, patients at traditional clinics were more likely to desire herbal remedies, while those in psychiatry clinics were more likely to desire modern medication. Patient–provider dyads also had different treatment beliefs, with patients desiring financial assistance, social support, and medication, and providers more likely to suggest counseling or advice. The study highlights the need to understand diverse beliefs and treatment trajectories in a multicultural context.

Malaysia is a Southeast Asian country in which multiple languages are prominently spoken, including English and Mandarin Chinese. As psychological science continues to develop within Malaysia, there is a need for psychometrically sound instruments that measure psychological phenomena in multiple languages. For example, assessment tools for measuring social desirability could be a useful addition in psychological assessments and research studies in a Malaysian context. This study examined the psychometric performance of the English and Mandarin Chinese versions of the Marlowe-Crowne Social Desirability Scale when used in Malaysia. Two hundred and eighty-three students (64% female; 83% Chinese, 9% Indian) from two college campuses completed the Marlowe-Crowne Social Desirability Scale in their language of choice (i.e., English or Mandarin Chinese). Proposed factor structures were compared with confirmatory factor analysis, and multiple indicators-multiple causes models were used to examine measurement invariance across language and sex. Factor analyses supported a two-factor structure (i.e., Attribution and Denial) for the measure. Invariance tests revealed the scale was invariant by sex, indicating that social desirability can be interpreted similarly across sex. The scale was partially invariant by language version, with some non-invariance observed within the Denial factor. Non-invariance may be related to differences in the English and Mandarin Chinese languages, as well as cultural differences. Directions for further research include examining the measurement of social desirability in other contexts where both English and Mandarin Chinese are spoken (i.e., China) and further examining the causes of non-invariance on specific items.