Validating mental health assessment in Kenya using an innovative gold standard

Watson, Leah; Kaiser, Bonnie N.; Giusto, Ali; Ayuku, David

doi:10.1002/ijop.12604

Cited by 13 publications

(10 citation statements)

References 29 publications

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“…For further ideas on integrating field and laboratory research, seeWillis and Miller (2011),Teddlie and Tashakkori (2012),Hay (2016),Gurven (2018),Hruschka et al (2018), andMatusz et al (2019). For field and clinical research, seeWeisner and Hay (2015),Kirmayer and Ryder (2016),Kaiser and Kohrt (2019),Lewis-Fernández andKirmayer (2019), andWatson et al (2019).…”

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confidence: 99%

Elements of Neuroanthropology

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Neuroanthropology is the integration of neuroscience into anthropology and aims to understand “brains in the wild.” This interdisciplinary field examines patterns of human variation in field settings and provides empirical research that complements work done in clinical and laboratory settings. Neuroanthropology often uses ethnography in combination with theories and methods from cognitive science as a way to capture how culture, mind, and brain interact. This article describes nine elements that outline how to do neuroanthropology research: (1) integrating biology and culture through neuroscience and biocultural anthropology; (2) extending focus of anthropology on what people say and do to include what people process; (3) sizing culture appropriately, from broad patterns of culture to culture in small-scale settings; (4) understanding patterns of cultural variation, in particular how culture produces patterns of shared variation; (5) considering individuals in interaction with culture, with levels of analysis that can go from biology to social structures; (6) focusing on interactive elements that bring together biological and cultural processes; (7) conceptual triangulation, which draws on anthropology, psychology, and neuroscience in conjunction with field, clinic, and laboratory; (8) critical complementarity as a way to integrate the strengths of critical scholarship with interdisciplinary work; and (9) using methodological triangulation as a way to advance interdisciplinary research. These elements are illustrated through three case studies: research on US combat veterans and how they use Brazilian Jiu Jitsu as a way to manage the transition to becoming civilians, work on human-raptor interactions to understand how and why these interactions can prove beneficial for human handlers, and adapting cue reactivity research on addiction to a field-based approach to understand how people interact with cues in naturalistic settings.

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Elements of Neuroanthropology

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“…We also demonstrate a method to combine empirical data on the prediction of caseness with theoretical grounding to identify items for an index test of family functioning. These methods may be beneficial in other low-resource contexts without typical “gold standards” and constraints that lead to smaller sample sizes (Also see Watson et al, 2020 for our related approach to adult mental health assessment).…”

Section: Discussionmentioning

confidence: 99%

Development of the Family Togetherness Scale: A Mixed-Methods Validation Study in Kenya

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Family functioning is an important target of clinical intervention and research given its close ties with mental health outcomes of both children and adults. However, we lack family functioning measures validated for use in many low- and middle-income country (LMIC) settings. In this mixed-methods prospective diagnostic accuracy study, we first used formative qualitative data to develop an extensive battery of screening items to measure family functioning in Kenya. We then recruited 30 Kenyan families (N = 44 adults; 30 youth aged 8–17 years) to complete the questionnaires and participate in clinical interviews conducted by local interviewers. Quantitative and qualitative analyses were then conducted to select a subset of screening items that balanced conceptual understanding of family distress with diagnostic efficiency and accuracy to yield a brief but valid scale. The final index test consisting of 30 items correctly identified distressed families in 89% of cases according to adult-report and 76% of cases according to child-report. The optimal cutoffs are associated with estimates of sensitivity/specificity of 0.88/0.90 and 0.75/0.77 for adult-report and child-report measures, respectively. The final measure—the Family Togetherness Scale (FTS)—assesses global family functioning, including items related to family organization, emotional closeness, and communication/problem-solving. In addition to general items, the scale also includes items explicitly assessing family responses to stressors common in LMIC settings. Results establish a strong rationale for larger-scale validation studies.

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“…Some studies also include ethnographic or qualitative methods to identify meaningful mental illness symptoms that are missed by existing screening tools ( Kaiser et al, 2013 ; Kohrt et al, 2016 ; Weaver & Kaiser, 2015 ). The “gold standard” for validating screening tools is clinician diagnosis, although alternative approaches have been tested, such as key informant judgment regarding distress or using interviews by non-clinicians to facilitate evaluation by clinicians at a distance ( Bolton, 2001 ; Watson et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%