Psychological Effects of Loss: Risk and Protective Factors

We want to see if it validates in our culture (Bali)

Intervention programs of individuals in Bali could use such assessment tools for screening and to analyse the effect of trauma on individuals. PCL could be used for self-monitoring of symptoms associated with PTSD. However, there is no such evidence that such tools and assessments validate in Bali also (Reuveni et. al. 2016). PCL-5 is used to analyse the symptoms of traumatic situations in individuals. It consist of 20 items and  four sub-scales corresponding to the four symptom clusters.

Risk or protective factors

There are several risk factors for PSTD in the individuals that are going through such kinds of traumatic situations.

• Acute trauma include accidents or some natural calamities. Such kinds of trauma have a short-term effect on individuals. But in chronic trauma, the accidents occur more than once in an individual's life. It includes sexual abuse, long-term child abuse, and a domestically violent environment (Wichmann et. al. 2017). 

• If an individual is present at the site of an accident, then there may be chances that he/she could be effected by some traumatic situations. DSM 4 and DSM 5 could also occur.

Psychometric validation of PTSD Checklist for DSM-5 (PCL-5).: Balinese version

The psychometric validation of PTSD for Bali people to help the victims. Some doctors initiated the psychometric validation of PCL-5 for the Bali people by describing the symptoms of PTSD. They make some questionnaire which consist of 14 questions to measure the level of PTSD (Blaine and Brenchley, 2017).                        

Hypothesis

Internal consistency

If PCL-5 questionnaire is reliable: how well the items of PCL-5 measure the severity of PTSD.

The PCL-5 has only one version of its items with this format, but with the self-report measure, it has 20 items of questionnaire. The three formats include an extended criterion A component, one with a criterion A component, one with the life event checklist for DSM-5, and one without a criterion A component (Gross and McIlveen, 2016). These items score the severity of past events by measuring through questions using 'not at all', 'moderately', 'a little bit' and 'extremely'.

Cronbach A

Cronbach alpha is used in PCL-5 to measure the PTSD symptoms. This ensures consistency in the questionnaires that are to be asked in questions. As it is easier to understand the questions and respond effectively by respondents.

We are expecting that PCL-5 to have good internal consistency: respondents should answer the same for each similar question.

For the good consistency of PCL-5, the Cronbach's alpha can be used. To make each question reliable, the Cronbach's alpha is used, which make it easier to understand the questions in PCL-5. This Cronbach's applies when the questions are measuring in one dimension.

Inter-rater reliability

1. The degree of the agreement two or more raters.

If the PCL-5 has good reliability

If the two or more raters are in agreement, then use of interclass correlation and intraclass correlation occur. It includes the homogeneity in the ratings, which are given by various people (Kopec, 2018). If the PCL-5 has good reliability, then the chances of same behaviour can be estimated from the questionnaire. 

2. Percent Agreement for two raters

The basic requirements to find the percent agreement for two rates are below.

• first is to count the numbers of ratings in agreement.

• Then, calculate the total number of ratings.

• After that, divide the total by the number to get a fraction.

• Lastly, convert it into percentage.

3. Because it is an established measurement, there will be a correlation

(But it depends: cultural influence).

The correlation measurement refers to measuring the strength between two variables. In this, the one is positive interlinked and the other one is negative interlinked and it helps in measuring the agreement among raters.             

Convergent validity

PCL-5 with LEC-5 and QUIS and TGI-RS

High positive correlation.

The LEC-5 is a self-report used to measure the traumatic events in the respondent's life. It is linked with the PCL-5 with 17 item self-report. With the use of this, it measure exposure to 16 events which show the symptoms of PTSD (Wells et. al., 2016).

The PCL-5 is highly co-linked with the QUIZ as to help in analyzing the post-traumatic disorder and help the individual to seek help from professionals. 

Construct validity

Gender differences in severity of PTSD

The PTSD causes severity differences among genders, as the female has a higher risk of getting affected than males. The women are to suffer more than the men, as they suffer more situations in respect to the men. In some cases, men can be affected by this disorder due to changes in their marital and financial problems. According to some evidence, it is estimated that the women suffer more PTSD symptoms for a longer period. These traumas involve different types of incidents, which include sexual assault or emotional abuse. 

Differences when you lose child and when you lose important others.

When someone loses the child, it can highly impact the parent's mind. Generally, a person can only suffer from PTSD when the person is highly emotionally attached to the lost one. But in other cases, if the loser is important but not emotionally attached to the person, then the chance of getting affected by this disorder is lower. 

Differences when you see the accident—or hear about the accident.

There is a difference that occurs between the witness and the hearer about the incident. The PTSD more commonly occurs when the individual witnesses the incidents or sees any type of act that is extremely disturbing. From the hear incident, the person can only hypothetically analyze the situation, which does not effect the mind's state.

Factor analysis

If the 20 questions create the 4 sub-scales. (Intrusion-avoidance—negative alterations in cognition and mood—alterations in arousal and reactivity).

The 4 subscales, including intrusion, avoidance, negative alterations in cognitions, and mood alterations, are much more effective in making questions. It is helpful to gain responses from respondents and gain more accurate information, which is favourable to achieving appropriate results. However, these four sub-scales are symptoms that are present in individuals suffering from post-PTSD.

True correlation between variables and factors.

With the help of factors, correlated variables can be described in terms of a possibly low number of unobserved variables. The factors can cause the variability in the data. It is also used to measure the errors (Woodhead, 2015). The work of factor is to make link between the variables.       

Interrelationships among items

The questionnaire involves 25 items from each of the factors, and each item is differentiated into each of the personality factors. Each item has a set of instructions that are interlinked to each other. The characteristics of items include following rather than leading. 

If the sample has a linear relationship between the questions.

If the linear relationship occurs in question, then one variable may be positive and the other variable may be negative. The one variable is independent, and the other one, which is dependent on the other, is a dependent variable. So, the benefit of linear combination is that it makes the combination between questions.

Divide the method part in

Participants: The people who are suffering from any mental or psychological disorder are regarded as the participants. The positive consent of each and every participant is required when it comes to the aim, system, environment, and behaviour of the research. There are total 50 respondents who are involved during the research.

Procedures: Once the number of participants has been decided, the researcher conducts several interviews and develops questionnaires for traumatised adults. During unstructured interviews, the questions are pre-described, whereas in structured interviews, the questions are in prearranged and exact order. 

Measurements: The signs and symptoms of the traumatised adults where the effectiveness of psychotherapy is being measured through some self-analyzed reports or a prearranged structured interview. Direct and particular questions are asked to the participants, focusing on their daily schedule or routine in life.

Statistical analysis: For 50 participants, the statistical analysis will be conducted. The analysis aids in knowing the severity of the psychological disorder, which may have large effect on some participants and some respondents may have less severity and can be treated with some therapies. 

From the above report, it can be concluded that the psychotherapies are only affected by some common factors of PTSD. The individuals suffering from various disabilities throughout their lifetime may get support by the psychotherapy. Various intervention programs that are conducted could be used for screening and to analyse the consequences of trauma in participants as assessment tools. It has been analysed that the emotional ability and intimacy action ranges between the female and male as each has different experience in coping and handling the various situations in day-to-day life.

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