Psychology

Balinese people a plethora with respect to the detection is noted. The persons in Bali, include that loss of mortal is a physical, spiritual and social condition that occur when a person injured by accident or trauma-related (Alexandrin, 2019). The impact of the incident justify by the organism interrupt from it to stay at the tract whatsoever disaster took place and natural event on the physical body. While in Bali vehicle accidents caused by physical forces as well as many people trust spirits or divinity campaign them. They also religiously intertwine to the interference of accidents and they have some social consequences that must be rectification through soul recovery custom, Fundamental way are socially, spiritually, psychologically heal the unfortunate person of an accident. In the traffic accidents, it can campaign the loss of person and soul loss, it is the hazardous condition which leads Balinese citizens to look for out or perform custom and religious ritual both to stop these accidents and for soul recovery intention leading accidents (Alexandrin, 2019). Bali is the highly customized and ritualized and aroused spiritual place, where 90% of the people recitation Balinese Hinduism (Watson 2000). The fact of the religionist black magic, spirits or gods are perpetually determinant human in the world. The people of Balinese accept this without any queries, and clasp it in their regular life. Many Balinese people, motorbikes accident can be appreciated like material internal representation to modify come about within the life. In traditional Balinese Hinduism forthcoming car accidents may be addressing the bigger issuance of a ever-changing property in a way which turned control to the people of Balinese. The natural event of motor accidents means Balinese population should slow down and stop this, to penetrate themselves in custom as well as execute spirit recovery rituals.

LINKING SENTENCE. : WESTERN SOCIETY – DIFFERENT REACTION OF BALINESE PEOPLE

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

The Posttraumatic Stress Disorder Checklist is one of the most commonly studied and used assessment instruments for PTSD (Weathers, Litz, Herman, Huska, & Keane, 1993; Weathers et al., 2013). The scale was recently updated to comport with changes to the PTSD symptom criteria adopted in the DSM-5 (American Psychiatric Association, 2013).

It is a reliable screening instrument for PTSD in community samples (Ashbaugh, Houle-Johnson, Herbert, El-Hage, & Brunet, 2016; Biehn et al., 2013). Although studies have examined the previous version of the PCL in different cultural contexts like China, Sri Lanka and Chile (Keane et al., 2013; Vera-Villarroel et al., 2011), only one published study (Ashbaugh et al., 2016) validated the newer PCL-5 in a language other than English (French).

At present, there are no known evidence that prove the validation of PCL-5 in Balinese population.

The reaction of western society with respect to PTSD is that they are highly develop and have the information about this disorder. They also understand the value of organization who are helping in this disorder and seek the help from this organization. But the reaction of Balinese people is much different on PTSD disorder. They consider this disorder as a some spiritually changes in the individual and uses some kind of the spiritual factors to prevent this disorder. The western society are more developed than the Balinese people as they adapt and understand the cause and outcomes of this disorder but the Balinese people have difficulties in adapting these factors (Robinson, 2018).

PCL -5 (summary subscales – items):

The PCL-5 was used to assess the DSM-5 symptoms of PTSD. It is composed 20 items which are for PTSD outlined in DSM-5 and contains four sub-scales corresponding to the four symptom clusters:

Write more about Four factors structure of pcl (2-3 sentences)

The four factors structure are interpersonal, lifestyle, antisocial and effective. They are internally linked. It is rated by psychologist and is used to allow people to rate their psychopathic and antisocial habits (Fodor and et. al., 2015).

 Risk or protective factors (read about that)- 1-2 sentences.

Proposed risk factors for PTSD

• 2 sentences The acute trauma is related with the single incident that occur in life. These incident include accidents, any natural disaster. It can have highly impacted on individuals life psychology. These trauma is linked with the short-term post-traumatic stress disorder.The acute and chronic trauma varies as the acute last for not more than four weeks but the chronic occur more than four weeks. But in chronic trauma, the accidents occur more than one time in individual's life. It includes sexual abuse, long term child abuse, from domestically violent environment. The person start administrating some of the behaviors like ignoring the problems, sexual avoidance, etc. (Bérubé and et. al., 2017). about Number of traumatic experiences (literature about: if someone have more traumatic events , then more PTSD they will face)
• 2-3 sentences / literature There are number of circumstances occur that influences the condition or problem. The events and situations which cannot be controlled by the human and can cause any incident.If the person is present on the accident then there is a chance of suffering from PTSD and from the DSM 4 and DSM 5, the person is diagnosed with both the method in order to understand whether the person have one or two or more symptoms of PTSD (Hourani, 2015). Circumstances of the event ( if they are present on the accident ? /no? )
• DSM 4- DSM 5)

The most notable change for PCL-5 included additing three new PTSD symptoms (blame, negative emotions, and reckless or self"destructive behavior),

Refer that were some changes but the most important is

There was a change in the rating scale, combined with the increase from 17 to 20 items means that PCL-5 scores are not compatible with PCL for DSM-IV scores and cannot be used interchangeably. Furthermore, it is important to mention that a fourth type of exposure regarding criterion A has been created. According to this, a person can develop PTSD symptoms when learned about an event where a close relative or friend experienced an actual or threatened violent or accidental death. Moreover, the number of symptom groups from three to four by separating avoidance symptoms into their group (Criterion C) has been increased.

• Gender Differences

Various studies have proved gender differences in PTSD. Females are approximately twice as likely as males to develop PTSD following exposure to a traumatic event (Breslau et al., 1998; Kessler et al., 1995). A meta-analysis by Tolin and Foa (2006) found that females were at greater risk for developing PTSD despite reporting exposure to fewer traumatic events than males. We are expecting that women will have more PTSD than men.

2 sentences about LEC (The more experience the more PTSD)

The LEC used for the exposure of PTSD traumatic event. The LEC are accessible from 3 info and it includes extended self report, standard self effort and interview.

In extended self report, in this more than one event occurred. The standard self-report is to found if circumstance occurred. In interview, criterion A is occurred. It can use to measure the possibly traumatic events in patient's life. In this 17 item self-report tool occur to checklist the life past events of people. The LEC-5 is linked with the PCL-5 with 17 item self report. a self-report is used to standard the health problem events in responsive life. It is in use to set up of revealing to a PTSD A traumatic event (Ospina, 2019).

The LEC is the most widely-used self-report instrument for assessment of potentially traumatic events in adults (Elhai et al., 2005), (Bae et al., 2008).

It is also one of the few scales of its type whose psychometric properties have already been critically evaluated (Gray et al., 2004).

- 2-3 sentences about questionnaire QIDS (connection between QUIS AND PTSD)- comorbidity –

The QIDS is a tool which is used to design a self-report to screening for depression and to measure the changes in individuals life. These QIDS involve basic questions which involves the basic daily life question of an individual like their sleep pattern and hours, concentration , their thoughts on their life to examine whether they have one disorder or more.

The co-morbidity refers to the presence of more than one conditions which are co-occurring with particular first condition. In this, the mental and physical disorders occur in inter linked. It also means that a person is diagnosed with two different disorder. It is highly occur among mental disorder patients as this disorder can cause some other disorder such as anxiety or eating disorder.

The connection between QUIS and PTSD is that to measure the PTSD among patients. The QUIS is responsible to measure the impact of past events of an individuals that how much the affected from their circumstances. It also use to measure the severity of PTSD. The co-morbidity between these two is occur is to analyze the severity of PTSD by questionnaire. By this, the questions are interlinked with the past conditions of individuals. With the help of co-morbidity, the analyses of the PTSD can be achieve in more effective manner so the patient can be treated well. The co-morbidity of QUIS and PTSD is involve both mentally and physically disorders so that the researcher can find out the cause of PTSD effectively.

 When you lose a child- when you lose important others. 

The main highly cause of PTSD is can be losing some important person of your life or a child. This incident highly cause depression among the individuals. Sometimes the impact of this incidents high that the person can take any adverse life therating decision (Worden, 2018).

The difference in PTSD when losing a child and important others is different. Whenever a person loses a child, it affects on the mental state of parent's mind. They lose the temper and consciousness of their mind and lose the ability to recognize the things. Sometimes they are hallucinated from some things that they are ready to adapt drastic step from which death can be occur. But when losing important others, the incident can affect the person but not effectively. They feel sad about the incident but can overcome by time. The chances of PTSD in this is relatively low, (Rosenblatt2016).

I didn’t find articles yet.

Additional research indicates that the direct observation of the traumatic event is not necessary to produce PTSD. Rynearson (1986) found that parents of murdered children may exhibit PTSD even though they had not witnessed any portion of the event.

Gap in the literature: To date, there is a lack of studies assessing the psychometric properties of PCL-5 in non-western societies, like Bali.

Hypothesis. What we expect- main research –

The present study has multiple objectives. The recent changes in the definition and diagnostic criteria of PTSD created an urgent need to revise the instruments available to measure the construct. The first is to assess the validity and reliability of PCL-5 in the Balinese population. Reliability will be assessed by internal consistency and interrater reliability. Aspects of validity will be assessed with convergent (Trough combining ….and construct validity. Finally, factor analysis will be used to examine the factor structure of the PCL-5. The final objective of this study is to assess the structural validity of PTSD. The above analyses are run in a sample of Balinese at risk for PTSD.

 NOTES :

• Bali, OR INDONESIA how people cope PTSD: It should be noted that traditional and non-Western medical systems have existed for many centuries and continue to constitute viable treatment alternatives that probably have been used to treat trauma-related disorders and impairments.

Methods ( 2 or 3 pages)

Read Also: Anatomy and physiology part b

Divide the method part in

• Participants :- Individuals who are having some psychological disorder are included as participants. The participants are allow to the researcher to analyzing them according to the researcher perspective. The participants should aware from the system and behavior of researcher. They should aware of the physical environment, social openings, etc. There are given names and number of persons in inquiry are 301 for this project. These persons are get through inquiry assistants. The person in this inquiry get a three-day training which includes training, workshops which is based on research requirements and the form of organization.
• Procedures :- The researcher conduct interviews for collecting information from a PTSD patient. The research can be collected through structured, semi-structured and unstructured interviews. In unstructured, the researcher don't specify any set of questions. In semi-structured, the quantitative and qualitative mode of information occur.
• Measurements:- Some self- report instruments and structured interviews are held to measure the symptoms of PTSD . In this, specific question are asked to the individual in their basis day of life . The measurement during the research analyze is depend on the factors of Intrusion, avoidance, negative alterations in cognition and mood- alterations in arousal and reactivity. It depends on the measure of the reactivity of person that they are engaging in the analyzing or not. The measure of a person can be affected by the avoidance, their mood changes in the activity, the negative impact of research on their mind and the feeling of forcing them in the activity.
• Statistical analysis From the procedures and measurements the data is being analyzed in context of population who are suffering from PTSD. The statistical analyzing of 301 people is can be analyzed. This can be done by level of measurement which includes the interval, nominal, ratio and ordinal. The statistical analysis can be measure by the ratio of same type of reactivity and conditions. Some people have same condition but they are having different age group. It is also measure by test and grade. It can be used in two ways which are parametric and non-parametric. The parametric can be used to measure the interval and ratio while non-parametric includes ordinal and nominal data. With respect to the given number of person, some are having severity of PTSD and some have not much serious cause of PTSD so these people can be treated from medications. In this, the 70% of adults are experiencing from one traumatic event and 30 % of adult can experiences from PTSD.

REPHRASE IT

By this cross-sectional survey of this project, the addresses and names of grieving persons (n=301), were get through with the organization from the educational institution of Udayana and through insurance policy and finance administration and the largest and biggest hospital in Bali is Sanglah Medical institution. Moreover, applicants were newcomer through with the frozen dessert selection method. The contestant were enquire to fill out many form considering the TGI-SR, the QIDS or WSAS.

By this thesis focusing on

In improver, all contestants were asked questioned about multiple sociology covariant, information just about the nature of their kinship to the dead person, their engagement in the accident, funeral ceremony, and message about mental unwellness the applicants or their family might endure from.

Encapsulated were male and female associate concluded the age of 18 who had wasted a relative, better half or relative in law by the reason to traffic accident. Get rid of the contestant who mislaid somebody more then three years earlier the study was passageway and player who were not adept in Bahasa Indonesia. The language of Balinese dwell of aggregate sub-languages. To get clear written record, this study was translated to only Bahasa Indonesia.

Two bilingual Public Health Medical doctors interpreted two questionnaires (TGI-SR and WSAS) from English into Bahasa Indonesia, They get the interlingual rendition of the QIDS from last study manage in Jakarta (Arjadi, Nauta, Utoya & Bckting, 2017). Pursuing, the translated form were uncritically critiqued focal point on the understand ability, relevancy and appreciation properness.

The data were gathered by interrogation the associate at home. The inquirer were enlistee supported on competency, seriousness to the investigation and their survey leading as well as advancement, Medical, psychological science and public health pupil, who were in past years of examination, could joint the task as inquiry assistants. After existence designated, they get a three- day training, regard as workshops on research acquirement and the organization form. 

Measures

PCL make some changes

The PCL-5 is used to measure of DSM-5 PTSD. It is used in quantifying severity of PTSD symptoms to change over time in members. 

These items are referred to a repeated, disturbing and unwanted memories of a stressful event that happened at least a last month ago. PCL-5 is rated on a 5- point Likert-type scale (0 = ‘‘not at all’’ to 4 = ‘‘extremely’’). Total scores range from 0 to 80 and a preliminary cutoff score of 38 is recommended as indicating PTSD caseness (Weathers et al., 2013).

Intrusion (five items), Avoidance (two items), Negative alterations in cognitions and mood (seven items), and Alterations in arousal and reactivity (six items).

• Participants TheIndividuals who are suffering from psychological disorder are included as participants. The contestant are allow to the investigator to examine them according to the investigator visual aspect. The associate should aware from the instrumentation and activity of researcher. They should aware of the physical surroundings, social group openings, etc.
• Procedures The investigator conduct examination for assembling data from a PTSD patient. The inquiry can be gathered through structured, semi-structured and unstructured interviews. In unstructured, the investigator don't define any fixed group of questions. In semi-structured, the quantitative and qualitative way of info occur.
• Measurements Some self- report device and structured examination are held to measuring the evidence of PTSD . In this, limited inquiry are asked to the individual in their basis day of living .
• Statistical analysis From the subroutine and activity the information is being analyzed in context of people who are troubled from PTSD.

Life Events Checklist (LEC)

• The LEC is a self-report questionnaire asking for the prevalence of 16 potentially traumatic life-time events plus an added open category (“any other very stressful event or experience”) with five answer categories (Weathers et al., 2013). LEC -5

These items include life events such as natural disasters, physical or sexual aggression, severe injuries, violent death (homicide or suicide), and others. For each situation, the respondent is asked to indicate the type of exposure (i.e., whether he/she experienced the event directly or witnessed an event or situation involving a close relative or friend and if it was related to occupational activities). The LEC-5 also identifies the most traumatic event ever experienced by the respondent, when this event occurred, and how many times similar events have occurred during the respondent’s lifetime.

Weathers FW, Blake DD, Schnurr PP, Kaloupek DG, Marx BP, Keane TM. Life Events Checklist for DSM-5 (LEC-5) [Internet]. 2013 [cited 2016 Apr 25]. http://www.ptsd.va.gov/professional/ assessment/te-measures/life_events_checklist.asp

• Quis questionnaire

It is used a tool which is designed to assess a users satisfaction with the help of computer. It brings interface satisfaction to humans. It is used in PTSD to measure the severity of disorder. Each Quis has its own criteria and factors which make the question variable and form the question in linear combination to measure the intensity of cause of this disorder. It has basically 20 items on the person past and present activities (Manea, 2015) 

• Sociodemographic Characteristics – ONLY WHAT I NEED FOR MY THESIS

Victim age, date of death (of the victim), gender, relationship between respondents and/ with the victim, if the victim was the main income earner in the family were registered. Member name, sex, gender of participant , place and day month ad year of birth of participant were also assessed. Finally, the age of the participant on day of the survey, the location (Banjar (close community)-village (Desa)- sub-district (Kecamatan)-districts (Kabupaten) level of education, if the participant stays together before the victim dies, the frequency of meeting the victim, the time of accident and if the participant was directly involved in an accident was examined.

Statistical Analyses

The data is being analyzed in context of population who are suffering from PTSD from selected instruments and interviews. It is vary among different communities. The statistical analysis is used by physiologist to conduct research, to interpret results and data of their findings. This method is mainly divided into two data analysis which are inferential and descriptive analysis. In descriptive, the psychologist can achieve a better perceptive of the general way in their research and by inferential statistics they can conclude the inter-linked of one variable to another. The statistics of PTSD has been analyzed that there are approx 30% of people are suffering from PTSD and 70 % are experienced from a traumatic life but they don't have majority of PTSD. With the help of multiple regression the researcher can understand the change in variables and the value of variables can be analyze.

multiple regression

It is used to measure the variable based value on the more than variables. It the hold of simple linear regression. The value which is want to be predict is dependent variable. The researcher need to use this regression as this help in the understanding the influence of a change in independent variables on dependent variables (O'Mahony, 2017).

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