Alastair Ager | Queen Margaret University, Edinburgh (original) (raw)
Papers by Alastair Ager
Intervention, 2019
Drawing upon evidence compiled in a recent literature review, we identify five arguments for seek... more Drawing upon evidence compiled in a recent literature review, we identify five arguments for seeking faith-sensitivity in psychosocial programming: it is indicated by the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support (MHPSS); it is implied by humanitarian law and principles; religion is an active and effective source of coping in many contexts; local faith actors have a 'comparative advantage' in humanitarian settings; and engaging with religion is coherent with emerging policy and practice. However, we also identify three major challenges in implementing faith-sensitive programming: religion may be used as a basis for maladaptive coping; religious engagement is considered a threat to impartiality; and practices of engaging with religion are poorly documented, disseminated and developed. This suggests the value of guidance on faith-sensitive psychosocial programming-consistent with the existing IASC MHPSS guidelines-suitable for implementation by both faith-based and non-faith-based actors.
Background: Evidence of 'what works' in humanitarian programming is especially important ... more Background: Evidence of 'what works' in humanitarian programming is especially important for addressing the disruptive consequences of conflict and forced displacement on adolescent mental health and development. However, the instability of crisis-affected settings renders rigorous methodologies and designs challenging to implement. Discussion: We evaluated a structured, 8-week psychosocial intervention (Advancing Adolescents), implemented by Mercy Corps as part of the No Lost Generation initiative deployed in the Middle East region. Our aims were to test the psychosocial, biological, and cognitive impacts of the intervention with Syrian refugee and host-community youth in Jordanian cities near active war zones and to develop a robust and contextually-relevant toolkit to support research goals and humanitarian practice. We faced challenges with respect to study design, methods, and dissemination: this included the logistics and acceptability of implementing a randomized controlled trial in a humanitarian context, the selection and refinement of culturally-relevant research tools and practices, and the dissemination of results to multiple stakeholders. We sought to go beyond self-reports in testing the effectiveness of a brief, scalable, community-based program to improve the psychosocial wellbeing of war-affected adolescents. We demonstrated beneficial and sustained impacts on self-reports of insecurity, stress, and mental health; developed a reliable and culturally-relevant measure of resilience; experimentally tested cognitive skills; and showed that levels of cortisol, a biomarker of chronic stress, reduced by one third in response to intervention. Using stress biomarkers offered proof-of-concept evidence: interventions targeting mental health and psychosocial wellbeing can improve self-reports of mental health and psychosocial wellbeing, as well as regulate physiological stress in the body. We fostered a strong sense of local ownership through community engagement, and built a network of partnerships between [...]
Berghahn Books, Dec 31, 2022
Berghahn Books, Dec 31, 2022
Intervention, 2019
Drawing upon evidence compiled in a recent literature review, we identify five arguments for seek... more Drawing upon evidence compiled in a recent literature review, we identify five arguments for seeking faith-sensitivity in psychosocial programming: it is indicated by the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support (MHPSS); it is implied by humanitarian law and principles; religion is an active and effective source of coping in many contexts; local faith actors have a 'comparative advantage' in humanitarian settings; and engaging with religion is coherent with emerging policy and practice. However, we also identify three major challenges in implementing faith-sensitive programming: religion may be used as a basis for maladaptive coping; religious engagement is considered a threat to impartiality; and practices of engaging with religion are poorly documented, disseminated and developed. This suggests the value of guidance on faith-sensitive psychosocial programming-consistent with the existing IASC MHPSS guidelines-suitable for implementation by both faith-based and non-faith-based actors.
Journal of Refugee Studies, 1993
Journal of The British Institute of Mental Handicap (apex), Aug 26, 2009
The MICROMATE project aimed to provide a means for people with severe mental handicaps to engage ... more The MICROMATE project aimed to provide a means for people with severe mental handicaps to engage in a range of microcomputer‐based activities, both educational and recreational. This involved the development of software (computer programmes written with regard to their special learning needs) and hardware (accessories to allow control of a programme for people unable to operate a standard microcomputer keyboard). A key feature of MICROMATE software is its ability to individualise activities – task difficulty being automatically adjusted in line with the level of performance of each individual – so providing an effective means of structuring learning and a mechanism for maintaining interest and attention over extended periods. The success of MICROMATE in a variety of settings has indicated that microcomputers are likely to become a powerful resource in work with people with severe mental handicaps.
DOAJ (DOAJ: Directory of Open Access Journals), Nov 1, 2014
There is good reason to engage faith-based organisations and local faith communities in humanitar... more There is good reason to engage faith-based organisations and local faith communities in humanitarian response but doing so raises challenging issues for the interpretation of humanitarian principles in what some see as a post-secular age.
UMI Books on Demand, Nov 1, 1991
The Role of Microcomputers in Clinical Psychology Issues in the Selection and Support of a Microc... more The Role of Microcomputers in Clinical Psychology Issues in the Selection and Support of a Microcomputer System Computer Assisted Assessment and Psychological Problems Microcomputers and Psychological Treatment Microcomputers in Psychometric and Neuropsychological Assessment Microcomputer-Based Cognitive Rehabilitation Clinical Applications of Microcomputers with Children Microcomputer Applications for People with Learning Difficulties Monitoring and Evaluating Clinical Service Delivery: Issues and Effectiveness of Computer Database Management Expert Systems and the Clinical Psychologist Psychological Aspects of the New Technological Age.
Continuum eBooks, 1999
This volume brings together senior authors from a range of disciplines to analyze key forces shap... more This volume brings together senior authors from a range of disciplines to analyze key forces shaping the contemporary experience of forced migration.
BMJ Open
ObjectivesAssess and describe the health service use and delivery patterns for non-communicable d... more ObjectivesAssess and describe the health service use and delivery patterns for non-communicable disease (NCD) services in two contrasting fragility contexts and by other principal equity-related characteristics including gender, nationality and health coverage.SettingPrimary healthcare centres located in the urbanised area of Greater Beirut and the rural area of the Beqaa Valley.DesignThis is a cross-sectional study using a structured survey tool between January and September 2020.Participants1700 Lebanese and Syrian refugee patients seeking primary care for hypertension and diabetes.Primary and secondary outcomesThe main outcome is the comprehensiveness of service delivery comparing differences in use and service delivery patterns by fragility setting, gender, nationality and health coverage.ResultsCompliance with routine NCD care management (eg, counselling, immunisations, diagnostic testing and referral rates) was significantly better in Beirut compared with Beqaa. Women were sig...
Sharing the Front Line and the Back Hills, 2018
Intersections of Religion and Migration, 2016
More than one in every hundred of the world’s population has experienced being forcibly displaced... more More than one in every hundred of the world’s population has experienced being forcibly displaced. Religion constitutes a key dimension of the experience of the vast majority of forced migrants, but humanitarian response—on the basis of its concern for neutrality and impartiality—has an uneasy relation with it. The secular framing of humanitarianism has come under sustained critique, encouraging a deeper understanding of the dynamics of local faith communities. Theological reflection within faith traditions speaks to both notions of hospitality among hosts and of life in exile among migrants. Dialogue with such reflection offers insight not only into the role of religion in the support of displaced communities but also in the reimagining of global polity in a complex, plural, post-secular age.
Psychological Assessment, 2013
Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD... more Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and valid measure of PTSD symptom severity in school-age children exposed to natural disasters (Foa, Johnson, Feeny & Treadwell, 2001). However, the psychometric properties of the CPSS are not known in youths who have experienced other types of trauma. The current study aims to fill this gap by examining the psychometric properties of the interview (CPSS-I) and self-report (CPSS-SR) administrations of the CPSS in a sample of 91 female youths with sexual abuse-related PTSD, a population that is targeted in many treatment studies. Scores on both the CPSS-I and CPSS-SR demonstrated good to excellent internal consistency. One week test-retest reliability assessed for CPSS-SR scores was excellent (r = .86); inter-rater reliability of CPSS-I scores was also excellent (r = .87). Symptombased diagnostic agreement between the CPSS-SR and CPSS-I was excellent at 85.5%; scores on both the CPSS-SR and CPSS-I also demonstrated good convergent validity (74.5-76.5% agreement) with the PTSD module of The Schedule of Affective Disorders and Schizophrenia for School-Age Children-Revised for DSM-IV (K-SADS; Kaufman, Birmaher, Brent, & Rao, 1997). The strong psychometric properties of the CPSS render it a valuable instrument for PTSD screening as well as for assessing symptom severity.
The Lancet Global Health, Sep 1, 2023
BMC Psychology
BackgroundStudies of psychological distress in Sierra Leone have typically used measures which we... more BackgroundStudies of psychological distress in Sierra Leone have typically used measures which were developed for use in other contexts, and which often have not been adapted or validated for use in Sierra Leone. This has resulted in a lack of reliable information about the patterns of psychological distress within the population, which is a barrier to the development of effective and appropriate mental health services. The aim of the study was to develop a locally-appropriate measure of psychological distress for Sierra Leone.MethodsThe new measure consists of two instruments: the Sierra Leone Psychological Distress Scale (SLPDS) and a gendered measure of ability to carry out daily tasks—a Function scale—as an indication of the severity of distress. A three-phase mixed methods exploratory sequential study was conducted. Phase 1 was item generation and testing, leading to the development of a set of potential items for both instruments. Phase 2 was a small pilot study (N = 202) lead...
European Journal of Psychotraumatology, Jun 10, 2019
In the 11th edition of the International Classification of Diseases (ICD-11) the diagnostic crite... more In the 11th edition of the International Classification of Diseases (ICD-11) the diagnostic criteria of prolonged grief disorder (PGD) is included as a new mental disorder. Consequently, there is a growing need for high-quality mental health care for bereaved persons. This care encompasses different forms of help for different levels of grief and can be conceptualized from a stepped care perspective in which (1) lowthreshold Internet-based interventions, which could be appropriate for high-risk groups with subsyndromal PGD, (2) psychotherapy for patients suffering already of PGD. This symposium will describe current bereavement interventions studies for bereaved children and bereaved siblings. Further, an overview will be given of the state of the field for European-based bereavement interventions. The network for Bereavement Research and Care in Europe (BRACE) will be introduced.
Intervention, 2019
Drawing upon evidence compiled in a recent literature review, we identify five arguments for seek... more Drawing upon evidence compiled in a recent literature review, we identify five arguments for seeking faith-sensitivity in psychosocial programming: it is indicated by the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support (MHPSS); it is implied by humanitarian law and principles; religion is an active and effective source of coping in many contexts; local faith actors have a 'comparative advantage' in humanitarian settings; and engaging with religion is coherent with emerging policy and practice. However, we also identify three major challenges in implementing faith-sensitive programming: religion may be used as a basis for maladaptive coping; religious engagement is considered a threat to impartiality; and practices of engaging with religion are poorly documented, disseminated and developed. This suggests the value of guidance on faith-sensitive psychosocial programming-consistent with the existing IASC MHPSS guidelines-suitable for implementation by both faith-based and non-faith-based actors.
Background: Evidence of 'what works' in humanitarian programming is especially important ... more Background: Evidence of 'what works' in humanitarian programming is especially important for addressing the disruptive consequences of conflict and forced displacement on adolescent mental health and development. However, the instability of crisis-affected settings renders rigorous methodologies and designs challenging to implement. Discussion: We evaluated a structured, 8-week psychosocial intervention (Advancing Adolescents), implemented by Mercy Corps as part of the No Lost Generation initiative deployed in the Middle East region. Our aims were to test the psychosocial, biological, and cognitive impacts of the intervention with Syrian refugee and host-community youth in Jordanian cities near active war zones and to develop a robust and contextually-relevant toolkit to support research goals and humanitarian practice. We faced challenges with respect to study design, methods, and dissemination: this included the logistics and acceptability of implementing a randomized controlled trial in a humanitarian context, the selection and refinement of culturally-relevant research tools and practices, and the dissemination of results to multiple stakeholders. We sought to go beyond self-reports in testing the effectiveness of a brief, scalable, community-based program to improve the psychosocial wellbeing of war-affected adolescents. We demonstrated beneficial and sustained impacts on self-reports of insecurity, stress, and mental health; developed a reliable and culturally-relevant measure of resilience; experimentally tested cognitive skills; and showed that levels of cortisol, a biomarker of chronic stress, reduced by one third in response to intervention. Using stress biomarkers offered proof-of-concept evidence: interventions targeting mental health and psychosocial wellbeing can improve self-reports of mental health and psychosocial wellbeing, as well as regulate physiological stress in the body. We fostered a strong sense of local ownership through community engagement, and built a network of partnerships between [...]
Berghahn Books, Dec 31, 2022
Berghahn Books, Dec 31, 2022
Intervention, 2019
Drawing upon evidence compiled in a recent literature review, we identify five arguments for seek... more Drawing upon evidence compiled in a recent literature review, we identify five arguments for seeking faith-sensitivity in psychosocial programming: it is indicated by the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support (MHPSS); it is implied by humanitarian law and principles; religion is an active and effective source of coping in many contexts; local faith actors have a 'comparative advantage' in humanitarian settings; and engaging with religion is coherent with emerging policy and practice. However, we also identify three major challenges in implementing faith-sensitive programming: religion may be used as a basis for maladaptive coping; religious engagement is considered a threat to impartiality; and practices of engaging with religion are poorly documented, disseminated and developed. This suggests the value of guidance on faith-sensitive psychosocial programming-consistent with the existing IASC MHPSS guidelines-suitable for implementation by both faith-based and non-faith-based actors.
Journal of Refugee Studies, 1993
Journal of The British Institute of Mental Handicap (apex), Aug 26, 2009
The MICROMATE project aimed to provide a means for people with severe mental handicaps to engage ... more The MICROMATE project aimed to provide a means for people with severe mental handicaps to engage in a range of microcomputer‐based activities, both educational and recreational. This involved the development of software (computer programmes written with regard to their special learning needs) and hardware (accessories to allow control of a programme for people unable to operate a standard microcomputer keyboard). A key feature of MICROMATE software is its ability to individualise activities – task difficulty being automatically adjusted in line with the level of performance of each individual – so providing an effective means of structuring learning and a mechanism for maintaining interest and attention over extended periods. The success of MICROMATE in a variety of settings has indicated that microcomputers are likely to become a powerful resource in work with people with severe mental handicaps.
DOAJ (DOAJ: Directory of Open Access Journals), Nov 1, 2014
There is good reason to engage faith-based organisations and local faith communities in humanitar... more There is good reason to engage faith-based organisations and local faith communities in humanitarian response but doing so raises challenging issues for the interpretation of humanitarian principles in what some see as a post-secular age.
UMI Books on Demand, Nov 1, 1991
The Role of Microcomputers in Clinical Psychology Issues in the Selection and Support of a Microc... more The Role of Microcomputers in Clinical Psychology Issues in the Selection and Support of a Microcomputer System Computer Assisted Assessment and Psychological Problems Microcomputers and Psychological Treatment Microcomputers in Psychometric and Neuropsychological Assessment Microcomputer-Based Cognitive Rehabilitation Clinical Applications of Microcomputers with Children Microcomputer Applications for People with Learning Difficulties Monitoring and Evaluating Clinical Service Delivery: Issues and Effectiveness of Computer Database Management Expert Systems and the Clinical Psychologist Psychological Aspects of the New Technological Age.
Continuum eBooks, 1999
This volume brings together senior authors from a range of disciplines to analyze key forces shap... more This volume brings together senior authors from a range of disciplines to analyze key forces shaping the contemporary experience of forced migration.
BMJ Open
ObjectivesAssess and describe the health service use and delivery patterns for non-communicable d... more ObjectivesAssess and describe the health service use and delivery patterns for non-communicable disease (NCD) services in two contrasting fragility contexts and by other principal equity-related characteristics including gender, nationality and health coverage.SettingPrimary healthcare centres located in the urbanised area of Greater Beirut and the rural area of the Beqaa Valley.DesignThis is a cross-sectional study using a structured survey tool between January and September 2020.Participants1700 Lebanese and Syrian refugee patients seeking primary care for hypertension and diabetes.Primary and secondary outcomesThe main outcome is the comprehensiveness of service delivery comparing differences in use and service delivery patterns by fragility setting, gender, nationality and health coverage.ResultsCompliance with routine NCD care management (eg, counselling, immunisations, diagnostic testing and referral rates) was significantly better in Beirut compared with Beqaa. Women were sig...
Sharing the Front Line and the Back Hills, 2018
Intersections of Religion and Migration, 2016
More than one in every hundred of the world’s population has experienced being forcibly displaced... more More than one in every hundred of the world’s population has experienced being forcibly displaced. Religion constitutes a key dimension of the experience of the vast majority of forced migrants, but humanitarian response—on the basis of its concern for neutrality and impartiality—has an uneasy relation with it. The secular framing of humanitarianism has come under sustained critique, encouraging a deeper understanding of the dynamics of local faith communities. Theological reflection within faith traditions speaks to both notions of hospitality among hosts and of life in exile among migrants. Dialogue with such reflection offers insight not only into the role of religion in the support of displaced communities but also in the reimagining of global polity in a complex, plural, post-secular age.
Psychological Assessment, 2013
Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD... more Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and valid measure of PTSD symptom severity in school-age children exposed to natural disasters (Foa, Johnson, Feeny & Treadwell, 2001). However, the psychometric properties of the CPSS are not known in youths who have experienced other types of trauma. The current study aims to fill this gap by examining the psychometric properties of the interview (CPSS-I) and self-report (CPSS-SR) administrations of the CPSS in a sample of 91 female youths with sexual abuse-related PTSD, a population that is targeted in many treatment studies. Scores on both the CPSS-I and CPSS-SR demonstrated good to excellent internal consistency. One week test-retest reliability assessed for CPSS-SR scores was excellent (r = .86); inter-rater reliability of CPSS-I scores was also excellent (r = .87). Symptombased diagnostic agreement between the CPSS-SR and CPSS-I was excellent at 85.5%; scores on both the CPSS-SR and CPSS-I also demonstrated good convergent validity (74.5-76.5% agreement) with the PTSD module of The Schedule of Affective Disorders and Schizophrenia for School-Age Children-Revised for DSM-IV (K-SADS; Kaufman, Birmaher, Brent, & Rao, 1997). The strong psychometric properties of the CPSS render it a valuable instrument for PTSD screening as well as for assessing symptom severity.
The Lancet Global Health, Sep 1, 2023
BMC Psychology
BackgroundStudies of psychological distress in Sierra Leone have typically used measures which we... more BackgroundStudies of psychological distress in Sierra Leone have typically used measures which were developed for use in other contexts, and which often have not been adapted or validated for use in Sierra Leone. This has resulted in a lack of reliable information about the patterns of psychological distress within the population, which is a barrier to the development of effective and appropriate mental health services. The aim of the study was to develop a locally-appropriate measure of psychological distress for Sierra Leone.MethodsThe new measure consists of two instruments: the Sierra Leone Psychological Distress Scale (SLPDS) and a gendered measure of ability to carry out daily tasks—a Function scale—as an indication of the severity of distress. A three-phase mixed methods exploratory sequential study was conducted. Phase 1 was item generation and testing, leading to the development of a set of potential items for both instruments. Phase 2 was a small pilot study (N = 202) lead...
European Journal of Psychotraumatology, Jun 10, 2019
In the 11th edition of the International Classification of Diseases (ICD-11) the diagnostic crite... more In the 11th edition of the International Classification of Diseases (ICD-11) the diagnostic criteria of prolonged grief disorder (PGD) is included as a new mental disorder. Consequently, there is a growing need for high-quality mental health care for bereaved persons. This care encompasses different forms of help for different levels of grief and can be conceptualized from a stepped care perspective in which (1) lowthreshold Internet-based interventions, which could be appropriate for high-risk groups with subsyndromal PGD, (2) psychotherapy for patients suffering already of PGD. This symposium will describe current bereavement interventions studies for bereaved children and bereaved siblings. Further, an overview will be given of the state of the field for European-based bereavement interventions. The network for Bereavement Research and Care in Europe (BRACE) will be introduced.