Adaptation and testing of psychosocial assessment instruments for cross-cultural use: an example from the Thailand Burma border

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Abstract

Background

The purpose of this study was to develop valid and reliable instruments to assess priority psychosocial problems and functioning among adult survivors of systematic violence from Burma living in Thailand.

Methods

The process involved four steps: 1) instrument drafting and piloting; 2) reliability and validity testing; 3) instrument revision; and 4) retesting revised instrument.

Results

A total of N = 158 interviews were completed. Overall subscales showed good internal consistency (0.73-0.92) and satisfactory combined test-retest/inter rater reliability (0.63-0.84). Criterion validity, was not demonstrated for any scale. The alcohol and functioning scales underperformed and were revised (step 3) and retested (step 4). Upon retesting, the function scale showed good internal consistency reliability (0.91-0.92), and the alcohol scale showed acceptable internal consistency (0.79) and strong test-retest/inter-rater reliability (0.86-0.89).

Conclusions

This paper describes the importance and process of adaptation and testing, illustrated by the experiences and results for selected instruments in this population.

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Most cited references 18

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Common mental disorders in postconflict settings.

Joop T. V. M. De Jong, Ivan H Komproe, Mark van Ommeren (2003)

Research into postconflict psychiatric sequelae in low-income countries has been focused largely on symptoms rather than on full psychiatric diagnostic assessment. We assessed 3048 respondents from postconflict communities in Algeria, Cambodia, Ethiopia, and Palestine with the aim of establishing the prevalence of mood disorder, somatoform disorder, post-traumatic stress disorder (PTSD), and other anxiety disorders. PTSD and other anxiety disorders were the most frequent problems. In three countries, PTSD was the most likely disorder in individuals exposed to violence associated with armed conflict, but such violence was a common risk factor for various disorders and comorbidity combinations in different settings. In three countries, anxiety disorder was reported most in people who had not been exposed to such violence. Experience of violence associated with armed conflict was associated with higher rates of disorder that ranged from a risk ratio of 2.10 (95% CI 1.38-2.85) for anxiety in Algeria to 10.03 (5.26-16.65) for PTSD in Palestine. Postconflict mental health programmes should address a range of common disorders beyond PTSD.

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Symptoms of emotional distress in a family planning service: stability over a four-week period.

A Winokur, D F Winokur, Adrienne D. Cox … (1984)

The 25-item Hopkins Symptom Checklist ( HSCL -25) was used on two occasions four weeks apart to identify self-reported symptoms of anxiety and depression in patients attending a family planning service. Only 28 per cent of patients classified as anxious to start with remained so four weeks later, but 62 per cent of those with high depression scores and 74 per cent of those with high depression and high anxiety scores maintained significant levels of depression. The implications of these findings for routine screening are discussed.

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Assessment of depression prevalence in rural Uganda using symptom and function criteria.

C Wilk, Lincoln Ndogoni, Paul Bolton (2004)

We sought to assess the prevalence of major depression in a region of sub-Saharan Africa severely affected by HIV, using symptom and functional criteria as measured with locally validated instruments. Six hundred homes in the Masaka and Rakai districts of southwest Uganda were selected by weighted systematic random sampling. A locally validated version of the depression section of the Hopkins Symptom Check List (DHSCL) and a community-generated index of functional impairment were used to interview 587 respondents. Of respondents, 21% were diagnosed with depression using three of the five DSM-IV criteria (including function impairment) compared with 24.4% using symptom criteria alone. Increased age and lower educational levels are associated with a greater risk for depression; however, a gender effect was not detected. Most community-based assessments of depression in sub-Saharan Africa based on the DSM-IV have used symptom criteria only. We found that expanding criteria to more closely match the complete DSM-IV is feasible, thereby making more accurate assessments of prevalence possible. This approach suggests that major depression and associated functional impairment are a substantial problem in this population.

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Author and article information

Contributors

Emily E Haroz: eharoz1@jhu.edu

Judith K Bass: jbass1@jhu.edu

Catherine Lee: clee147@jhu.edu

Laura K Murray: lmurra15@jhu.edu

Courtland Robinson: court.robinson@jhu.edu

Paul Bolton: pbolton1@jhu.edu

Journal

Journal ID (nlm-ta): BMC Psychol

Journal ID (iso-abbrev): BMC Psychol

Title: BMC Psychology

Publisher: BioMed Central (London )

ISSN (Electronic): 2050-7283

Publication date (Electronic): 31 August 2014

Publication date PMC-release: 31 August 2014

Publication date Collection: 2014

Volume: 2

Issue: 1

Electronic Location Identifier: 31

Affiliations

[ ]Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 780, Baltimore, MD 21205 USA

[ ]Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA

Article

Publisher ID: 31

DOI: 10.1186/s40359-014-0031-6

PMC ID: 4317135

SO-VID: 4d97a261-08f6-4ef7-9eae-3bdf4e7d7bbf

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 17 December 2013

Date accepted : 19 August 2014

Custom metadata

Keywords: validation,refugee,psychometrics,instrument development

Data availability:

Keywords: validation, refugee, psychometrics, instrument development

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Adaptation and testing of psychosocial assessment instruments for cross-cultural use: an example from the Thailand Burma border

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Abstract

Background

Methods

Results

Conclusions

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Special Issue: Social pedagogical work with children, youth and their families with refugee and migrant background in Europe

Most cited references 18

Common mental disorders in postconflict settings.

Symptoms of emotional distress in a family planning service: stability over a four-week period.

Assessment of depression prevalence in rural Uganda using symptom and function criteria.

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Cited by 14

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