Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal
Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal
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DOI：
10.1186/1471-244x-11-127
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发表时间：
2011-08-04
期刊：
影响因子：
4.4
通讯作者：
Upadhaya, Nawaraj
中科院分区：
文献类型：
--
作者：
Kohrt, Brandon A.;Jordans, Mark J. D.;Upadhaya, Nawaraj
背景资料：在低收入和中等收入国家，缺乏文化适应和有效的儿童心理健康和心理社会支持工具，是评估心理健康问题患病率、评估干预措施和确定方案成本效益的一个障碍。替代程序需要验证工具，在这些settings.Methods：提出了六个标准来评估儿童心理健康工具的跨文化效度：（一）工具的目的，（二）结构测量，（三）内容的结构，（四）当地的成语，（五）结构的反应集，（六）与其他可测量的现象比较。这些标准适用于跨文化翻译和替代验证的抑郁症自评量表（DSRS）和儿童创伤后应激障碍症状量表（CPSS）在尼泊尔，最近遭受了十年的战争，包括招募儿童兵和广泛流离失所的青年。跨文化翻译进行了尼泊尔精神卫生专业人员和6个重点小组与儿童（n = 64）年龄在11-15岁。由于尼泊尔缺乏儿童心理健康专业人员，一名心理咨询师采用了另一种验证程序，将心理功能作为干预标准。验证样本为162名儿童（11-14岁）。采用Kiddie-Schedule for Affective Disorders and Schizophrenia（K-SADS）和Global Assessment of Psychosocial Disability（GAPD）作为外部标准，得出治疗指征。（曲线下面积（AUC）= 0.82，灵敏度= 0.71，特异性= 0.81，截止评分= 14）; CPSS（AUC = 0.77，灵敏度= 0.68，特异性= 0.73，截止评分= 20）。判别效度显著的DSRS项目是“有精力完成日常活动”（DSRS。7），“感觉生活不值得过”（DSRS。10），和“感觉孤独”（DSRS。15）。判别效度显著的条目为噩梦。2），闪回（CPSS. 3）、创伤性遗忘症（CPSS. 8），一个缩短的未来的感觉（CPSS。12），并容易激怒在小事情（CPSS。14）.结论：跨文化翻译和替代验证可行地可以在低临床资源设置通过任务转移验证过程中训练有素的心理健康准专业人员使用结构化面试。这一过程有助于评估心理社会干预措施的成本效益。
Background: The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings.Methods: Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i) purpose of instrument, (ii) construct measured, (iii) contents of construct, (iv) local idioms employed, (v) structure of response sets, and (vi) comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS) and Child PTSD Symptom Scale (CPSS) in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64) aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old). The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Global Assessment of Psychosocial Disability (GAPD) were used to derive indication for treatment as the external criterion.Results: The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC) = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score = 14); CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score = 20). The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS. 7), "feeling that life is not worth living" (DSRS. 10), and "feeling lonely" (DSRS. 15). The CPSS items with significant discriminant validity were nightmares (CPSS. 2), flashbacks (CPSS. 3), traumatic amnesia (CPSS. 8), feelings of a foreshortened future (CPSS. 12), and easily irritated at small matters (CPSS. 14).Conclusions: Transcultural translation and alternative validation feasibly can be performed in low clinical resource settings through task-shifting the validation process to trained mental health paraprofessionals using structured interviews. This process is helpful to evaluate cost-effectiveness of psychosocial interventions.