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Community-based cross-cultural adaptation of mental health measures in emergency settings: validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo

Cindy Mels UGent, Ilse Derluyn UGent, Eric Broekaert and Yves Rosseel UGent (2010) SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY. 45(9). p.899-910
abstract
This study aims at providing qualitative and quantitative evidence on the relevance of two broadly used mental health self-report measures-Impact of Event Scale Revised (IES-R) and Hopkins Symptom Checklist 37 for Adolescents (HSCL-37A)-for use in Eastern Democratic of Congo, as no psychological assessment instruments were available for this region. We therefore describe an apt procedure to adapt and translate standard screening instruments in close collaboration with the local community, feasible under challenging conditions in emergency settings. Focus groups and interviews with community key figures in psychosocial care were employed to ensure local validity of the adaptation and translation process. Consequently, the questionnaires' internal consistency (Cronbach's alpha) and construct validity (principal component analysis, testing of theoretical assumptions) were assessed based on a clustered school-based community survey among 1,046 adolescents (13-21 years) involving 13 secondary schools in the Ituri district in Eastern Democratic Republic of Congo. Key-informant qualitative data confirmed face and construct validity of all IES-R and all HSCL-37A anxiety items. Additional culture-specific symptoms of adolescent mental ill-health were added to enhance local relevance of the HSCL-37A depression and externalizing subscales. Quantitative analysis of the survey data revealed adequate internal consistency and construct validity of both adapted measures, yet weaker results for the externalizing scale. Furthermore, it confirmed the internalizing/externalizing factor structure of the HSCL-37A and the theoretically deviating intrusion/arousal versus active avoidance factor structure for the IES-R. Community-based adaptation can extend the validity and local relevance of mental health screening in emergency and low-income settings. The availability of adequate Swahili and Congolese French adaptations of the IES-R and HSCL-37A could stimulate the assessment of psychosocial needs in war-exposed Eastern Congolese adolescents.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
QUESTIONNAIRE, IMPACT, TRAUMA, Mental health, ADOLESCENTS, SYMPTOM, CHILDREN, WAR, EVENT SCALE, POSTTRAUMATIC-STRESS, MULTIPLE LANGUAGE VERSIONS, Cross-cultural assessment, War, Democratic Republic of Congo
journal title
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
Soc. psychiatry psychiatr. epidemiol.
volume
45
issue
9
pages
899 - 910
Web of Science type
Article
Web of Science id
000280846500006
JCR category
PSYCHIATRY
JCR impact factor
2.147 (2010)
JCR rank
38/107 (2010)
JCR quartile
2 (2010)
ISSN
0933-7954
DOI
10.1007/s00127-009-0128-z
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
VABB id
c:vabb:281342
VABB type
VABB-1
id
758526
handle
http://hdl.handle.net/1854/LU-758526
date created
2009-09-25 13:59:07
date last changed
2016-12-19 15:45:00
@article{758526,
  abstract     = {This study aims at providing qualitative and quantitative evidence on the relevance of two broadly used mental health self-report measures-Impact of Event Scale Revised (IES-R) and Hopkins Symptom Checklist 37 for Adolescents (HSCL-37A)-for use in Eastern Democratic of Congo, as no psychological assessment instruments were available for this region. We therefore describe an apt procedure to adapt and translate standard screening instruments in close collaboration with the local community, feasible under challenging conditions in emergency settings. Focus groups and interviews with community key figures in psychosocial care were employed to ensure local validity of the adaptation and translation process. Consequently, the questionnaires' internal consistency (Cronbach's alpha) and construct validity (principal component analysis, testing of theoretical assumptions) were assessed based on a clustered school-based community survey among 1,046 adolescents (13-21 years) involving 13 secondary schools in the Ituri district in Eastern Democratic Republic of Congo. Key-informant qualitative data confirmed face and construct validity of all IES-R and all HSCL-37A anxiety items. Additional culture-specific symptoms of adolescent mental ill-health were added to enhance local relevance of the HSCL-37A depression and externalizing subscales. Quantitative analysis of the survey data revealed adequate internal consistency and construct validity of both adapted measures, yet weaker results for the externalizing scale. Furthermore, it confirmed the internalizing/externalizing factor structure of the HSCL-37A and the theoretically deviating intrusion/arousal versus active avoidance factor structure for the IES-R. Community-based adaptation can extend the validity and local relevance of mental health screening in emergency and low-income settings. The availability of adequate Swahili and Congolese French adaptations of the IES-R and HSCL-37A could stimulate the assessment of psychosocial needs in war-exposed Eastern Congolese adolescents.},
  author       = {Mels, Cindy and Derluyn, Ilse and Broekaert, Eric and Rosseel, Yves},
  issn         = {0933-7954},
  journal      = {SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY},
  keyword      = {QUESTIONNAIRE,IMPACT,TRAUMA,Mental health,ADOLESCENTS,SYMPTOM,CHILDREN,WAR,EVENT SCALE,POSTTRAUMATIC-STRESS,MULTIPLE LANGUAGE VERSIONS,Cross-cultural assessment,War,Democratic Republic of Congo},
  language     = {eng},
  number       = {9},
  pages        = {899--910},
  title        = {Community-based cross-cultural adaptation of mental health measures in emergency settings: validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo},
  url          = {http://dx.doi.org/10.1007/s00127-009-0128-z},
  volume       = {45},
  year         = {2010},
}

Chicago
Mels, Cindy, Ilse Derluyn, Eric Broekaert, and Yves Rosseel. 2010. “Community-based Cross-cultural Adaptation of Mental Health Measures in Emergency Settings: Validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo.” Social Psychiatry and Psychiatric Epidemiology 45 (9): 899–910.
APA
Mels, C., Derluyn, I., Broekaert, E., & Rosseel, Y. (2010). Community-based cross-cultural adaptation of mental health measures in emergency settings: validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo. SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 45(9), 899–910.
Vancouver
1.
Mels C, Derluyn I, Broekaert E, Rosseel Y. Community-based cross-cultural adaptation of mental health measures in emergency settings: validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo. SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY. 2010;45(9):899–910.
MLA
Mels, Cindy, Ilse Derluyn, Eric Broekaert, et al. “Community-based Cross-cultural Adaptation of Mental Health Measures in Emergency Settings: Validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo.” SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY 45.9 (2010): 899–910. Print.