The adaptation and testing of diagnostic and outcome measures for cross-cultural research

Abstract

Specific symptom presentations as well as patterns of onset, duration, risk and outcome of mental illness have been shown to vary across cultures. Cross cultural research aims to understand the processes which explain these differences in the expression of mental illness. This endeavor can give clues to the etiology of disorders and can provide evidence on whether different societal responses to mental illness affects its course, thus ultimately providing clues to the improvement of treatment. However, cross-cultural research is affected by a number of methodological and substantive issues, namely, the definition of what constitutes a “true” case, the use of culturally sensitive diagnostic tools and the need for evaluating outcomes in the particular context in which they occur. The present paper focuses on these main issues and describes a particular cross-cultural method consisting of obtaining content, semantic, technical, and criterion equivalence. The method has been found successful in achieving the cultural equivalence of several psychiatric and diagnostic measures.