DESNOS in three postconflict settings: assessing cross-cultural construct equivalence

Area of Science:

• Psychiatry
• Cross-cultural psychology
• Trauma studies

Background:

• Assessing mental health in diverse populations requires culturally equivalent instruments.
• The Structured Interview for Disorders of Extreme Stress (SIDES) was developed to evaluate Disorders of Extreme Stress Not Otherwise Specified (DESNOS).
• Previous research has not established the cross-cultural construct equivalence of the SIDES.

Purpose of the Study:

• To examine the cross-cultural construct equivalence of the SIDES.
• To assess the stability of the SIDES factor structure across different cultural groups of survivors.
• To propose a method for improving the cross-cultural validity of psychiatric concepts.

Main Methods:

• The SIDES was administered to survivors of war or mass violence in Algeria (n=652), Ethiopia (n=1,200), and Gaza (n=585) between 1997-1999.
• Epidemiological survey methods were employed.
• Statistical analysis examined the factor structure of the SIDES across the three samples.

Main Results:

• The factor structure of the SIDES was not stable across the Algerian, Ethiopian, and Gazan samples.
• Cross-cultural construct equivalence of the SIDES was not demonstrated.
• Significant differences in symptom presentation related to extreme stress were observed across cultures.

Conclusions:

• The SIDES, in its current form, is not suitable for cross-cultural assessment of DESNOS symptoms.
• A multistep interdisciplinary approach is needed to develop culturally valid psychiatric assessment tools.
• Future research should focus on integrating universal stress sequelae with culture-specific symptom presentations.