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Assessing local instrument reliability and validity: a field-based example from northern Uganda.

Theresa S Betancourt1, Judith Bass, Ivelina Borisova

  • 1Dept. of Population and International Health, François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, Boston, MA 02115, USA. theresa_betancourt@harvard.edu

Social Psychiatry and Psychiatric Epidemiology
|January 24, 2009
PubMed
Summary
This summary is machine-generated.

This study developed a reliable mental health assessment for war-affected adolescents in Uganda. The Acholi psychosocial assessment instrument (APAI) showed good validity for depression-like symptoms, aiding cross-cultural mental health research.

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Area of Science:

  • Global Mental Health
  • Psychological Assessment
  • Cross-Cultural Psychiatry

Background:

  • Evaluating mental health in non-Western settings presents unique challenges.
  • The Acholi psychosocial assessment instrument (APAI) was developed for war-affected adolescents in Uganda.
  • Existing measures may not be culturally appropriate or valid in diverse populations.

Purpose of the Study:

  • To present an approach for evaluating the reliability and validity of mental health measures in non-Western field settings.
  • To describe the development and validation of the APAI for assessing depression-like, anxiety-like, and conduct problems.
  • To establish culturally relevant methods for mental health assessment in post-conflict regions.

Main Methods:

  • Developed the APAI to assess depression-like (two tam, par, kumu), anxiety-like (ma lwor), and conduct problems (kwo maraco).
  • Examined criterion validity using locally derived syndrome terms from qualitative data as a reference point.
  • Assessed reliability using standard test-retest and inter-rater methods.

Main Results:

  • Strong internal reliability (alpha = 0.84-0.87) for depression-like syndromes.
  • Good internal reliability for anxiety (0.70) and conduct problems (0.83).
  • Criterion validity confirmed for depression-like syndromes, but not for anxiety or conduct problems when using local syndrome terms.

Conclusions:

  • The APAI demonstrates a viable approach for culturally sensitive mental health assessment in challenging field settings.
  • The instrument shows good reliability and criterion validity for depression-like symptoms among war-affected adolescents.
  • Further refinement may be needed for anxiety and conduct problem measures to enhance their validity in this population.