Ethnic differences in the reliability and validity of a Panic Disorder Screen.
OBJECTIVE
The purpose of this study was to compare the reliability and validity of the Brief Panic Disorder Screen (BPDS) in samples of African American and Caucasian American primary care patients.


METHODS
The BPDS was administered to 295 patients scheduled to visit a primary care clinic for medical reasons. The presence or absence of a panic disorder diagnosis was established during a clinical interview with a psychiatrist. Measures of reliability (internal consistency) and validity (criterion validity) were compared between the two ethnic subgroups.


RESULTS
The BPDS demonstrated greater reliability and validity for Caucasians than African Americans. This effect was maintained even after controlling for group differences in key demographic variables. Differences between ethnic groups were apparent in both those with and those without panic disorder (PD). BPDS responses of African Americans with PD demonstrated very low internal consistency whereas a high rate of false positive PD diagnoses was related to higher than expected BPDS scores among African Americans without PD, particularly on the level of fear felt when experiencing shortness of breath or heart palpitations.


CONCLUSIONS
These findings support the notion that cultural differences in the language and meaning associated with anxiety disorders contribute to the difficulty of accurately diagnosing PD in primary care populations. Additional research is needed to provide a better understanding of the cultural aspects of the anxiety experience. Such research would facilitate the development of better screening tools for panic and other anxiety disorders for ethnic minority primary care populations.
Johnson
Michael R
MR
University of Florida, Gainesville, FL 32610-0496, USA.
Hartzema
Abraham G
AG
Mills
Terry L
TL
De Leon
Jessica M
JM
Yang
Mark
M
Frueh
Christopher
C
Santos
Alberto
A
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D010054:Brief Psychiatric Rating Scale / Q000592:standards*; D003431:Cross-Cultural Comparison; D018864:Cultural Diversity; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000208:ethnology*; D011320:Primary Health Care / Q000379:methods*; D011594:Psychometrics / Q000295:instrumentation*; D013022:South Carolina; D011795:Surveys and Questionnaires / Q000592:standards*; D044465:White People / Q000523:psychology*