title: "Tension" in South Asian women: developing a measure of common mental disorder using participatory methods.
abstract: BACKGROUND
  Although common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be owing in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. Community-based participatory research (CBPR) is ideally suited to help address measurement issues in CMD as well as to develop culturally appropriate treatment models.
  
  
  OBJECTIVE
  To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome.
  
  
  METHODS
  We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/illness, "tension," as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx.
  
  
  RESULTS
  The 24-item "Tension Scale" had high internal consistency (α = 0.83). On bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the Patient Health Questionnaire (PHQ-2), age, education, self-rated health, having seen a physician in the past year, and other variables.
  
  
  CONCLUSIONS
  Using participatory techniques, we created a new measure designed to assess CMD in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder.
authors.forename: Alison
authors.initials: A
authors.lastname: Karasz
authors.forename: Viraj
authors.initials: V
authors.lastname: Patel
authors.forename: Mahbhooba
authors.initials: M
authors.lastname: Kabita
authors.forename: Parvin
authors.initials: P
authors.lastname: Shimu
mesh_terms: D000328:Adult; D001210:Asia, Southeastern / Q000208:ethnology; D055812:Community-Based Participatory Research; D003466:Cultural Characteristics; D005260:Female; D006301:Health Services Needs and Demand; D006305:Health Status Indicators; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D009519:New York City / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors