title: Clinical use of the Kessler psychological distress scales with culturally diverse groups.
abstract: The Kessler 10 (K10) and embedded Kessler 6 (K6) was developed to screen for non-specific psychological distress and serious mental illness in mental health surveys of English-speaking populations, but has been adopted in Western and non-Western countries as a screening and outcome measure in primary care and mental health settings. This review examines whether the original K6/K10's validity for culturally diverse populations was established, and whether the cultural equivalence, and sensitivity to change of translated or culturally adapted K6/K10s, has been demonstrated with culturally diverse client groups. Evidence for the original K6/K10's validity for culturally diverse populations is limited. Questions about the conceptual and linguistic equivalence of translated/adapted K6/K10s arise from reports of changes in item connotation and differential item functioning. Evidence for structural equivalence is inconsistent, as is support for criterion equivalence, with the majority of studies compromising on accuracy in case prediction. Research demonstrating sensitivity to change with culturally diverse groups is lacking. Inconsistent evidence for the K6/K10's cultural appropriateness in clinical settings, and a lack of clinical norms for either majority or culturally diverse groups, indicate the importance of further research into the psychological distress construct with culturally diverse clients, and the need for caution in interpreting K6/K10 scores.
authors.affiliation: Research Consultant, Victorian Foundation for Survivors of Torture, Brunswick, Vic., Australia.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Stolk
authors.forename: Ida
authors.initials: I
authors.lastname: Kaplan
authors.forename: Josef
authors.initials: J
authors.lastname: Szwarc
mesh_terms: D003431:Cross-Cultural Comparison; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000175:diagnosis*; D014175:Translating
keywords: K10; K6; cultural equivalence; mental health; primary care; psychological distress; screening scale
references.citation: J Health Soc Behav. 2011 Dec;52(4):404-29
references.pmid: 22144731
references.citation: Aust N Z J Psychiatry. 2011 Jun;45(6):432-43
references.pmid: 21510721
references.citation: Aust N Z J Psychiatry. 2010 Apr;44(4):314-22
references.pmid: 20307164
references.citation: Int J Methods Psychiatr Res. 2012 Jun;21(2):88-97
references.pmid: 22351472
references.citation: Med J Aust. 2010 Jun 7;192(S11):S31-5
references.pmid: 20528705
references.citation: BMC Public Health. 2009 Aug 23;9:307
references.pmid: 19698174
references.citation: Br J Gen Pract. 2009 Mar;59(560):e61-70
references.pmid: 19275825
references.citation: Psychol Med. 2003 Feb;33(2):357-62
references.pmid: 12622315
references.citation: Alcohol Clin Exp Res. 2010 Jul;34(7):1235-45
references.pmid: 20477768
references.citation: Aust J Rural Health. 2009 Aug;17(4):174-82
references.pmid: 19664081
references.citation: Int J Methods Psychiatr Res. 2011 Dec;20(4):215-23
references.pmid: 22113964
references.citation: Int Rev Psychiatry. 2010;22(2):99-113
references.pmid: 20397836
references.citation: Int J Methods Psychiatr Res. 2010 Jun;19 Suppl 1:36-48
references.pmid: 20527004
references.citation: J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
references.pmid: 9881538
references.citation: J Psychiatr Res. 2011 Jan;45(1):104-10
references.pmid: 20537658
references.citation: JAMA. 2004 Jun 2;291(21):2581-90
references.pmid: 15173149
references.citation: Ment Health Serv Res. 2005 Sep;7(3):171-9
references.pmid: 16194002
references.citation: Aust N Z J Psychiatry. 2011 Sep;45(9):696-9
references.pmid: 21888606
references.citation: Int J Methods Psychiatr Res. 2010 Jun;19 Suppl 1:49-60
references.pmid: 20527005
references.citation: J Affect Disord. 2010 May;122(3):253-9
references.pmid: 19679358
references.citation: Aust N Z J Public Health. 2001 Dec;25(6):494-7
references.pmid: 11824981
references.citation: BMC Public Health. 2012 Feb 01;12:95
references.pmid: 22296820
references.citation: Asian J Psychiatr. 2010 Sep;3(3):130-3
references.pmid: 23051570
references.citation: Arch Womens Ment Health. 2011 Jun;14(3):209-16
references.pmid: 21061137
references.citation: Psychol Med. 2008 Feb;38(2):221-8
references.pmid: 18047768
references.citation: Prev Chronic Dis. 2012;9:E52
references.pmid: 22321144
references.citation: J Affect Disord. 2010 Apr;122(1-2):102-8
references.pmid: 19615753
references.citation: Int J Methods Psychiatr Res. 2008;17(3):152-8
references.pmid: 18763695
references.citation: Aust N Z J Psychiatry. 2007 Feb;41(2):166-8
references.pmid: 17464695
references.citation: Arch Gen Psychiatry. 2003 Feb;60(2):184-9
references.pmid: 12578436
references.citation: Int Psychogeriatr. 2012 Feb;24(2):231-42
references.pmid: 21933463
references.citation: Psychiatry Clin Neurosci. 2011 Aug;65(5):434-41
references.pmid: 21851452
references.citation: PLoS One. 2012;7(2):e31209
references.pmid: 22348057
references.citation: Compr Psychiatry. 2012 Jan;53(1):48-53
references.pmid: 21489424
references.citation: CMAJ. 2011 Sep 6;183(12):E959-67
references.pmid: 20603342
references.citation: Psychol Assess. 2006 Mar;18(1):62-70
references.pmid: 16594813
references.citation: Psychiatry Res. 2010 Mar 30;176(1):45-50
references.pmid: 20071036
references.citation: Trop Med Int Health. 2007 Oct;12(10):1225-9
references.pmid: 17956505
references.citation: Int J Methods Psychiatr Res. 2010 Jun;19 Suppl 1:61-87
references.pmid: 20527006
references.citation: Arch Gen Psychiatry. 1976 Jun;33(6):766-71
references.pmid: 938196
references.citation: Aust N Z J Psychiatry. 2006 Oct;40(10):835-44
references.pmid: 16959009
references.citation: Aust N Z J Psychiatry. 2000 Apr;34(2):197-205
references.pmid: 10789524
references.citation: Int J Methods Psychiatr Res. 2009 Sep;18(3):159-68
references.pmid: 19701920
references.citation: Arch Womens Ment Health. 2009 Apr;12(2):69-74
references.pmid: 19238521
references.citation: J Prim Health Care. 2012 Sep 01;4(3):231-8
references.pmid: 22946072
references.citation: Med J Aust. 2002 Aug 19;177(4):205-7
references.pmid: 12175326
references.citation: J Immigr Minor Health. 2009 Apr;11(2):131-8
references.pmid: 18690536
references.citation: Aust N Z J Psychiatry. 2011 Oct;45(10):880-9
references.pmid: 21875309
references.citation: Arch Gen Psychiatry. 1988 Dec;45(12):1069-77
references.pmid: 2848472
references.citation: BMC Res Notes. 2010 Sep 08;3:237
references.pmid: 20825681
references.citation: Compr Psychiatry. 2012 Jul;53(5):584-92
references.pmid: 22104556
references.citation: Psychol Assess. 2011 Sep;23(3):752-61
references.pmid: 21534694
references.citation: Int J Methods Psychiatr Res. 2010 Jun;19 Suppl 1:4-22
references.pmid: 20527002
references.citation: Aust N Z J Psychiatry. 2011 Apr;45(4):308-16
references.pmid: 21332432
references.citation: Int J Epidemiol. 2009 Apr;38(2):470-7
references.pmid: 19047078
references.citation: Med J Aust. 2011 Aug 1;195(3):S31-7
references.pmid: 21806516
references.citation: Eur Psychiatry. 2011 Mar;26(2):122-7
references.pmid: 20620023
references.citation: Annu Rev Clin Psychol. 2012;8:131-60
references.pmid: 22149479
references.citation: J Affect Disord. 2006 Feb;90(2-3):123-30
references.pmid: 16337690
references.citation: Aust N Z J Obstet Gynaecol. 2010 Feb;50(1):70-6
references.pmid: 20219001
references.citation: Arch Gen Psychiatry. 2008 Oct;65(10):1205-12
references.pmid: 18838637
references.citation: Soc Sci Med. 2004 Feb;58(4):739-52
references.pmid: 14672590
references.citation: J Nerv Ment Dis. 2009 Sep;197(9):695-9
references.pmid: 19752650
references.citation: Psychol Med. 2002 Aug;32(6):959-76
references.pmid: 12214795