title: The importance of establishing reliability and validity of assessment instruments for mental health problems: An example from Somali children and adolescents living in three refugee camps in Ethiopia.
abstract: Assessing mental health problems cross-culturally for children exposed to war and violence presents a number of unique challenges. One of the most important issues is the lack of validated symptom measures to assess these problems. The present study sought to evaluate the psychometric properties of two measures to assess mental health problems: the Achenbach Youth Self-Report and the Child Posttraumatic Stress Disorder Symptom Scale. We conducted a validity study in three refugee camps in Eastern Ethiopia in the outskirts of Jijiga, the capital of the Somali region. A total of 147 child and caregiver pairs were assessed, and scores obtained were submitted to rigorous psychometric evaluation. Excellent internal consistency reliability was obtained for symptom measures for children and their caregivers. Validation of study instruments based on local case definitions was obtained for the caregivers but not consistently for the children. Sensitivity and specificity of study measures were generally low, indicating that these scales would not perform adequately as screening instruments. Combined test-retest and inter-rater reliability was low for all scales. This study illustrates the need for validation and testing of existing measures cross-culturally. Methodological implications for future cross-cultural research studies in low- and middle-income countries are discussed.
authors: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health ; Department of Psychology, The University of Macau.
authors: Brian J
authors: BJ
authors: Hall
authors: Department of Psychology and Neuroscience, Global Health Institute, Duke University.
authors: Eve
authors: E
authors: Puffer
authors: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health.
authors: Laura K
authors: LK
authors: Murray
authors: International Rescue Committee ; Jigjiga University & the Addis Continental Institute of Public Health.
authors: Abdulkadir
authors: A
authors: Ismael
authors: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health.
authors: Judith K
authors: JK
authors: Bass
authors: International Rescue Committee.
authors: Amanda
authors: A
authors: Sim
authors: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health ; Department of International Health, Johns Hopkins Bloomberg School of Public Health.
authors: Paul A
authors: PA
authors: Bolton
keywords: PTSD; adolescents; assessment; children; refugees; reliability; validity