title: Development process of an assessment tool for disruptive behavior problems in cross-cultural settings: the Disruptive Behavior International Scale - Nepal version (DBIS-N).
abstract: Systematic processes are needed to develop valid measurement instruments for disruptive behavior disorders (DBDs) in cross-cultural settings. We employed a four-step process in Nepal to identify and select items for a culturally valid assessment instrument: 1) We extracted items from validated scales and local free-list interviews. 2) Parents, teachers, and peers (n=30) rated the perceived relevance and importance of behavior problems. 3) Highly rated items were piloted with children (n=60) in Nepal. 4) We evaluated internal consistency of the final scale. We identified 49 symptoms from 11 scales, and 39 behavior problems from free-list interviews (n=72). After dropping items for low ratings of relevance and severity and for poor item-test correlation, low frequency, and/or poor acceptability in pilot testing, 16 items remained for the Disruptive Behavior International Scale-Nepali version (DBIS-N). The final scale had good internal consistency (α=0.86). A 4-step systematic approach to scale development including local participation yielded an internally consistent scale that included culturally relevant behavior problems.
authors.affiliation: Johns Hopkins University School of Public Health, Department of Health, Behavior, and Society, 624 N. Broadway, Baltimore, MD 21205, USA. Tel 250-392-4481.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Burkey
authors.affiliation: Transcultural Psychosocial Organization (TPO) Nepal, PO Box 8974, Baluwatar, Kathmandu, Nepal. Tel +977-01-4431717.
authors.forename: Lajina
authors.initials: L
authors.lastname: Ghimire
authors.affiliation: Transcultural Psychosocial Organization (TPO) Nepal, PO Box 8974, Baluwatar, Kathmandu, Nepal. Tel +977-01-4431717.
authors.forename: Ramesh P
authors.initials: RP
authors.lastname: Adhikari
authors.affiliation: Duke University, Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, 213 Trent Hall, 310 Trent Drive, Duke Box #90519, Durham, NC 27008, USA. Tel (919) 681-7516.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Kohrt
authors.affiliation: War Child, Helmholtzstraat 61-G, 1098 LE Amsterdam, Amsterdam, Netherlands. Tel +31-20-422-7777.
authors.forename: Mark J D
authors.initials: MJ
authors.lastname: Jordans
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N. Broadway, Baltimore, MD 21205, USA. Tel 410-955-3910.
authors.forename: Emily
authors.initials: E
authors.lastname: Haroz
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N. Broadway, Baltimore, MD 21205, USA. Tel 410-614-1243.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Wissow
keywords: Conduct Disorder; Disruptive Behavior Disorders; Low-income countries; Nepal; Oppositional Defiant Disorder; Scale; Validation