Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria
Open accessAbstract
Background: The Boko Haram insurgency has brought turmoil and instability to Nigeria, generating a large number of internally displaced people and adding to the country's 17.5 million orphans and vulnerable children. Recently, steps have been taken to improve the mental healthcare infrastructure in Nigeria, including revamping national policies and initiating training of primary care providers in mental healthcare. In order for these efforts to succeed, they require means for community-based detection and linkage to care. A major gap preventing such efforts is the shortage of culturally appropriate, valid screening tools for identifying emotional and behavioral disorders among adolescents. In particular, studies have not conducted simultaneous validation of screening tools in multiple languages, to support screening and detection efforts in linguistically diverse populations. We aim to culturally adapt screening tools for emotional and behavioral disorders for use among adolescents in Nigeria, in order to facilitate future validation studies. Methods: We used a rigorous mixed-method process to culturally adapt the Depression Self Rating Scale, Child PTSD Symptom Scale, and Disruptive Behavior Disorders Rating Scale. We employed expert translations, focus group discussions (N= 24), and piloting with cognitive interviewing (N= 24) to achieve semantic, content, technical, and criterion equivalence of screening tool items. Results: We identified and adapted items that were conceptually difficult for adolescents to understand, conceptually non-equivalent across languages, considered unacceptable to discuss, or stigmatizing. Findings regarding problematic items largely align with existing literature regarding cross-cultural adaptation. Conclusions: Culturally adapting screening tools represents a vital first step toward improving community case detection.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Preschool-onset depression can display a persistent course through late adolescence, with multiple negative outcomes.
“Depression among preschool children has been recognized only recently; and, although less common than at other ages, preschool-onset depression can display a persistent course through late adolescence, with multiple negative outcomes. 91”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [91]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997) · Psychological Assessment · doi:10.1037/1040-3590.9.4.445 · Cited by 2,709 · see citing works
The Developmental Niche: A Conceptualization at the Interface of Child and Culture
Super, C. M., & Harkness, S. (1986) · International Journal of Behavioral Development · doi:10.1177/016502548600900409 · Cited by 1,523 · see citing works
Teacher Ratings of DSM-III-R Symptoms for the Disruptive Behavior Disorders
Pelham, W. E., Gnagy, E. M., Greenslade, K. E., & Milich, R. S. (1992) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199203000-00006 · Cited by 1,294 · see citing works
The Child PTSD Symptom Scale: A Preliminary Examination of its Psychometric Properties
Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. H. (2001) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3003_9 · Cited by 1,103 · see citing works
Birleson, P. (1981) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1981.tb00533.x · Cited by 859 · see citing works
Adewuya, A. O., Ola, B. A., & Afolabi, O. O. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.05.021 · Cited by 474 · see citing works
Nichter, M. (2010) · Culture Medicine and Psychiatry · doi:10.1007/s11013-010-9179-6 · Cited by 389 · see citing works
Toward an Empirical Definition of Pediatric PTSD: The Phenomenology of PTSD Symptoms in Youth
Carrión, V. G., Weems, C. F., Ray, R. D., & Reiss, A. L. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200202000-00010 · Cited by 362 · see citing works
Ali, G.-C., Ryan, G., & De Silva, M. J. (2016) · PLOS ONE · doi:10.1371/journal.pone.0156939 · Cited by 358 · see citing works
Kohrt, B. A., Rasmussen, A., Kaiser, B. N., Haroz, E. E., Maharjan, S. M., Mutamba, B. B., de Jong, J. T., & Hinton, D. E. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyt227 · Cited by 355 · see citing works
Self-citationvan Ommeren, M., Sharma, B., Thapa, S. B., Makaju, R., Prasain, D., Bhattarai, R., & de Jong, J. T. V. M. (1999) · Transcultural Psychiatry · doi:10.1177/136346159903600304 · Cited by 338 · see citing works
“Thinking too much”: a systematic review of a common idiom of distress
Kaiser, B. N., Haroz, E. E., Kohrt, B. A., Bolton, P. A., Bass, J. K., & Hinton, D. E. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.10.044 · Cited by 287 · see citing works
Self-citationPrevalence of Child Mental Health Problems in Sub-Saharan Africa
Cortina, M. A. (2012) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2011.592 · Cited by 282 · see citing works
Hanlon, C., Medhin, G., Alem, A., Araya, M., Abdulahi, A., Hughes, M., Tesfaye, M., Wondimagegn, D., Patel, V., & Prince, M. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.10.023 · Cited by 278 · see citing works
Violence, suffering, and mental health in Afghanistan: a school-based survey
Panter‐Brick, C., Eggerman, M., Gonzalez, V., & Safdar, S. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61080-1 · Cited by 263 · see citing works
Kohrt, B. A., Luitel, N. P., Acharya, P., & Jordans, M. J. D. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0768-y · Cited by 239 · see citing works
Self-citationMiller, K. E., Omidian, P. A., Quraishy, A. S., Quraishy, N., Nasiry, M. N., Nasiry, S., Karyar, N. M., & Yaqubi, A. A. (2006) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.76.4.423 · Cited by 226 · see citing works
Dyregrov, A., & Yule, W. (2006) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2005.00384.x · Cited by 217 · see citing works
Kohrt, B. A., Jordans, M. J., Tol, W. A., Luitel, N. P., Maharjan, S. M., & Upadhaya, N. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-127 · Cited by 213 · see citing works
Self-citationGureje, O., Abdulmalik, J., Kola, L., Musa, E., Yasamy, M. T., & Adebayo, K. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0911-3 · Cited by 188 · cited 2× · see citing works
“In line with World Health Organization (WHO) recommendations, Nigeria’s 2013 National Mental Health Policy recommends task-shifting mental healthcare to non-specialist providers in primary care settings (Gureje et al., 2015).”
BackgroundKar, N., Mohapatra, P. K., Nayak, K. C., Pattanaik, P., Swain, S. P., & Kar, H. C. (2007) · BMC Psychiatry · doi:10.1186/1471-244x-7-8 · Cited by 181 · see citing works
Ventevogel, P., De Vries, G., Scholte, W. F., Shinwari, N. R., Faiz, H., Nassery, R., van den Brink, W., & Olff, M. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0161-8 · Cited by 179 · see citing works
The comparative validity of screening scales for postnatal common mental disorder in Kintampo, Ghana
Weobong, B., Akpalu, B., Doku, V. C. K., Owusu‐Agyei, S., Hurt, L. S., Kirkwood, B. R., & Prince, M. J. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.05.009 · Cited by 154 · see citing works
Kaiser, B. N., Kohrt, B. A., Keys, H. M., Khoury, N. M., & Brewster, A.-R. T. (2013) · Transcultural Psychiatry · doi:10.1177/1363461513502697 · Cited by 123 · see citing works
Self-citationAllden, K., JONES, L. M., Weissbecker, I., Wessells, M., Bolton, P. A., Betancourt, T. S., Hijazi, Z., Galappatti, A., Yamout, R., Patel, P., et al. (2009) · Prehospital and Disaster Medicine · doi:10.1017/s1049023x00021622 · Cited by 97 · see citing works
Parental HIV/AIDS status and death, and children's psychological wellbeing
Doku, P. N. (2009) · International Journal of Mental Health Systems · doi:10.1186/1752-4458-3-26 · Cited by 81 · see citing works
Development and validation of a Haitian Creole screening instrument for depression
Rasmussen, A., Eustache, E., Raviola, G. J., Kaiser, B. N., Grelotti, D. J., & Belkin, G. S. (2014) · Transcultural Psychiatry · doi:10.1177/1363461514543546 · Cited by 76 · see citing works
Self-citationA study of mental morbidity among primary care patients in Nigeria
Abiodun, O. A. (1993) · Comprehensive Psychiatry · doi:10.1016/0010-440x(93)90030-8 · Cited by 70 · see citing works
Adeosun, I. I., Adegbohun, A. A., Adewumi, T. A., & Jeje, O. O. (2013) · Schizophrenia Research and Treatment · doi:10.1155/2013/769161 · Cited by 66 · see citing works
Screening for depression: the global mental health context
Reynolds, C. F., & Patel, V. (2017) · World Psychiatry · doi:10.1002/wps.20459 · Cited by 57 · see citing works
Denda, K., Kako, Y., Kitagawa, N., & Koyama, T. (2006) · The International Journal of Psychiatry in Medicine · doi:10.2190/3ycx-h0mt-49dk-c61q · Cited by 56 · see citing works
Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement
Abdulmalik, J. O., Kola, L., & Gureje, O. (2016) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2016.2 · Cited by 56 · see citing works
Developing and Testing Locally Derived Mental Health Scales
Weaver, L. J., & Kaiser, B. N. (2014) · Field Methods · doi:10.1177/1525822x14547191 · Cited by 52 · see citing works
Self-citationHaroz, E. E., Bass, J., Lee, C., Oo, S., Lin, K., Kohrt, B. A., Michalopolous, L., Nguyen, A. J., & Bolton, P. A. (2017) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2017.16 · Cited by 50 · see citing works
Self-citationIvarsson, T., Lidberg, A., & Gillberg, C. (1994) · Journal of Affective Disorders · doi:10.1016/0165-0327(94)90069-8 · Cited by 48 · see citing works
Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia
Murray, L. K., Bass, J., Chomba, E., Imasiku, M. L., Thea, D. M., Semrau, K. E. A., Cohen, J. A., Lam, C., & Bolton, P. A. (2011) · International Journal of Mental Health Systems · doi:10.1186/1752-4458-5-24 · Cited by 45 · see citing works
Iheanacho, T., Obiefune, M. C., Ezeanolue, C. O., Ogedegbe, G. G., Nwanyanwu, O. C., Ehiri, J. E., OHAERI, J. U., & Ezeanolue, E. E. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0952-7 · Cited by 42 · see citing works
Cross-cultural child and adolescent psychiatry research in developing countries
Atilola, O. (2015) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2015.8 · Cited by 41 · see citing works
Adewuya, A. O., Coker, O., Atilola, O., Ola, B. A., Zachariah, M. P., Adewumi, T. A., Olugbile, O. B., Fasawe, A. A., & Idris, O. (2018) · Archives of Women s Mental Health · doi:10.1007/s00737-018-0839-9 · Cited by 38 · see citing works
Kumar, M. (2015) · Journal of Pregnancy and Child Health · doi:10.4172/2376-127x.1000134 · Cited by 37 · see citing works
Fabian, K., Fannoh, J., Washington, G. G., Geninyan, W. B., Nyachienga, B., Cyrus, G., Hallowanger, J. N., Beste, J., Rao, D., & Wagenaar, B. H. (2018) · Culture Medicine and Psychiatry · doi:10.1007/s11013-018-9581-z · Cited by 35 · see citing works
Validation of mental health screening instruments in the Kashmir Valley, India
Housen, T., Lenglet, A., Ariti, C. A., Ara, S., Shah, S., Dar, M. M., Hussain, A., Paul, A., Wagay, Z. A., Viney, K. A., et al. (2018) · Transcultural Psychiatry · doi:10.1177/1363461518764487 · Cited by 31 · see citing works
Ventevogel, P., Komproe, I. H., Jordans, M. J. D., Feo, P., & de Jong, J. T. V. M. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-36 · Cited by 28 · see citing works
Ogunsemi, O., Oluwole, F., Abasiubong, F., Erinfolami, A. R., Amoran, O., Ariba, A., Alebiosu, C. O., & Olatawura, M. O. (2010) · Mental Illness · doi:10.4081/mi.2010.e10 · Cited by 28 · see citing works
Omigbodun, O. O., Gureje, O., Ikuesan, B. A., et al. (1996) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/bf00785766 · Cited by 22 · see citing works
Validation of a Mental Health Assessment in an African Conflict Population
Ertl, V., Pfeiffer, A., Saile, R., Schauer, E., Elbert, T. R., & Neuner, F. (2011) · International Perspectives in Psychology · doi:10.1037/2157-3883.1.s.19 · Cited by 22 · see citing works
Amoran, O., Ogunsemi, O., & Vo, L. (2012) · Journal of Neurosciences in Rural Practice · doi:10.4103/0976-3147.91922 · Cited by 21 · see citing works
Reconsidering Somatic Presentation of Generalized Anxiety Disorder in Nepal
Kohrt, B. A., Tol, W. A., & Harper, I. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318064e7eb · Cited by 20 · see citing works
Self-citationDoes Acquiescence Affect Individual Items Consistently?
Kam, C. C. S., & Zhou, M. (2014) · Educational and Psychological Measurement · doi:10.1177/0013164414560817 · Cited by 18 · see citing works
State of the Nigerian child – neglect of child and adolescent mental health: a review
Atilola, O., Ayinde, O. O., Emedoh, C. T., & Oladimeji, O. (2014) · Paediatrics and International Child Health · doi:10.1179/2046905514y.0000000137 · Cited by 14 · see citing works
Atilola, O., Ola, B. A., & Abiri, G. (2016) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2016.25 · Cited by 13 · see citing works
Adeniyi, Y. E., & Omigbodun, O. O. (2017) · International Neuropsychiatric Disease Journal · doi:10.9734/indj/2017/37760 · Cited by 11 · see citing works
Atilola, O. (2012) · African Journal for the Psychological Study of Social Issues · Cited by 10 · see citing works
Mazzuca, A., Nagarchi, D., Ramanaik, S., Raghavendra, T., Javalkar, P., Rotti, S., Bhattacharjee, P., Isac, S. K., Cohen, A., & Beattie, T. (2018) · Transcultural Psychiatry · doi:10.1177/1363461518789540 · Cited by 10 · see citing works
Burkey, M. D., Ghimire, L., Adhikari, R. P., Kohrt, B. A., Jordans, M. J. D., Haroz, E. E., & Wissow, L. S. (2016) · International Journal of Culture and Mental Health · doi:10.1080/17542863.2016.1226372 · Cited by 9 · see citing works
Self-citationTunde-Ayinmode, M., Ayinmode, B. A., Adegunloye, O. A., et al. (2012) · Annals of African Medicine · doi:10.4103/1596-3519.102849 · Cited by 5 · see citing works
Omigbodun, O. O., & Gureje, O. (2004) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v10i1.118 · Cited by 3 · see citing works
Olagundoye, O., Igundunasse, A. T., & Alugo, M. (2018) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2017-0134 · Cited by 3 · see citing works
13th National Congress of the South African Society of Psychiatrists, 20-23 September 2004
Allers, E., Allgulander, C., Baumann, S. E., et al. (2004) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v10i3.150 · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Time for united action on depression: a Lancet–World Psychiatric Association Commission
Herrman, H., Patel, V., Kieling, C., Berk, M., Buchweitz, C., Cuijpers, P., Furukawa, T. A., Kessler, R. C., Kohrt, B. A., Maj, M., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02141-3 · Cited by 1,104 · see citing works
Self-citationKaiser, B. N., & Jo Weaver, L. (2019) · Transcultural Psychiatry · doi:10.1177/1363461519862708 · Cited by 120 · see citing works
Self-citationBah, A. J., Wurie, H. R., Samai, M., Horn, R., & Ager, A. (2025) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2024.100852 · Cited by 7 · see citing works
- Authors
- Kaiser, B. N., Ticao, C., Anoje, C., Minto, J., Boglosa, J., & Kohrt, B. A.
- Affiliations
- Duke University (US)
- Catholic Relief Services (US)
- George Washington University (US)
- Corresponding author
- Kaiser, B. N.
- Ticao, C.
- Venue
- Global Mental Health
- Publisher
- Cambridge University Press (CUP)
- Published
- 2019
- Volume
- 6
- Pages
- e10-e10
- ISSN
- 2054-4251 (ISSN-L)
- PMC
- PMC6582460
- OpenAlex
- W2949045471
- Cited by
- 69
- References
- 59
- Citations by year
- 2026: 11 · 2025: 4 · 2024: 4 · 2023: 21 · 2022: 15 · 2021: 7 · 2020: 4 · 2019: 3
- FWCI
- 9.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Cambridge Prisms Global Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- United States Agency for International Development (AID620A1300003)
- U.S. President’s Emergency Plan for AIDS Relief
- Catholic Relief Services
- National Institutes of Health
- National Institute of Mental Health (F32MH113288, K01MH104310, R21MH111280)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Education › Health Education and Validation
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- cross-cultural adaptation, mental health screening tools, adolescents, emotional and behavioral disorders, Boko Haram insurgency, conflict-affected populations, internally displaced persons, orphans and vulnerable children, semantic equivalence, content validity, criterion validity, Nigeria
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
