Scale properties of the Kreyòl Distress Idioms (KDI) screener: association of an ethnographically-developed instrument with depression, anxiety, and sociocultural risk factors in rural Haiti
Abstract
Psychiatric instruments have limitations cross-culturally due to variations in conceptualizations and communication of mental distress. We evaluated a locally-developed screening tool for measuring mental distress in rural Haiti. We employed mixed methods to develop the Kreyòl Distress Idioms (KDI) screening tool. We piloted the KDI in an epidemiologic survey (n = 408) and assessed it using principal component analysis and comparison with the Beck Depression Inventory and Beck Anxiety Inventory (BDI, BAI). Linear regression was used to identify risk factors. Principal component analysis extracted four components: (1) lack of control over thoughts and behaviors, (2) worry and rumination, (3) somatic indicators of anxiety, and (4) fatigue and foreshortened future. The KDI correlated with the BAI (r = 0.67) and BDI (r = 0.52). Factors associated with KDI score included female gender, older age, alcohol consumption, traumatic exposures, and having a household member with mental distress. Belief that disasters cause distress was associated with higher KDI scores, whereas belief that interpersonal relationships cause distress was associated with lower scores. Associations with BDI and BAI scores and established predictors of mental distress support convergent and external validity of the KDI. The KDI provides a more ethnographically-valid measure for mental distress in Haiti than culturally-adapted psychiatric instruments.
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Local screening instruments designed with idioms of distress have demonstrated higher specificity and cultural congruence compared to direct translations.
“Local screening instruments, designed with idioms of distress, have demonstrated higher specificity and cultural congruence compared to direct translations, underscoring the importance of developing culturally appropriate assessment tools (Kaiser et al., 2015; Rasmussen et al., 2014).”
From Developing and validating the Sierra Leone perinatal psychological distress scale through an emic-etic approach (2025) · cites this paper as Kaiser et al., 2015
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- Authors
- Kaiser, B. N., Kohrt, B. A., Wagenaar, B. H., Kramer, M. R., McLean, K. E., Hagaman, A. K., Khoury, N. M., & Keys, H. M.
- Affiliations
- Emory University (US)
- Duke University (US)
- University of Washington (US)
- Yale University (US)
- Arizona State University (US)
- Cambridge Health Alliance (US)
- Corresponding author
- Kaiser, Bonnie N
- ORCID
- Venue
- International Journal of Culture and Mental Health
- Publisher
- Informa UK Limited
- Published
- 2015-09-11
- Volume
- 8
- Issue
- 4
- Pages
- 341-358
- ISSN
- 1754-2863 (ISSN-L)
- 1754-2871
- OpenAlex
- W1914378882
- Cited by
- 14
- References
- 76
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 2
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Culture and Mental Health (publishedVersion)
- Funders
- National Science Foundation (0234618,BCS-1260270)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- depression, anxiety, rural Haiti, culturally adapted instruments, sociocultural risk factors, alcohol consumption, trauma exposure, interpersonal relationships, Beck Depression Inventory, Beck Anxiety Inventory, cross-cultural validity
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