Müller Matthias J, Zink Sabrina, Koch Eckhardt
Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, Licher Straße 106, 35394, Giessen, Germany.
Faculty of Medicine, University of Giessen, Giessen, Germany.
Psychiatr Q. 2017 Sep;88(3):473-483. doi: 10.1007/s11126-016-9461-z.
Assessment of stressors related to migration and acculturation in patients with psychiatric disorder and migration background could help improve culturally sensitive concepts of psychiatry and psychotherapy for diagnosis and treatment. The present overview delineates development and psychometric properties of an instrument (MIGSTR10) for assessment of stressors related to migration and acculturation, particularly for application in patients with psychiatric disorders. Ten migration-related stressors were derived from a qualitative content analysis of case histories of patients with psychiatric disorder and migration background and put into a suitable interview and questionnaire format (MIGSTR10; 10 questions, answer format: categorical yes/no, and dimensional 0-10) for self-assessment and observer ratings in several languages. Reliability (interrater agreement, internal consistency) and dimensionality (multi-dimensional scaling, MDS) were investigated in n = 235 patients with migration background and n = 612 indigenous German patients. Interrater agreement (ICC) for MIGSTR10 single items and sum scores (categorical and dimensional) was sufficiently high (≥.58); internal consistency (Cronbach's α) reached medium to high values (.56-.73). MDS revealed a two-dimensional solution with two item clusters (A: communication, migration history, forced marriage, homesickness, discrimination, other stressors; B: family conflicts, loss of status, feelings of shame, guilt feelings). The MIGSTR10 is a rationally developed, straightforward 10-item screening instrument with satisfactory psychometric properties for the assessment of individual and specific stressors related to migration and acculturation.
评估有精神疾病和移民背景患者中与移民及文化适应相关的应激源，有助于改进精神病学和心理治疗中对文化敏感的诊断和治疗概念。本综述阐述了一种用于评估与移民和文化适应相关应激源的工具（MIGSTR10）的开发过程和心理测量特性，该工具尤其适用于有精神疾病的患者。通过对有精神疾病和移民背景患者病史的定性内容分析，得出了10个与移民相关的应激源，并将其整理成合适的访谈和问卷形式（MIGSTR10；10个问题，答案格式：分类的是/否，以及0 - 10维度），用于多种语言的自我评估和观察者评分。在235名有移民背景的患者和612名德国本土患者中研究了信度（评分者间一致性、内部一致性）和维度（多维标度法，MDS）。MIGSTR10单个项目及总分（分类和维度）的评分者间一致性（ICC）足够高（≥.58）；内部一致性（克朗巴哈α系数）达到中到高值（.56 -.73）。MDS揭示了一个二维解决方案，有两个项目集群（A：沟通、移民史、强迫婚姻、思乡、歧视、其他应激源；B：家庭冲突、地位丧失、羞耻感、内疚感）。MIGSTR10是一种经过合理开发、简单直接的10项筛查工具，在评估与移民和文化适应相关的个体及特定应激源方面具有令人满意的心理测量特性。
