冲突地区的快速心理健康筛查:将简化版修订儿童焦虑抑郁量表(RCADS - 25)翻译成阿拉伯语并进行跨文化调适
Rapid mental health screening in conflict zones: a translation and cross-cultural adaptation into Arabic of the shortened Revised Child Anxiety and Depression Scale (RCADS-25).
作者信息
Perkins Jon D, Alós Julieta
机构信息
PMARC, Edinburgh University, Edinburgh, UK.
Department of English Literature & Linguistics, Qatar University, P.O. Box 2713, Doha, Qatar.
出版信息
Confl Health. 2021 Jul 1;15(1):51. doi: 10.1186/s13031-021-00386-1.
BACKGROUND
During conflict, children and adolescents are at increased risk of mental health problems and in particular, anxiety and depression. However, mental health screening in conflict settings is problematic and carries risk making the need for fast, easy-to-administer, screening instruments paramount. The shortened version of the Revised Child Anxiety and Depression Scale (RCADS-25) is one method of rapidly assessing anxiety and depressive symptoms in youths. This self-report questionnaire demonstrates good internal consistency and diagnostic capacity in clinical and non-clinical populations. Nevertheless, few studies have tested the psychometric properties of translated versions of the RCADS-25 limiting its applicability worldwide.
OBJECTIVES
To expand the reach and utility of the RCADS-25, the present study sought to develop an Arabic version of the instrument (RCADS25-Arabic) and to explore its reliability and underlying factor structure. In light of changes to DSM classification, the effects of removing indicator variables for obsessive-compulsive disorder on the psychometrics of the RCADS25-Arabic were also explored.
METHOD
The scale was back translated into Modern Standard Arabic and administered to 250 Arabic speaking schoolchildren between 8 and 15 years of age in Syria. Mean and standard deviation were used to characterise the sample and summarize scores. The reliability and factor structure of the RCADS25-Arabic was explored using confirmatory factor analysis.
RESULTS
Females were 127 and mean age was 12.11 ± SD 2.35. Males scored lower on anxiety (M 15.05 SD ± 8.0, t(248) = - 3.15, p = .003, d = 0.39) and internalizing factors (M 26.1 SD ± 13.1, t(248) = - 2.36, p = .0160, d = 0.31) with no statistical gender difference recorded for depression (t(248) = - 1.27, p = .202). Fit statistics were good for two- and one-factor solutions (χ/df = 1.65, RMSEA 0.051, CFI .91, TLI .90 and χ/df = 1.64 and RMSEA 0.051, CFI .91 and TLI .89 respectively). DIFFTEST showed no significant difference between models (χ (1) = 0.03, p < 0.86) indicating a one-factor (internalizing) solution was preferable. No improvement in scale integrity was found after deleting obsessive-compulsive disorder items.
CONCLUSION
The RCADS25-Arabic is useful for rapid screening of depression and anxiety but is better used to identify a one-factor internalizing construct. Obsessive-compulsive disorder items should be retained in the RCADS-25.
背景
在冲突期间,儿童和青少年出现心理健康问题的风险增加,尤其是焦虑和抑郁。然而,在冲突环境中进行心理健康筛查存在问题且有风险,这使得对快速、易于实施的筛查工具的需求至关重要。修订版儿童焦虑与抑郁量表简版(RCADS - 25)是快速评估青少年焦虑和抑郁症状的一种方法。这份自陈问卷在临床和非临床人群中显示出良好的内部一致性和诊断能力。然而,很少有研究测试RCADS - 25翻译版本的心理测量特性,限制了其在全球的适用性。
目的
为了扩大RCADS - 25的应用范围和效用,本研究旨在开发该工具的阿拉伯语版本(RCADS25 - 阿拉伯语版),并探索其信度和潜在因素结构。鉴于《精神疾病诊断与统计手册》分类的变化,还探讨了去除强迫症指标变量对RCADS25 - 阿拉伯语版心理测量学的影响。
方法
该量表被回译为现代标准阿拉伯语,并施用于叙利亚250名8至15岁讲阿拉伯语的学童。使用均值和标准差来描述样本特征并汇总得分。采用验证性因素分析探索RCADS25 - 阿拉伯语版的信度和因素结构。
结果
女性有127人,平均年龄为12.11±标准差2.35岁。男性在焦虑(M = 15.05±标准差8.0,t(248) = - 3.15,p = 0.003,d = 0.39)和内化因素(M = 26.1±标准差13.1,t(248) = - 2.36,p = 0.0160,d = 0.31)方面得分较低,抑郁方面未记录到统计学上的性别差异(t(248) = - 1.27,p = 0.202)。二因素和单因素模型的拟合统计良好(χ/df = 1.65,RMSEA = 0.051,CFI = 0.91,TLI = 0.90和χ/df = 1.64,RMSEA = 0.051,CFI = 0.91,TLI = 0.89)。差异检验显示模型间无显著差异(χ(1) = 0.03,p < 0.86),表明单因素(内化)模型更可取。删除强迫症项目后未发现量表完整性有改善。
结论
RCADS25 - 阿拉伯语版可用于快速筛查抑郁和焦虑,但更适合用于识别单因素内化结构。强迫症项目应保留在RCADS - 25中。