Gudyanga Denford, Nyamayaro Primrose, Frandsen Summer, Easter Rebecca, Derveeuw Sarah, Thibaut Pauline, Dillahunt Alina, O'Cleirigh Conall, Rubin Leah, Langenecker Scott A, Abas Melanie
Department of Mental Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Ohio State University, Columbus, United States.
S Afr J Psychiatr. 2025 May 28;31:2434. doi: 10.4102/sajpsychiatry.v31i0.2434. eCollection 2025.
In African countries, including Zimbabwe, about half of those with depression respond to first-line therapies like problem-solving therapy. Predicting who needs more intensive treatment is challenging. In the US and Europe, tools like the Facial Emotion Perception Test (FEPT) help match treatments to likely responders. However, its applicability in Zimbabwe is unexplored.
To develop a racially diverse adaptation of the FEPT for Shona-speaking Zimbabweans.
Outpatient primary healthcare clinics at Marondera Provincial Hospital and Chitungwiza Central Hospital, Zimbabwe.
Facial Emotion Perception Test was adapted using the Ecological Validity Model's eight constructs through a four-step process: expert consultation, preliminary content adaptation, iterative content adaptation, and finalising adaptation. Three focus groups and 12 cognitive interviews assessed cultural appropriateness, suitability, usability and acceptability of FEPT for Zimbabwean Shona speakers. Fifteen participants, including graduates, primary healthcare workers and individuals with lived experience of depression, took part.
Key adaptations of FEPT-Multiple-Races (MR)-Shona include: (1) added 20 black and 20 Asian face stimuli for cultural relevance; (2) improved stimuli resolution for clarity; (3) extended test duration from 6 to 10 minutes for repeatable tutorials; (4) provided bilingual instructions in Shona and English; (5) shifted to a low-cost touchscreen tablet, familiar to Zimbabwean participants.
The adaptation shows promising cultural relevance and usability for Shona speakers. Further testing with diverse educational and contextual backgrounds is needed to enhance cross-cultural and ecological validity.
This study highlights the importance of culturally adapting cognitive performance tools that can potentially improve depression treatment outcomes in low-income countries.
在包括津巴布韦在内的非洲国家，约一半抑郁症患者对解决问题疗法等一线治疗有反应。预测谁需要更强化的治疗具有挑战性。在美国和欧洲，面部情绪感知测试（FEPT）等工具有助于使治疗与可能的反应者相匹配。然而，其在津巴布韦的适用性尚未得到探索。
为讲绍纳语的津巴布韦人开发一种种族多样化的FEPT改编版。
津巴布韦马龙德拉省医院和奇通圭扎中心医院的门诊初级保健诊所。
通过四个步骤，利用生态效度模型的八个构建要素对面部情绪感知测试进行改编：专家咨询、初步内容改编、迭代内容改编和最终确定改编。三个焦点小组和12次认知访谈评估了FEPT对讲绍纳语的津巴布韦人的文化适宜性、适用性、可用性和可接受性。包括毕业生、初级保健工作者和有抑郁症生活经历的个人在内的15名参与者参加了此次研究。
FEPT-多种族（MR）-绍纳语版的主要改编包括：（1）增加20张黑人面孔和20张亚洲面孔刺激图片以增强文化相关性；（2）提高刺激图片的分辨率以使其更清晰；（3）将测试时间从6分钟延长至10分钟以便进行可重复的教程讲解；（4）提供绍纳语和英语双语指导语；（5）改用津巴布韦参与者熟悉的低成本触摸屏平板电脑。
该改编版显示出对讲绍纳语者有良好的文化相关性和可用性。需要在不同教育和背景下进行进一步测试，以提高跨文化和生态效度。
本研究强调了对认知表现工具进行文化改编的重要性，这可能会改善低收入国家的抑郁症治疗效果。
