The present mixed methods study developed a comprehensive measure and a screening scale of depression for Chinese American immigrants by combining an emic approach with item response analysis. Clinical participants were immigrants diagnosed by licensed clinicians who worked in the community. Qualitative interviews with clinicians and clinical participants (N = 63) supported the definition of the construct of depression—which guided scale development—and a 47-item pilot scale. Clinical and community participants (N = 227) completed the pilot scale and measures of neurasthenia and acculturative stress, and the Patient Health Questionnaire Depression Module (PHQ-9). A Rasch Partial Credit Model of 42-items—representing psychological, somatic and interpersonal domains of distress—best fit the data. Twenty-three items overlapped with the DSM-IV symptoms of major depression. Twenty-seven items were biased by acculturation-related variables. Nine items appropriate for self-report screening in primary care and community organizations were chosen to form a brief scale. Both measures showed strong reliability and concurrent and convergent validity. The 9-item scale had better content validity than the PHQ-9. Implications regarding the impact of culture for assessment are highlighted.

Can non-clinicians spot preschoolers likely to have autism spectrum disorder by observing their everyday peer interaction? We set out to develop a screening tool that capitalizes on peer interaction as a naturalistic “stress test” to identify children more likely than their peers to have autism spectrum disorder. A total of 304 3- to 4-year-olds were observed at school with an 84-item preliminary checklist; data-driven item reduction yielded a 13-item Classroom Observation Scale. The Classroom Observation Scale scores correlated significantly with Autism Diagnostic Observation Schedule–2 scores. To validate the scale, another 322 2- to 4-year-olds were screened using the Classroom Observation Scale. The screen-positive children and randomly selected typically developing peers were assessed for autism spectrum disorder 1.5 years later. The Classroom Observation Scale as used by teachers and researchers near preschool onset predicted autism spectrum disorder diagnoses 1.5 years later (odds ratios = 14.6 and 6.7, respectively). This user-friendly 13-item Classroom Observation Scale enables teachers and healthcare workers with little or no clinical training to identify, with reliable and valid results, preschoolers more likely than their peers to have autism spectrum disorder. Lay abstract With professional training and regular opportunities to observe children interacting with their peers, preschool teachers are in a good position to notice children’s autism spectrum disorder symptomatology. Yet even when a preschool teacher suspects that a child may have autism spectrum disorder, fear of false alarm may hold the teacher back from alerting the parents, let alone suggesting them to consider clinical assessment for the child. A valid and convenient screening tool can help preschool teachers make more informed and hence more confident judgment. We set out to develop a screening tool that capitalizes on peer interaction as a naturalistic “stress test” to identify children more likely than their peers to have autism spectrum disorder. A total of 304 3- to 4-year-olds were observed at school with an 84-item preliminary checklist; data-driven item reduction yielded a 13-item Classroom Observation Scale. The Classroom Observation Scale scores correlated significantly with Autism Diagnostic Observation Schedule–2 scores. To validate the scale, another 322 2- to 4-year-olds were screened using the Classroom Observation Scale. The screen-positive children and randomly selected typically developing peers were assessed for autism spectrum disorder 1.5 years later. The Classroom Observation Scale as used by teachers and researchers near preschool onset predicted autism spectrum disorder diagnoses 1.5 years later. This user-friendly 13-item Classroom Observation Scale enables teachers and healthcare workers with little or no clinical training to identify, with reliable and valid results, preschoolers more likely than their peers to have autism spectrum disorder.

This study examined the epidemiology of trauma exposure (TE) and posttraumatic stress disorder (PTSD) among community‐dwelling Chinese adults in Hong Kong. Multistage stratification sampling design was used, and 5,377 participants were included. In Phase 1, TE, probable PTSD (p‐PTSD), and psychiatric comorbid conditions were examined. In Phase 2, the Structured Clinical Interview for the DSM‐IV (SCID‐I) was used to determine the weighted diagnostic prevalence of lifetime full PTSD. Disability level and health service utilization were studied. The findings showed that the weighted prevalence of TE was 64.8%, and increased to 88.7% when indirect TE types were included, with transportation accidents (50.8%) reported as the most common TE. The prevalence of current p‐PTSD among participants with TE was 2.9%. Results of logistic regression suggested that nine specific trauma types were significantly associated with p‐PTSD; among this group, severe human suffering, sexual assault, unwanted or uncomfortable sexual experience, captivity, and sudden and violent death carried the greatest risks for developing PTSD, odds ratio (OR) = 2.32–2.69. The occurrence of p‐PTSD was associated with more mental health burdens, including (a) sixfold higher rates for any past‐week common mental disorder, OR = 28.4, (b) more mental health service utilization, p < .001, (c) poorer mental health indexes in level of symptomatology, suicide ideation and functioning, p < .001, and (d) more disability, ps < .001–p = .014. The associations found among TE, PTSD, and health service utilization suggest that both TE and PTSD should be considered public health concerns.

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