The Cultural Validity of Diagnostic Psychiatric Measures for Indigenous Australians

Black, Emma; Toombs, Maree; Kisely, Steve

doi:10.1111/ap.12335

Cited by 6 publications

(10 citation statements)

References 37 publications

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“…No studies were identified in this review that directly assessed a diagnostic or screening tool for eating disorders among Indigenous Australians. One systematic review aimed to examine the cultural validity of the methods used to diagnose psychiatric disorders among Indigenous Australians, however, it not include any articles directly assessing eating disorders, thus it was not included in this review [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…This tool was designed and validated with multiple Indigenous communities across Australia and is free to use [ 21 ]. However, a systematic review of diagnostic methods for psychiatric disorders in Indigenous Australians did not identify any culturally specific or validated diagnostic or screening tools for eating disorders among Indigenous Australians [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review

et al. 2020

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Background Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have poorer mental health compared to other Australians. Yet, there is a lack of research into mental disorders among this population, especially for eating disorders (ED), which are amongst the most lethal and debilitating mental disorders. Aim We aimed to answer 2 questions: 1. What is the volume and content of literature on ED among Indigenous Australians? 2. Has a screening or diagnostic tool/instrument been developed for the assessment of ED amongst Indigenous Australians? Method We conducted a scoping review of electronic databases (Pubmeb, Embase, PsychInfo, Proquest, Cochrane Library, Indigenous HealtInfoNet and Scopus), for studies addressing ED, body image, muscle dysmorphia, weight and shape concern among Indigenous Australians, as well as diagnostic and screening tools. All relevant studies were reviewed in full by 2 researchers. Narrative synthesis of the data was performed. Results There is limited evidence for ED among Indigenous Australians, however, the evidence available strongly suggests that ED are more common among Indigenous Australians compared to other Australians. Eating disorders among Indigenous Australians are also associated with high levels of overvaluation of weight and shape. The increased risk of ED among Indigenous Australians was largely explained by factors such as poorer psychosocial wellbeing. No evidence was found for the existence of validated diagnostic or screening tools for ED in Indigenous Australians. Conclusion The evidence suggests ED are common among Indigenous Australians, and there are no diagnostic or screening tools available to assist clinicians in assessing them. More research is required in this field, especially towards the development of a validated and culturally specific screening or diagnostic tool for ED among Indigenous Australians.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review

et al. 2020

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“…We completed structured training for site staff, achieved high rates of interview completion, recruited an adequate number of participants with a MINI major depressive episode diagnosis to enable subgroup analyses, and complied with the National Health and Medical Research Council guidelines for Indigenous health research . Ideally, our criterion standard would have been a semi‐structured, culturally valid psychiatric interview, but such a diagnostic assessment is not available . However, the interviews were conducted by local, culturally aware clinicians.…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review of diagnostic psychiatric instruments found that none had been formally validated for Indigenous Australians . To rectify the paucity of Indigenous Australian‐specific depression research, a culturally adapted depression screening tool validated in multiple Australian states and territories is needed.…”

mentioning

confidence: 99%

Getting it Right: validating a culturally specific screening tool for depression ( aPHQ ‐9) in Aboriginal and Torres Strait Islander Australians

Hackett¹,

Teixeira‐Pinto²,

Farnbach³

et al. 2019

Medical Journal of Australia

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Objectives To determine the validity, sensitivity, specificity and acceptability of the culturally adapted nine‐item Patient Health Questionnaire (aPHQ‐9) as a screening tool for depression in Aboriginal and Torres Strait Islander people. Design Prospective observational validation study, 25 March 2015 – 2 November 2016. Setting, participants 500 adults (18 years or older) who identified as Aboriginal or Torres Strait Islander people and attended one of ten primary health care services or service events in urban, rural and remote Australia that predominantly serve Indigenous Australians, and were able to communicate sufficiently to respond to questionnaire and interview questions. Main outcome measures Criterion validity of the aPHQ‐9, with the depression module of the Mini‐International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standard. Results 108 of 500 participants (22%; 95% CI, 18–25%) had a current episode of major depression according to the MINI criterion. The sensitivity of the aPHQ‐9 algorithm for diagnosing a current major depressive episode was 54% (95% CI, 40–68%), its specificity was 91% (95% CI, 88–94%), with a positive predictive value of 64%. For screening for a current major depressive episode, the area under the receiver operator characteristic curve was 0.88 (95% CI, 0.85–0.92); with a cut‐point of 10 points its sensitivity was 84% (95% CI, 74–91%) and its specificity 77% (95% CI, 71–83%). The aPHQ‐9 was deemed acceptable by more than 80% of participants. Conclusions Indigenous Australians found the aPHQ‐9 acceptable as a screening tool for depression. Applying a cut‐point of 10 points, the performance characteristics of the aPHQ were good.

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“…Originally developed and validated with a sample of postnatal women in Scotland, the use of EPDS has gained widespread acceptance and extensive use over the ensuing 30 years evidenced by its ubiquitous translation and validation (Alvarado et al 2015;Cox et al 2014;Department of Health, Government of Western Australia 2006;Hewitt et al 2010;Joshi et al 2020;Rhee et al 2018;Shrestha et al 2016). However, in recent years, there has been emerging discussion around the limitations of the EPDS, including questioning of the cultural suitability and validity when applied in Indigenous or cross-cultural contexts (Black et al 2018;Gausia et al 2013;Geia et al 2013;State of Queensland 2014). A recent systematic review reported a lack of research investigating the effectiveness of the standard EPDS with Indigenous Australian women, providing neither psychometric properties nor qualitative validation of the standard EPDS (Kotz et al 2020).…”

Section: Introductionmentioning

confidence: 99%

A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective

Chan

Reid

Skeffington

et al. 2020

Arch Womens Ment Health

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The Edinburgh Postnatal Depression Scale (EPDS) is used extensively as the “gold standard” perinatal depression and anxiety screening tool. This study contributes to an emerging discussion about the tool’s shortcomings, specifically around cultural suitability for use with Indigenous women. A systematic search was conducted in ProQuest, PsycINFO, MEDLINE (Web of Science), PubMed, Scopus, Informit, and CINAHL research databases, and grey literature. The quality of the body of evidence was assessed using the NHMRC Level of Evidence framework. Three studies supported the cultural validation of the EPDS with Indigenous groups in Canada (n = 2) and the USA (n = 1). The remaining eleven Australian studies demonstrated that cultural concerns were suggested by either Indigenous mothers, healthcare professionals (Indigenous and non-Indigenous), or both, though cultural concerns were more weighted from the perspectives of healthcare professionals. The quality of the evidence was not strong, and thus, there is a critical and urgent need for targeted research in this area. This review identified and recommended Indigenous-specific methodologies that can be adopted for more trustworthy, culturally safe, and effective research in this area. Given that the EPDS is currently considered gold standard in routine perinatal mental health screening practice in countries around the world, these findings raise significant concerns. Using culturally relevant research methodologies, such as the use of mixed-methods design, could lay stronger groundwork for further investigation of the broader utility and cultural relevance of the tool.

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The Cultural Validity of Diagnostic Psychiatric Measures for Indigenous Australians

Cited by 6 publications

References 37 publications

Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review

Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review

Getting it Right: validating a culturally specific screening tool for depression ( aPHQ ‐9) in Aboriginal and Torres Strait Islander Australians

A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective

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