"Tension" in South Asian women: Developing a measure of common mental disorder using participatory methods

Alison Karasz, Viraj V. Patel, Mahbhooba Kabita, Parvin Shimu

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Although common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be owing in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. Community-based participatory research (CBPR) is ideally suited to help address measurement issues in CMD as well as to develop culturally appropriate treatment models. Objectives: To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. Methods: We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/ illness, "tension," as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. Results: The 24-item "Tension Scale" had high internal consistency (α = 0.83). On bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the Patient Health Questionnaire (PHQ-2), age, education, self-rated health, having seen a physician in the past year, and other variables. Conclusions: Using participatory techniques, we created a new measure designed to assess CMD in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder.

Original languageEnglish (US)
Pages (from-to)429-441
Number of pages13
JournalProgress in Community Health Partnerships: Research, Education, and Action
Volume7
Issue number4
DOIs
StatePublished - 2013

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mental disorder
Mental Disorders
immigrant
community
mental health
Mental Health
Community-Based Participatory Research
health
psychometrics
Health
diagnostic
Psychometrics
illness
Group
physician
Research Personnel
questionnaire
lack
Depression
Physicians

Keywords

  • Community health partnerships
  • Community-based participatory research
  • Conceptual models of illness
  • Health beliefs
  • Health disparities
  • Illness representations
  • Mental health
  • Mood disorders
  • Process issues

ASJC Scopus subject areas

  • Health(social science)
  • Education
  • Sociology and Political Science

Cite this

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title = "{"}Tension{"} in South Asian women: Developing a measure of common mental disorder using participatory methods",
abstract = "Background: Although common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be owing in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. Community-based participatory research (CBPR) is ideally suited to help address measurement issues in CMD as well as to develop culturally appropriate treatment models. Objectives: To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. Methods: We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/ illness, {"}tension,{"} as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. Results: The 24-item {"}Tension Scale{"} had high internal consistency (α = 0.83). On bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the Patient Health Questionnaire (PHQ-2), age, education, self-rated health, having seen a physician in the past year, and other variables. Conclusions: Using participatory techniques, we created a new measure designed to assess CMD in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder.",
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AU - Shimu, Parvin

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N2 - Background: Although common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be owing in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. Community-based participatory research (CBPR) is ideally suited to help address measurement issues in CMD as well as to develop culturally appropriate treatment models. Objectives: To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. Methods: We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/ illness, "tension," as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. Results: The 24-item "Tension Scale" had high internal consistency (α = 0.83). On bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the Patient Health Questionnaire (PHQ-2), age, education, self-rated health, having seen a physician in the past year, and other variables. Conclusions: Using participatory techniques, we created a new measure designed to assess CMD in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder.

AB - Background: Although common mental disorder (CMD) is highly prevalent among South Asian immigrant women, they rarely seek mental treatment. This may be owing in part to the lack of conceptual synchrony between medical models of mental disorder and the social models of distress common in South Asian communities. Furthermore, common mental health screening and diagnostic measures may not adequately capture distress in this group. Community-based participatory research (CBPR) is ideally suited to help address measurement issues in CMD as well as to develop culturally appropriate treatment models. Objectives: To use participatory methods to identify an appropriate, culturally specific mental health syndrome and develop an instrument to measure this syndrome. Methods: We formed a partnership between researchers, clinicians, and community members. The partnership selected a culturally specific model of emotional distress/ illness, "tension," as a focus for further study. Partners developed a scale to measure Tension and tested the new scale on 162 Bangladeshi immigrant women living in the Bronx. Results: The 24-item "Tension Scale" had high internal consistency (α = 0.83). On bivariate analysis, the scale significantly correlated in the expected direction with depressed as measured by the Patient Health Questionnaire (PHQ-2), age, education, self-rated health, having seen a physician in the past year, and other variables. Conclusions: Using participatory techniques, we created a new measure designed to assess CMD in an isolated immigrant group. The new measure shows excellent psychometric properties and will be helpful in the implementation of a community-based, culturally synchronous intervention for depression. We describe a useful strategy for the rapid development and field testing of culturally appropriate measures of mental distress and disorder.

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