Initial Development of a New Culture-Specific Screen for Emotional Distress in Oldercaribbean People

Abstract

Previous research and our own observations suggested that older Caribbean people might use terms for emotional distress that differed from those found in standard screening instruments. Using a combination of qualitative approaches derived from the ‘new cross‐cultural psychiatry’, we have developed a new 13‐item culture‐specific screen containing items which both overlap and differ from those found in, for example, the Geriatric Depression Scale. Further research is in progress to test the validity of this screen in a large community sample.

Culturally Appropriate Instrument: A Systematic Literature Review

“…Most of the new tools reported in the articles were developed for adults, followed by adolescents and youth (66.67% and 18.18%, respectively). Three screening tools were developed for older people, including older Caribbean populations (Abas et al, 1996), older…”

“…Different symptoms were identified among older Caribbean residents in London, UK (Abas et al, 1996), Acholi youth in Northern Uganda (Betancourt et al, 2009), and Vietnamese (Kinzie et al, 1982). Depression was also presented in a social context, including among Pakistanis in Peshawar and Lahore (Mumford et al, 2005), Singaporean Chinese children (Koh et al, 2007), and Asian adolescents in Singapore (Woo et al, 2004).…”

Psychiatry of old age and ethnic minority older people in the United Kingdom

“…118 All three instruments showed satisfactory sensitivity and specificity in detecting depression in older Jamaicans with little difference between the three scales. The CCSS was developed 'a priori' by ascertaining terminology used to describe emotional distress, 119 because older African Caribbeans rarely use the terms 'sad' or 'unhappy' to describe emotional distress, but they use other terms including 'being low spirited', 'fed up' and 'weighed down'. 117,119,120 In general, lower cutoff scores have been suggested on some scales like the GDS for African Caribbean older people in the UK.…”

“…The CCSS was developed 'a priori' by ascertaining terminology used to describe emotional distress, 119 because older African Caribbeans rarely use the terms 'sad' or 'unhappy' to describe emotional distress, but they use other terms including 'being low spirited', 'fed up' and 'weighed down'. 117,119,120 In general, lower cutoff scores have been suggested on some scales like the GDS for African Caribbean older people in the UK. 117 The Symptoms of Anxiety and Depression Scale 121 was used as a diagnostic instrument for depression in Gujarati, Somali and Bengali older people in London, 28,31 but data on its psychometric properties are not available.…”

Can the recognition of clinical features of mental illness at clinical presentation in ethnic elders be improved?

“…Emotional disorders, including depression, may present with different clinical features in the elderly from different ethnic minority groups in the UK (Abas, 1996;Abas et al, 1996Abas et al, , 1998Lindesay, 1998;Shah, 1999;Livingston and Sembhi, 2003). Emotional expression in different cultures can be influenced by several overlapping concepts: the context of disclosure, available vocabulary and language of emotional expression, selective expression of emotions and definition of self (Lindesay, 1998).…”