WHO CROSS-CULTURAL APPLICABILITY RESEARCH ON DIAGNOSIS AND ASSESSMENTOF SUBSTANCE USE DISORDERS - AN OVERVIEW OF METHODS AND SELECTED RESULTS

The cross-cultural applicability of criteria for the diagnosis of subs tance use disorders and of instruments used for their assessment were studied in nine cultures. The qualitative and quantitative methods use d in the study are described. Equivalents for English terms and concep ts were found for all instrument items, diagnostic criteria, diagnoses and concepts, although often there was no single term equivalent to t he English in the languages studied. Items assuming self-consciousness about feelings, and imputing causal relations, posed difficulties in several cultures. Single equivalent terms were lacking for some diagno stic criteria, and criteria were sometimes not readily differentiated from one another. Several criteria-narrowing of the drinking repertoir e, time spent obtaining and using the drug, and tolerance for the drug -were less easy to use in cultures other than the United States. Thres holds for diagnosis used by clinicians often differed. In most culture s, clinicians were more likely to make a diagnosis of drug dependence than of alcohol dependence although behavioural signs were equivalent. The attitudes of societies to alcohol and drug use affects the use of criteria and the making of diagnoses.