K. Bhui et al., Cross-cultural validity of the Amritsar Depression Inventory and the General Health Questionnaire amongst English and Punjabi primary care attenders, SOC PSY PSY, 35(6), 2000, pp. 248-254
Background: In order to estimate the health needs of cultural groups, the c
ross-cultural validity of instruments requires investigation in distinct cu
ltural rather than ethnic or racial groups. Method: We screened 'Punjabi' a
nd 'English' primary care attenders in South London (UK), using the General
Health Questionnaire (GHQ-12), an English origin instrument, and the Amrit
sar Depression Inventory (ADI), which was developed in the Punjab in India.
The criterion measure was the Clinical Interview Schedule (CIS-R). We calc
ulated the validity coefficients, optimal thresholds and the area under the
'Receive Operating Characteristic' curve to compare cross-cultural perform
ance. We identified items on each questionnaire that contribute to performa
nce of the instruments. Results: The GHQ-12 has high validity coefficients
in both cultural groups. The ADI performs as well amongst English subjects,
but among Punjabis it is poorer than the GHQ-12. Among Punjabis who have b
een resident in the UK for over 30 years, the ADI performs no better than c
hance. Few items on the ADI or the GHQ are strongly predictive of case stat
us. Conclusions: The GHQ-12 shows good validity in both cultures. Expressio
ns of distress may change due to acculturation. 'Culturally sensitive' scre
ening instruments need to reflect this. Further work might attend to the ch
anging expressions of distress following migration.