Title

Development process of an assessment tool for disruptive behavior problems in cross-cultural settings: the Disruptive Behavior International Scale – Nepal version (DBIS-N)

Document Type

Journal Article

Publication Date

10-1-2016

Journal

International Journal of Culture and Mental Health

Volume

9

Issue

4

DOI

10.1080/17542863.2016.1226372

Keywords

conduct disorder; Disruptive behavior disorders; low-income countries; Nepal; oppositional defiant disorder; scale; validation

Abstract

© 2016 Informa UK Limited, trading as Taylor & Francis Group. Systematic processes are needed to develop valid measurement instruments for disruptive behavior disorders in cross-cultural settings. We employed a four-step process in Nepal to identify and select items for a culturally valid assessment instrument: (1) we extracted items from validated scales and local free-list interviews; (2) parents, teachers and peers (n = 30) rated the perceived relevance and importance of behavior problems; (3) highly rated items were piloted with children (n = 60) in Nepal; (4) we evaluated internal consistency of the final scale. We identified 49 symptoms from 11 scales, and 39 behavior problems from free-list interviews (n = 72). After dropping items for low ratings of relevance and severity and for poor item-test correlation, low frequency and/or poor acceptability in pilot testing, 16 items remained for the Disruptive Behavior International Scale – Nepali version (DBIS-N). The final scale had good internal consistency (α = 0.86). A 4-step systematic approach to scale development including local participation yielded an internally consistent scale that included culturally relevant behavior problems.

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