Skip to main content
SpringerLink
Log in

Cross-Cultural Equivalence of HSCL-25 and WHO (ten) Wellbeing Index: Findings From a Population-Based Survey of Immigrants and Non-Immigrants in Sweden

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The aim of this study was to investigate whether the Hopkins Symptom Checklist (HSCL-25) and the WHO (ten) Wellbeing Index are cross-culturally equivalent by comparing Scandinavians with Middle Eastern immigrants in Sweden. The study population consisted of a stratified random sample of native-born Swedes and immigrants from Finland, Iraq and Iran. Both instruments loaded on a single factor in the respective populations. A few of the items did however not discriminate or predict equally well in the groups, nonetheless it was found to have marginally influenced the instruments’ total scores in both groups. The analyses also revealed that the groups had similar intercept and slope when the exogenous factor traumatic episodes was used to predict the measurement scores, supporting scalar equivalency. In conclusion, the results support the use of these instruments in population-based surveys within multicultural Western societies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Al-Issa, I. (1997). General issues and research problems. In I. Al-Issa & M. Tousignant (Eds.), Ethnicity, immigration, and psychopathology (pp. 17–32). New York.: Plenum Press.

    Google Scholar 

  • Al-Saffar, S., Borga, P., Edman, G., & Hallstrom, T. (2003). The aetiology of posttraumatic stress disorder in four ethnic groups in outpatient psychiatry. Social Psychiatry and Psychiatric Epidemiology, 38(8), 456–462.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association Task Force on DSM-IV & American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4. ed. ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Azayem, G. A. E., & Hedayat-Diba, Z. (1994). The psychological aspects of Islam: Basic principles of Islam and their psychological corollary. International Journal for the Psychology of Religion, 4(1), 41–50.

    Article  Google Scholar 

  • Bech, P., Gudex, C., & Johansen, K. S. (1996). The WHO (Ten) well-being index: Validation in diabetes. Psychotherapy and Psychosomatics, 65(4), 183–190.

    Article  CAS  PubMed  Google Scholar 

  • Becht, M. C., & Vingerhoets, A. J. J. M. (2002). Crying and mood change: A cross-cultural study. Cognition & Emotion, 16(1), 87–101.

    Article  Google Scholar 

  • Bolton, P. (2001). Cross-cultural validity and reliability testing of a standard psychiatric assessment instrument without a gold standard. Journal of Nervous and Mental Disease, 189(4), 238–242.

    Article  CAS  PubMed  Google Scholar 

  • Bradley, C. (1994). The Well-being questionnaire. In C. Bradley (Ed.), Handbook of psychology and diabetes. Amsterdam: Harwood Academic Publishers.

    Google Scholar 

  • Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1(3), 185–216.

    Article  Google Scholar 

  • De Jong, J. T. V. M., & Van Ommeren, M. (2002). Toward a culture-informed epidemiology: Combining qualitative and quantitative research in transcultural contexts. Transcultural Psychiatry, 39(4), 422–433.

    Article  Google Scholar 

  • Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins symptom checklist (HSCL): A self-report symptom inventory. Behaviour Science, 19(1), 1–15.

    Article  CAS  Google Scholar 

  • Embretson, S. E. (1983). Construct validity: Construct representation versus nomothetic span. Psychological Bulletin, 93, 179–197.

    Article  Google Scholar 

  • Goodkind, J. R., & Deacon, Z. (2004). Methodological issues in conducting research with refugee women: Principles for recognizing and re-centering the multiply marginalized. Journal of Community Psychology, 32(6), 721–739.

    Article  Google Scholar 

  • Guadagnoli, E., & Velicer, W. (1991). A comparison of pattern matching indices. Multivariate Behavioural Research, 26(2), 323–343.

    Article  Google Scholar 

  • Häder, S., & Gabler, S. (2003). Sampling and estimation. In J. Harkness, F. van de Vijver, & P. Mohler (Eds.), Cross cultural survey methods. New York: Wiley.

    Google Scholar 

  • Hansson, L., Nettelbladt, P., Borgquist, L., & Nordstrom, G. (1994). Screening for psychiatric illness in primary care. A cross-sectional study in a Swedish health district. Social Psychiatry and Psychiatric Epidemiology, 29(2), 83–87.

    CAS  PubMed  Google Scholar 

  • Hermansson, A. C., Timpka, T., & Thyberg, M. (2003). The long-term impact of torture on the mental health of war-wounded refugees: findings and implications for nursing programmes. Scandinavian Journal of Caring Sciences, 17(4), 317–324.

    Article  PubMed  Google Scholar 

  • Herva, A., Jokelainen, J., Pouta, A., Veijola, J., Timonen, M., Karvonen, J. T., et al. (2004). Age at menarche and depression at the age of 31 years: Findings from the Northern Finland 1966 Birth Cohort Study. Journal of Psychosomatic Research, 57(4), 359–362.

    PubMed  Google Scholar 

  • Hollander, A. C., Ekblad, S., Mukhamadiev, D., & Muminova, R. (2007). The validity of screening instruments for posttraumatic stress disorder, depression, and other anxiety symptoms in Tajikistan. Journal of Nervous and Mental Disease, 195(11), 955–958.

    Article  PubMed  Google Scholar 

  • Hui, C. H., & Triandis, H. C. (1985). Measurment in cross-cultural psychology: A review and comparison of strategies. Journal of Cross-Cultural Psychology, 16(2), 131–152.

    Article  Google Scholar 

  • Jensen, A. R. (1998). The g factor: The science of mental ability. Westport: Praeger.

    Google Scholar 

  • Johnson, T. (1998). Approches to equivalence in cross-cultural and cross-national research. ZUMA Nachrichten Spezial, 3, 1–40.

    Google Scholar 

  • Kaaya, S. F., Fawzi, M. C., Mbwambo, J. K., Lee, B., Msamanga, G. I., & Fawzi, W. (2002). Validity of the Hopkins Symptom Checklist-25 amongst HIV-positive pregnant women in Tanzania. Acta Psychiatrica Scandinavica, 106(1), 9–19.

    Article  CAS  PubMed  Google Scholar 

  • Kirmayer, L. J. (1989). Cultural variations in the response to psychiatric disorders and emotional distress. Social Science and Medicine, 29(3), 327–339.

    Article  CAS  PubMed  Google Scholar 

  • Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62(SUPPL. 13), 22–30.

    PubMed  Google Scholar 

  • Kirmayer, L. J., Dao, T. H., & Smith, A. (1998). Somatization and psychologization: Understanding cultural idioms of distress. In S. O. Okpaku (Ed.), Clinical methods in transcultural psychiatry (pp. 233–265). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Kirmayer, L. J., Young, A., & Hayton, B. C. (1995). The cultural context of anxiety disorders. Psychiatric Clinics of North America, 18(3), 503–521.

    CAS  PubMed  Google Scholar 

  • Kleinman, A., & Good, B. (1985). Culture and depression: Studies in the anthropology and cross-cultural psychiatry of affect and disorder. Berkeley: University of California Press.

    Google Scholar 

  • Knight, G. P., & Hill, N. E. (1998). Measurement equivalence in research involving minority adolescents. In V. McLoyd & L. Steinberg (Eds.), Studying minority adolescents: Conceptual, methodological and theoretical issues (pp. 183–210). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Knight, G. P., Virdin, L. M., Ocampo, K. A., & Roosa, M. (1994). An examination of the cross-ethnic equivalence of measures of negative life events and mental-health among Hispanic and Anglo-American children. American Journal of Community Psychology, 22(6), 767–783.

    Article  CAS  PubMed  Google Scholar 

  • Lai, J., & Linden, W. (1993). The smile of Asia—Acculturation effects on symptom reporting. Canadian Journal of Behavioural Science-Revue Canadienne Des Sciences Du Comportement, 25(2), 303–313.

    Article  Google Scholar 

  • Lavik, N. J., Hauff, E., Solberg, Ø., & Laake, P. (1999). The use of self-reports in psychiatric studies of traumatized refugees: Validation and analysis of HSCL-25. Nordic Journal of Psychiatry, 53(1), 17–20.

    Article  Google Scholar 

  • Lee, B., Kaaya, S. F., Mbwambo, J. K., Smith-Fawzi, M. C., & Leshabari, M. T. (2008). Detecting depressive disorder with the Hopkins symptom checklist-25 in Tanzania. International Journal of Social Psychiatry, 54(1), 7–20.

    Article  PubMed  Google Scholar 

  • Littlewood, R., & Lipsedge, M. (1987). The butterfly and the serpent: Culture, psychopathology and biomedicine. Culture, Medicine and Psychiatry, 11(3), 289–335.

    Article  CAS  PubMed  Google Scholar 

  • Lorenzo-Seva, U., & ten Berge, J. M. F. (2006). Tucker’s congruence coefficient as a meaningful index of factor similarity. Methodology, 2(2), 57–64.

    Google Scholar 

  • Mavreas, V., Bebbington, P., & Der, G. (1989). The structure and validity of acculturation. Analysis of an acculturation scale. Social Psychiatry and Psychiatric Epidemiology, 24(5), 233–240.

    Article  CAS  PubMed  Google Scholar 

  • Mellenberg, G. J. (1982). Contingency table models for assessing item bias. Journal of Educational Statistics, 7(2), 105–108.

    Article  Google Scholar 

  • Mollica, R. F., Wyshak, G., de Marneffe, D., Khuon, F., & Lavelle, J. (1987). Indochinese versions of the Hopkins Symptom Checklist-25: A screening instrument for the psychiatric care of refugees. American Journal of Psychiatry, 144(4), 497–500.

    CAS  PubMed  Google Scholar 

  • Nettelbladt, P., Hansson, L., Stefansson, C. G., Borgquist, L., & Nordstrom, G. (1993). Test characteristics of the Hopkins Symptom Check List-25 (HSCL-25) in Sweden, using the present state examination (PSE-9) as a caseness criterion. Social Psychiatry Psychiatric Epidemiology, 28(3), 130–133.

    Article  CAS  Google Scholar 

  • Paniaguia, F. A. (2000). Culture-bound syndromes, cultural variations, and psychopathology. In I. Cuéllar & F. A. Paniaguia (Eds.), Handbook of multicultural mental health: Assessment and treatment of diverse populations (pp. 139–169). San Diego, CA: Academic Press.

    Google Scholar 

  • Parker, G., Chan, B., Tully, L., & Eisenbruch, M. (2005). Depression in the Chinese: The impact of acculturation. Psychological Medicine, 35(10), 1475–1483.

    Article  PubMed  Google Scholar 

  • Parloff, M. B., Kelman, H. C., & Frank, J. D. (1954). Comfort, effectiveness, and self-awareness as criteria of improvement in psychotherapy. American Journal of Psychiatry, 111(5), 343–352.

    CAS  PubMed  Google Scholar 

  • Poortinga, Y. H. (1989). Equivalence of cross-cultural data—An overview of basic issues. International Journal of Psychology, 24(6), 737–756.

    Google Scholar 

  • Punamaki, R. L., Komproe, I. H., Qouta, S., Elmasri, M., & de Jong, J. T. (2005). The role of peritraumatic dissociation and gender in the association between trauma and mental health in a Palestinian community sample. American Journal of Psychiatry, 162(3), 545–551.

    Article  PubMed  Google Scholar 

  • Qvist, J., & Statistics Sweden. (1999). Täckningsproblem i Registret över totalbefolkningen RTB: Skattning av övertäckning med en indirekt metod (Coverage problem in the register of total population RTB: Estimation of over coverage with an indirect method). Stockholm: Statistiska Centralbyrån.

    Google Scholar 

  • Reise, S. P., Waller, N. G., & Comrey, A. L. (2000). Factor analysis and scale revision. Psychological Assessment, 12(3), 287–297.

    Article  CAS  PubMed  Google Scholar 

  • Russell, D. W. (2002). In search of underlying dimensions: The use (and abuse) of factor analysis in personality and social psychology bulletin. Personality and Social Psychology Bulletin, 28(12), 1629–1646.

    Article  Google Scholar 

  • Sandanger, I., Moum, T., Ingebrigtsen, G., Dalgard, O. S., Sorensen, T., & Bruusgaard, D. (1998). Concordance between symptom screening and diagnostic procedure: The Hopkins symptom checklist-25 and the composite international diagnostic interview I. Social Psychiatry and Psychiatric Epidemiology, 33(7), 345–354.

    Article  CAS  PubMed  Google Scholar 

  • Schweitzer, R., Melville, F., Steel, Z., & Lacherez, P. (2006). Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees. Australian and New Zealand Journal of Psychiatry, 40(2), 179–187.

    PubMed  Google Scholar 

  • Silove, D., Sinnerbrink, I., Field, A., Manicavasagar, V., & Steel, Z. (1997). Anxiety, depression and PTSD in asylum-seekers: Associations with pre-migration trauma and post-migration stressors. British Journal of Psychiatry, 170(4), 351–357.

    Article  CAS  PubMed  Google Scholar 

  • Strand, B. H., Dalgard, O. S., Tambs, K., & Rognerud, M. (2003). Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nordic Journal of Psychiatry, 57(2), 113–118.

    Article  PubMed  Google Scholar 

  • Tengland, P.-A. (2001). Mental health: A philosophical analysis. Dordrecht; London: Kluwer Academic.

    Google Scholar 

  • Tinghög, P., Al-Saffar, S., Carstensen, J., & Nordenfelt, L. (2009). Immigrant- and non-immigrant-specific factors’ association with mental ill health among immigrants in Sweden International Journal of Social Psychiatry. doi:10.1177/0020764008096163

  • Tucker, L. R. (1951). A method for synthesis of factor analysis studies (No. 984). Washington, DC: Department of the Army.

    Google Scholar 

  • Uebelacker, L. A., Strong, D., Weinstock, L. M., & Miller, I. W. (2009). Use of item response theory to understand differential functioning of DSM-IV major depression symptoms by race, ethnicity and gender. Psychological Medicine, 39(4), 591–601.

    Article  CAS  PubMed  Google Scholar 

  • van de Vijver, F. (2003). Bias and substantive analyses. In J. A. Harkness, F. van de Vijver, & P. P. Mohler (Eds.), Cross-cultural survey methods (pp. 207–233). Hoboken, NJ: Wiley.

    Google Scholar 

  • van de Vijver, F., & Leung, K. (1997a). Methods and data analysis of comparative research. In J. W. Berry, Y. H. Poortinga, & J. Pandey (Eds.), Handbook of cross-cultural psychology: theory and method (pp. 357–400). Boston, MA: Allyn and Bacon.

    Google Scholar 

  • van de Vijver, F., & Leung, K. (1997b). Methods and data analysis for cross-cultural research. Thousand Oaks: Sage Publications.

    Google Scholar 

  • van de Vijver, F., & Tanzer, N. K. (1997). Bias and equivalence in cross-cultural assessment: An overview. European Review of Applied Psychology-Revue Europeenne De Psychologie Appliquee, 47(4), 263–280.

    Google Scholar 

  • Veijola, J., Jokelainen, J., Laksy, K., Kantojarvi, L., Kokkonen, P., Jarvelin, M. R., et al. (2003). The Hopkins symptom checklist-25 in screening DSM-III-R axis-I disorders. Nordic Journal of Psychiatry, 57(2), 119–123.

    Article  PubMed  Google Scholar 

  • Ventevogel, P., De Vries, G., Scholte, W. F., Shinwari, N. R., Faiz, H., Nassery, R., et al. (2007). Properties of the Hopkins symptom checklist-25 (HSCL-25) and the self-reporting questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan. Social Psychiatry and Psychiatric Epidemiology, 42(4), 328–335.

    Article  PubMed  Google Scholar 

  • Ward, C. A., Bochner, S., & Furnham, A. (2001). The psychology of culture shock (New ed. ed.). London: Routledge.

    Google Scholar 

  • Winokur, A., Winokur, D. F., Rickels, K., & Cox, D. S. (1984). Symptoms of emotional distress in a family planning service: Stability over a four-week period. British Journal of Psychiatry, 144(4), 395–399.

    Article  CAS  PubMed  Google Scholar 

  • Ying, Y. W., & Han, M. (2007). The longitudinal effect of intergenerational gap in acculturation on conflict and mental health in Southeast Asian American adolescents. American Journal of Orthopsychiatry, 77(1), 61–66.

    Article  PubMed  Google Scholar 

  • Zegers, F. E., & ten Berge, J. M. F. (1985). A family of association coefficients for metric scales. Psychometrika, 50(1), 17–24.

    Article  Google Scholar 

Download references

Acknowledgments

The preparation of this paper was supported by a grant from the Swedish Council for Working Life and Social Research, Grant no. 2005-0387.

Author information

Authors and Affiliations

  1. Department of Medicine and Health Sciences, Division of Health and Society, Linköping University, 581 83, Linköping, Sweden

    Petter Tinghög & John Carstensen

Authors
  1. Petter Tinghög
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John Carstensen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Petter Tinghög.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tinghög, P., Carstensen, J. Cross-Cultural Equivalence of HSCL-25 and WHO (ten) Wellbeing Index: Findings From a Population-Based Survey of Immigrants and Non-Immigrants in Sweden. Community Ment Health J 46, 65–76 (2010). https://doi.org/10.1007/s10597-009-9227-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-009-9227-2

Keywords

Search

Navigation