Objective To describe the psychometric properties of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) interview, which surveys additional disorders not assessed in prior K-SADS, contains improved probes and anchor points, includes diagnosis-specific impairment ratings, generates DSM-III-R and DSM-IV diagnoses, and divides symptoms surveyed into a screening interview and five diagnostic supplements. Method Subjects were 55 psychiatric outpatients and 11 normal controls (aged 7 through 17 years). Both parents and children were used as informants. Concurrent validity of the screen criteria and the K-SADS-PL diagnoses was assessed against standard self-report scales. Interrater ( n = 15) and test-retest ( n = 20) reliability data were also collected (mean retest interval: 18 days; range: 2 to 38 days). Results Rating scale data support the concurrent validity of screens and K-SADS-PL diagnoses. Interrater agreement in scoring screens and diagnoses was high (range: 93% to 100%). Test-retest reliability κ coefficients were in the excellent range for present and/or lifetime diagnoses of major depression, any bipolar, generalized anxiety, conduct, and oppositional defiant disorder (.77 to 1.00) and in the good range for present diagnoses of posttraumatic stress disorder and attention-deficit hyperactivity disorder (.63 to .67). Conclusion Results suggest the K-SADS-PL generates reliable and valid child psychiatric diagnoses. J. Am. Acad. Child Adolesc. Psychiatry , 1997, 36(7): 980–988.

Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Initial Reliability and Validity Data

In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress— explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications. The study of mental health of lesbian, gay, and bisexual (LGB) populations has been complicated by the debate on the classification of homosexuality as a mental disorder during the 1960s and early 1970s. That debate posited a gay-affirmative perspective, which sought to declassify homosexuality, against a conservative perspective, which sought to retain the classification of homosexuality as a mental disorder (Bayer, 1981). Although the debate on classification ended in 1973 with the removal of homosexuality from the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1973), its heritage has lasted. This heritage has tainted discussion on mental health of lesbians and gay men by associating— even equating— claims that LGB people have higher prevalences of mental disorders than heterosexual people with the historical antigay stance and the stigmatization of LGB persons (Bailey, 1999). However, a fresh look at the issues should make it clear that whether LGB populations have higher prevalences of mental disorders is unrelated to the classification of homosexuality as a mental disorder. A retrospective analysis would suggest that the attempt to find a scientific answer in that debate rested on flawed logic. The debated scientific question was, Is homosexuality a mental disorder? The operationalized research question that pervaded the debate was, Do homosexuals have high prevalences of mental disorders? But the research did not accurately operationalize the scientific question. The question of whether homosexuality should be considered a mental disorder is a question about classification. It can be answered by debating which behaviors, cognitions, or emotions should be considered indicators of a mental

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Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence

La psychologie interculturelle a montre qu'il existait des rapports etroits entre le contexte culturel et le developpement comportemental de l'individu. Cette relation etablie, l'effort des recherches interculturelles a de plus en plus porte sur ce qu'il advenait des individus quand ils tentaient de refaire leur vie dans une culture differente de leur culture d'origine. Les consequences psychologiques a long terme de ce processus d'acculturation sont tres variables, dependant de variables sociales et personnelles qui renvoient a la societe de depart, a la societe d'accueil et a des phenomenes qui existent avant, mais qui emergent pendant la periode d'acculturation. Cet article esquisse un schema conceptuel a partir duquel acculturation et adaptation peuvent ětre etudiees, puis presente quelques conclusions et resultats generaux tires d'un echantillon de travaux empiriques. On envisage des applications possibles a la politique et aux programmes d'insertion en prenant en consideration les couts et les benefices sociaux et psychologiques emanant de l'adoprion d'une orientation pluraliste et integrationniste.

Cross-cultural psychology has demonstrated important links between cultural context and individual behavioural development. Given this relationship, cross-cultural research has increasingly investigated what happens to individuals who have developed in one cultural context when they attempt to re-establish their lives in another one. The long-term psychological consequences of this process of acculturation are highly variable, depending on social and personal variables that reside in the society of origin, the society of settlement. and phenomena that both exist prior to, and arise during, the course of acculturation. This article outlines a conceptual framework within which acculturation and adaptation can be investigated, and then presents some general findings and conclusions based on a sample of empirical studies. Applications to public policy and programmes are proposed. along with a consideration of the social and psychological costs and benefits of adopting a pluralist and integrationist orientation to these issues.

Immigration, Acculturation, and Adaptation

https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0040297&type=printable

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration

Ethnic identity is central to the psychological functioning of members of ethnic and racial minority groups, but research on the topic is fragmentary and inconclusive. This article is a review of 70 studies of ethnic identity published in refereed journals since 1972. The author discusses the ways in which ethnic identity has been defined and conceptualized, the components that have been measured, and empirical findings. The task of understanding ethnic identity is complicated because the uniqueness that distinguishes each group makes it difficult to draw general conclusions. A focus on the common elements that apply across groups could lead to a better understanding of ethnic identity.

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Ethnic identity in adolescents and adults: Review of research.

Acculturation, the process whereby immigrants change their behavior and attitudes toward those of the host society, is a fundamental part of migration-induced adaptations to new sociocultural environments. A rapidly expanding research literature on acculturation has accompanied the growth of international migrations. In response to the need to integrate the growing literature on acculturation and mental health status among Hispanics in the United States, and to identify points of convergence and new directions for research, 30 publications were examined. Points of convergence are identified, as are problems and limitations. The research needs new directions, proceeding from but not constricted by the assumptions and procedures in the work already done.

Acculturation and Mental Health Status Among Hispanics. Convergence and New Directions for Research

The authors argue that the concept of help-seeking pathways, defined generically, oriented toward institutional structures, and put at the forefront of research, can help integrate much of what we know about the use of mental health care and how to make such care more accessible and effective among underserved populations. They focus the concept of help-seeking pathways on current issues and research findings pertinent to the onset of psychological distress, the contacting of mental health care facilities, and treatment in such facilities. Pathways are not random; they are structured by the convergence of psychosocial and cultural factors and have sufficient integrity to be studied directly as unfolding processes.

Help-seeking pathways : a unifying concept in mental health care

What do culturally sensitive mental health services mean? The case of Hispanics

To answer the question of what culturally sensitive mental health research is, the author focuses on the entire process of research. He argues that research is made culturally sensitive through a continuing, incessant, and open-ended series of substantive and methodological insertions and adaptations designed to mesh the process of inquiry with the cultural characteristics of the group being studied. Illustrations include pretesting and planning of research, collection of data and translation of instruments, instrumentation of measures, and analysis and interpretation of data. The insertions and adaptations ideally have a cumulative effect in rendering individual projects culturally sensitive and in building culturally informed research.

The meaning of culturally sensitive research in mental health.

The concept of procedural norms, which is taken from the analysis of science as an institutionally structured social process, is used to explain the persistence of cultural insensitivity in research. The concept refers to the canons of research that tell scientists what should be studied and how, and they are taught to successive generations of researchers. An examination of cross-cultural studies in mental health reveals that cultural insensitivity stems from procedural norms in the development of content validity based on experts' rational analysis of concepts, in linguistic translations that try to conform to the exact terms of standardized instruments, and in the uncritical transferring of concepts across cultures. We need a wide-ranging examination of our procedural norms, with the objective of keeping such norms from suppressing, biasing, or deflecting cultural understandings. This article proposes a dialogue on the intricate connections between culture and our customary methodologies.

Lloyd H. Rogler

Papers

Acculturation and Mental Health Status Among Hispanics. Convergence and New Directions for Research

Help-seeking pathways : a unifying concept in mental health care

What do culturally sensitive mental health services mean? The case of Hispanics

The meaning of culturally sensitive research in mental health.

Methodological sources of cultural insensitivity in mental health research.