Abstract
This study developed and validated the Youth Conduct Problems Scale-Rwanda (YCPS-R). Qualitative free listing (n = 74) and key informant interviews (n = 47) identified local conduct problems, which were compared to existing standardized conduct problem scales and used to develop the YCPS-R. The YCPS-R was cognitive tested by 12 youth and caregiver participants, and assessed for test-retest and inter-rater reliability in a sample of 64 youth. Finally, a purposive sample of 389 youth and their caregivers were enrolled in a validity study. Validity was assessed by comparing YCPS-R scores to conduct disorder, which was diagnosed with the Mini International Neuropsychiatric Interview for Children, and functional impairment scores on the World Health Organization Disability Assessment Schedule Child Version. ROC analyses assessed the YCPS-R's ability to discriminate between youth with and without conduct disorder. Qualitative data identified a local presentation of youth conduct problems that did not match previously standardized measures. Therefore, the YCPS-R was developed solely from local conduct problems. Cognitive testing indicated that the YCPS-R was understandable and required little modification. The YCPS-R demonstrated good reliability, construct, criterion, and discriminant validity, and fair classification accuracy. The YCPS-R is a locally-derived measure of Rwandan youth conduct problems that demonstrated good psychometric properties and could be used for further research.
Highlights
The prevalence of youth mental health disorders in sub-Saharan Africa (SSA) is estimated at approximately 10% [1]
Only seven of the 21 uburara indicators corresponded to symptoms of conduct disorder (CD) or ODD, and only four of eleven CD symptoms and three of seven ODD symptoms were captured by uburara indicators
These results suggest that uburara is a related but distinct manifestation of youth conduct problems in Rwanda
Summary
The prevalence of youth mental health disorders in sub-Saharan Africa (SSA) is estimated at approximately 10% [1]. Conduct problems are thought to affect 3.1% to 5.7% of youth, with a median age of onset between 7 and 15 [5]. Research in many countries indicates that children with HIV-positive caregivers are at increased risk for a range of mental health problems including conduct problems due to disrupted parent-child relationships, fear, and misinformation [19,20,21], family conflict, stigma, economic insecurity, lower education achievement, and caregiver depression and physical impairment [22,23,24]. Given the large number of children in Rwanda impacted by HIV, and their subsequent increased risk for conduct problems, developing context-appropriate measures of conduct problems, is critical for identifying children and assisting them with accessing services and care
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