Abstract
ABSTRACTThe Western culturally developed Hopkins Symptom Checklist (HSCL-10) is a self-report measure of mental distress widely used for both clinical and epidemiological purposes – also in the multiethnic epidemiological SAMINOR studies in Northern Norway, but without any proper cross-cultural validation. Our objective was to test invariance of the HSCL-10 measurements among Sami and the non-indigenous majority population in Northern Norway (participants in the SAMINOR 2 study) and whether the previously used HSCL-10 cut-off level (1.85) fits the Sami subgroups in the study. Participants belonged to Sami core, Sami affiliation, Sami background or majority Norwegian groups. The confirmatory factor analysis framework adapted for testing of measurement invariance showed no significant measurement invariance between the groups indicating that the HSCL-10 response scale predominantly was used in the same way and that significantly different meanings were not ascribed to the same set of questions. The cut-off criteria of 1.85 as indicative of psychological distress based on Norwegian data equal a score of 1.89, 1.94 and 1.91 in the Sami core, Sami affiliation and Sami background groups, respectively. Thus, the same cut-off criterion 1.85 may be safely used in all groups. However, one should still be looking for culture-specific expressions of mental stress.
Highlights
Culture influences concepts of normality and pathology as well as the experience, expression, meaning and communication of symptoms [1]
Participants in the present study belonged to the Sami and the non-indigenous majority population in Northern Norway
The present study focused on testing the invariance at an item level exclusively and set free those measurement model parameters that worked differently between the ethnic groups, in order to produce adjusted estimated item raw scores equated for the same underlying latent trait score
Summary
Culture influences concepts of normality and pathology as well as the experience, expression, meaning and communication of symptoms [1]. This may have implications for identification, prevention and prognosis of mental disorders. The majority of contemporary Sami, except perhaps those living in socalled “core Sami areas”, have Norwegian as their mother tongue language. They speak Norwegian language about as fluently as the majority population do, and some Sami children learn to speak both languages in kindergarten. The Sami still have a somewhat lower level of education, employment rate, income and living expectancy than majority Norwegians [10]
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