Abstract
BackgroundAboriginal and Torres Strait Islander peoples are the first people of Australia. Consequences of historic and contemporary settler-colonialism including racism, trauma, grief and loss (of land, culture, spirituality, and freedoms) have led to substantial negative health and wellbeing impacts. The Kessler Psychological Distress Scales are population and individual-level tools designed to measure general psychological health status. There has been limited assessment of the psychometric properties and validity of the Kessler Psychological Distress Scale for use with the Aboriginal and Torres Strait Islander population in Australia, despite its widespread use.MethodsA national sample of Aboriginal and Torres Strait Islander adults (n = 6988 ≥ 16 years) was used in the psychometric assessment of the MK-K5, which involved face validity, acceptability, internal consistency/reliability, construct validity, and convergent and divergent validity testing. Receiver Operator Characteristics (ROC) curves were produced to assess clinical utility for depression and anxiety screening.ResultsThe MK-K5 demonstrated face validity for psychological distress in two focus groups, and had good acceptability, good internal consistency/reliability (α = 0.89), good construct validity (uni-dimensional; one underlying component explaining 70.1% of variance), and demonstrated convergent and divergent validity in the sample. The MK-K5 had good clinical utility at a cut-off score of 11 for detecting ever being diagnosed with depression or anxiety.ConclusionsThe MK-K5 is a valid measure of psychological distress and has clinical utility in the Aboriginal and Torres Strait Islander population.
Highlights
Aboriginal and Torres Strait Islander peoples are the first people of Australia
This study demonstrated internal and construct validity of the Kessler 10 (K10) and unmodified 5 item Kessler Psychological Distress Scale (K5) for measuring unidimensional psychological distress among Aboriginal and Torres Strait Islander people aged 45 years and older
For an assessment of divergent validity, we examined the association between psychological distress and a measure we considered to be less strongly related to psychological distress than in the convergent validity assessment (Heart Disease)
Summary
Consequences of historic and contemporary settler-colonialism including racism, trauma, grief and loss (of land, culture, spirituality, and freedoms) have led to substantial negative health and wellbeing impacts. There has been limited assessment of the psychometric properties and validity of the Kessler Psychological Distress Scale for use with the Aboriginal and Torres Strait Islander population in Australia, despite its widespread use. Aboriginal and Torres Strait Islander peoples are the first people of Australia, having lived on and from the land for tens of thousands of years, with archaeological records placing Aboriginal and Torres Strait Islander peoples in Australia at least 65,000 years ago [1]. Decades of attempted destruction of Aboriginal and Torres Strait Islander families and communities, coupled with contemporary racism, trauma, and marginalisation (including in the healthcare system), have had detrimental impacts on the lives, health, and wellbeing of Aboriginal and Torres Strait Islander peoples [5, 6]. People removed during the Stolen Generation and their descendants today experience poorer health and wellbeing outcomes, lower educational and socioeconomic outcomes, and increased trauma, than those not removed [8,9,10]
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