Development process of an assessment tool for disruptive behavior problems in cross-cultural settings: the Disruptive Behavior International Scale–Nepal version (DBIS-N)

Burkey, M. D., Ghimire, L., Adhikari, R. P., Kohrt, B. A., Jordans, M. J., Haroz, E. E., & Wissow, L. S. (2016).

International journal of culture and mental health

Published on: 14 September 2016

Abstract: Systematic processes are needed to develop valid measurement instruments for disruptive behavior disorders in cross-cultural settings. We employed a four-step process in Nepal to identify and select items for a culturally valid assessment instrument: (1) we extracted items from validated scales and local free-list interviews; (2) parents, teachers and peers (n = 30) rated the perceived relevance and importance of behavior problems; (3) highly rated items were piloted with children (n = 60) in Nepal; (4) we evaluated internal consistency of the final scale. We identified 49 symptoms from 11 scales, and 39 behavior problems from free-list interviews (n = 72). After dropping items for low ratings of relevance and severity and for poor item-test correlation, low frequency and/or poor acceptability in pilot testing, 16 items remained for the Disruptive Behavior International Scale – Nepali version (DBIS-N). The final scale had good internal consistency (α = 0.86). A 4-step systematic approach to scale development including local participation yielded an internally consistent scale that included culturally relevant behavior problems.

Keywords: Disruptive behavior disorders, oppositional defiant disorder, conduct disorder, scale, validation, Nepal, low-income countries

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