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Background <p>Since August 2021, over 90,000 Afghan evacuees have been resettled in the USA. An estimated 40% of evacuees are under the age of 18. These youth are at risk for poor mental health because of migration-related trauma and stress. Health care providers need screening tools to accurately assess mental health problems in this population. The objective of this study was to identify and develop culturally appropriate screening tools for mental health problems facing resettled Afghan youth ages 10–17.</p> Methods <p>A total of 80 Afghan refugees in the Northeast USA and 4 Afghan mental health experts participated in this mixed-method study. Measures matching, expert feedback, and cognitive testing were used to identify and adapt mental health assessments that aligned with culturally relevant mental health syndromes in the Afghan community. Standardized assessments were selected based on their alignment with Afghan mental health constructs. Experts provided feedback on the content validity of selected assessments. During cognitive testing, participants were asked questions to examine dimensions of scale item comprehension, retrieval, judgment, and response. Quantitative surveys were used to assess the reliability of assessments in both Dari and Pashto.</p> Results <p>Screening tools, including the Center for Epidemiological Studies Depression Scale for Children (CES-DC), the War-Affected Youth Psychosocial Assessment (WAYPA), Generalized Anxiety Disorder-7 (GAD-7), Hogan Bereavement Inventory for Adolescents, and Migration Grief and Loss Questionnaire (MGLQ), were well-matched to Afghan mental health syndromes. Reliability assessment indicated that the MGLQ and Hogan growth subscales performed well among both children and adults. A reduced, four-item GAD scale also has good psychometric properties among children. The Hogan grief subscale works well for adults, but not for children. Both the CES-DC and WAYPA had poor psychometric properties among both children and adults.</p> Conclusion <p>Culturally validated screening tools for use with Afghan children and adolescents were mixed in their psychometric properties. Further refinement and testing are warranted and will require a greater sample size to improve the fit of standard measures to Afghan mental health concepts.</p>

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Mental Health Assessments for Resettled Afghan Children and Adolescents

  • 期刊论文

  • 发表日期：

    2025年6月30日

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  • Rochelle L. Frounfelker,
  • Caroline Dilts,
  • Matias Placencio-Castro,
  • Farhad Sharifi,
  • Said Hasib Arwal,
  • Theresa S. Betancourt

摘要

Background

Since August 2021, over 90,000 Afghan evacuees have been resettled in the USA. An estimated 40% of evacuees are under the age of 18. These youth are at risk for poor mental health because of migration-related trauma and stress. Health care providers need screening tools to accurately assess mental health problems in this population. The objective of this study was to identify and develop culturally appropriate screening tools for mental health problems facing resettled Afghan youth ages 10–17.

Methods

A total of 80 Afghan refugees in the Northeast USA and 4 Afghan mental health experts participated in this mixed-method study. Measures matching, expert feedback, and cognitive testing were used to identify and adapt mental health assessments that aligned with culturally relevant mental health syndromes in the Afghan community. Standardized assessments were selected based on their alignment with Afghan mental health constructs. Experts provided feedback on the content validity of selected assessments. During cognitive testing, participants were asked questions to examine dimensions of scale item comprehension, retrieval, judgment, and response. Quantitative surveys were used to assess the reliability of assessments in both Dari and Pashto.

Results

Screening tools, including the Center for Epidemiological Studies Depression Scale for Children (CES-DC), the War-Affected Youth Psychosocial Assessment (WAYPA), Generalized Anxiety Disorder-7 (GAD-7), Hogan Bereavement Inventory for Adolescents, and Migration Grief and Loss Questionnaire (MGLQ), were well-matched to Afghan mental health syndromes. Reliability assessment indicated that the MGLQ and Hogan growth subscales performed well among both children and adults. A reduced, four-item GAD scale also has good psychometric properties among children. The Hogan grief subscale works well for adults, but not for children. Both the CES-DC and WAYPA had poor psychometric properties among both children and adults.

Conclusion

Culturally validated screening tools for use with Afghan children and adolescents were mixed in their psychometric properties. Further refinement and testing are warranted and will require a greater sample size to improve the fit of standard measures to Afghan mental health concepts.