Studying Depression Among Arab Adolescents: Methodological Considerations, Challenges, and Lessons Learned From Jordan

• Published in: Stigma and health (Washington, D.C.) Vol. 3; no. 4; pp. 296 - 304
• Main Authors: Dardas, Latefa A., Silva, Susan, Noonan, Devon, Simmons, Leigh Ann
• Format: Journal Article
• Language: English
• Published: Educational Publishing Foundation 01-11-2018
• Subjects: Adolescent Psychopathology; Arab Cultural Groups; Attitudes; Collaboration; Cross Cultural Differences; Female; Foreign Language Translation; Health Care Seeking Behavior; Human; Major Depression; Male; Measurement; Methodology; Severity (Disorders); Stigma; Test Reliability; Test Validity; stigma; cross-cultural research; active consents; Arab; adolescent depression
• ISSN: 2376-6972; 2376-6964
• DOI: 10.1037/sah0000101

The purpose of this study was to evaluate the methodology for research examining depression severity, depression sigma, and attitudes toward seeking professional help for depression among Jordanian adolescents aged 12 to 17 years. Because this was a novel area of research in the Arab countries generally, and Jordan specifically, we aimed to (a) assess the feasibility of collaboration with recruitment sites, (b) evaluate the sampling method and recruitment strategies, and (c) confirm the utility of the measures translated from English to Arabic, namely, the Depression Stigma Scale (DSS; Griffiths, Christensen, & Jorm, 2008) and the Attitudes Toward Seeking Professional Psychological Help Scale (ASPPH; Fischer & Farina, 1995). Cross-sectional data were collected using self-report questionnaires from 88 adolescents attending public schools in Jordan. Active parental consents and adolescent assents were obtained as required by an American institutional review board (IRB), which was 1 of 2 entities providing approval for the study protocol. Depression was evaluated using a validated Arabic version of the Beck Depression Inventory II (BDI-II; Beck, Steer, & Brown, 1996). A systematic translation procedure was utilized for the DSS and ASPPH scales. Feasibility of collaboration with recruitment sites was established. However, the active consent procedure reduced the response rate and influenced sample characteristics. Both the BDI-II and the DSS showed adequate reliability. Reliability of the ASPPH scale was questionable. Conducting cross-cultural research requires careful considerations of all ethical, methodological, cultural, linguistic, and logistical issues that might potentially affect the validity and reliability of collected data. This study taps a significant gap in the literature, and provides important recommendations on how to address the potential impacts of the consent process on subjects' decision to participate or opt out of studies addressing stigmatizing issues, such as mental illness.