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The Measurement of Personality to Assess Psychopathology across Cultures
One of the interesting ways in which personality tests are used cross-culturally involves the assessment not only of personality but also of clinical states and psychopathology. The most widely used scale in such cross-cultural assessments is the Minnesota Multiphasic Personality Inventory (MMPI). Re- cently, Butcher, Lim, and Nezami (1998) reviewed the use of the MMPI in various countries and cultures, including six Asian cultures, six Spanish- speaking cultures, eight European cultures, and three cultures in the Middle East. They reported on the procedures most researchers used in adapting the MMPI for use in their particular cultural milieu, including translation and back-translation, bilingual test–retest evaluation, study of equivalency, and the like. They concluded:

Clinical case studies involving the assessment of patients from different cultures have shown that MMPI-2 interpretations drawn from an American perspective generally produce congruent conclusions about clinical patients tested in other countries. . . . Computer-based MMPI-2 interpretations appear to have a high degree of accuracy when applied to patients from other countries. Computer- based reports derived on interpretive strategies developed for the United States were rated as highly accurate by clinicians when they were applied in Norway, Australia, and France. (p. 207)

Thus, clinical studies across cultures involving personality scales such as the MMPI have been shown to be quite reliable and valid in assessing psychopathology and abnormal behavior in other cultures as well. This finding is once again consistent with the premise of a universal underlying personality structure that can be reliably and validly assessed by methods typically developed and refined in the United States or Europe. If such a universal personality structure exists and can be measured by some means, then deviations from that personality structure in the form of psychopathology should also be measurable using those same means.
However, others argue that some of the items of the MMPI simply do not mean the same thing in other cultures. For instance, answering “yes” to items such as “Evil spirits possess me at times” may not be a marker of pathology for Puerto Rican individuals, as spiritism is widely practiced in that culture (Rogler, Malgady, & Rodriguez, 1989). To address these problems, there have been recent attempts at developing culture-specific measures of personality, such as the Chinese Personality Assessment Inventory (CPAI) by Cheung, Kwong, and Zhang (2003). Based on a combined etic emic approach that included indigenous concepts from Chinese culture, this personality measure was created for use specifically with Chinese individuals. The CPAI measure may be more valid and useful in assessing mental health with this population than purely imported assessments.

Mental Health of Ethnic Minorities and Migrants
Currently, we have an inadequate understanding of the prevalence of mental disorders among ethnic minority groups in the United States. One reason is that in the past, institutional populations, in which minority groups are disproportionately represented, were overlooked in national studies on the epidemi- ology of mental disorders (U.S. Department of Health and Human Services, 1999). More recently, efforts have been made to address this gap in knowledge. In this final section of the chapter, we will first discuss rates of psychopathology among four ethnic groups that have been a focus of recent research: African Americans, Asian Americans, Latino Americans, and Native Americans. Because most research has focused on primarily European American samples, prevalence rates are usually compared to this group. Second, we will discuss the mental health of immigrants and refugees both within and outside the United States.

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The Measurement of Personality to Assess Psychopathology across CulturesOne of the interesting ways in which personality tests are used cross-culturally involves the assessment not only of personality but also of clinical states and psychopathology. The most widely used scale in such cross-cultural assessments is the Minnesota Multiphasic Personality Inventory (MMPI). Re- cently, Butcher, Lim, and Nezami (1998) reviewed the use of the MMPI in various countries and cultures, including six Asian cultures, six Spanish- speaking cultures, eight European cultures, and three cultures in the Middle East. They reported on the procedures most researchers used in adapting the MMPI for use in their particular cultural milieu, including translation and back-translation, bilingual test–retest evaluation, study of equivalency, and the like. They concluded:Clinical case studies involving the assessment of patients from different cultures have shown that MMPI-2 interpretations drawn from an American perspective generally produce congruent conclusions about clinical patients tested in other countries. . . . Computer-based MMPI-2 interpretations appear to have a high degree of accuracy when applied to patients from other countries. Computer- based reports derived on interpretive strategies developed for the United States were rated as highly accurate by clinicians when they were applied in Norway, Australia, and France. (p. 207)Thus, clinical studies across cultures involving personality scales such as the MMPI have been shown to be quite reliable and valid in assessing psychopathology and abnormal behavior in other cultures as well. This finding is once again consistent with the premise of a universal underlying personality structure that can be reliably and validly assessed by methods typically developed and refined in the United States or Europe. If such a universal personality structure exists and can be measured by some means, then deviations from that personality structure in the form of psychopathology should also be measurable using those same means.However, others argue that some of the items of the MMPI simply do not mean the same thing in other cultures. For instance, answering “yes” to items such as “Evil spirits possess me at times” may not be a marker of pathology for Puerto Rican individuals, as spiritism is widely practiced in that culture (Rogler, Malgady, & Rodriguez, 1989). To address these problems, there have been recent attempts at developing culture-specific measures of personality, such as the Chinese Personality Assessment Inventory (CPAI) by Cheung, Kwong, and Zhang (2003). Based on a combined etic emic approach that included indigenous concepts from Chinese culture, this personality measure was created for use specifically with Chinese individuals. The CPAI measure may be more valid and useful in assessing mental health with this population than purely imported assessments. Mental Health of Ethnic Minorities and MigrantsCurrently, we have an inadequate understanding of the prevalence of mental disorders among ethnic minority groups in the United States. One reason is that in the past, institutional populations, in which minority groups are disproportionately represented, were overlooked in national studies on the epidemi- ology of mental disorders (U.S. Department of Health and Human Services, 1999). More recently, efforts have been made to address this gap in knowledge. In this final section of the chapter, we will first discuss rates of psychopathology among four ethnic groups that have been a focus of recent research: African Americans, Asian Americans, Latino Americans, and Native Americans. Because most research has focused on primarily European American samples, prevalence rates are usually compared to this group. Second, we will discuss the mental health of immigrants and refugees both within and outside the United States.
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Pengukuran Kepribadian untuk Menilai Psikopatologi di Budaya
Salah satu cara yang menarik di mana tes kepribadian digunakan lintas-budaya melibatkan penilaian tidak hanya kepribadian, tetapi juga dari negara-negara klinis dan psikopatologi. Skala yang paling banyak digunakan dalam penilaian lintas budaya tersebut adalah Tes MMPI (MMPI). Ulang cently, Butcher, Lim, dan Nezami (1998) Ulasan penggunaan MMPI di berbagai negara dan budaya, termasuk enam budaya Asia, enam budaya berbicara Spanyol-delapan budaya Eropa, dan tiga budaya di Timur Tengah. Mereka melaporkan pada prosedur yang paling peneliti digunakan dalam mengadaptasi MMPI untuk digunakan dalam lingkungan budaya tertentu mereka, termasuk terjemahan dan back-terjemahan, evaluasi tes-tes ulang bilingual, studi kesetaraan, dan sejenisnya. Mereka menyimpulkan: studi kasus klinis yang melibatkan penilaian pasien dari budaya yang berbeda telah menunjukkan bahwa MMPI-2 interpretasi diambil dari perspektif Amerika umumnya menghasilkan kesimpulan kongruen tentang pasien klinis diuji di negara lain. . . . -Komputer berbasis MMPI-2 interpretasi tampaknya memiliki tingkat akurasi yang tinggi bila diterapkan pada pasien dari negara lain. Komputer-laporan berdasarkan diperoleh pada strategi interpretif dikembangkan untuk Amerika Serikat dinilai sebagai sangat akurat oleh dokter ketika mereka diterapkan di Norwegia, Australia, dan Perancis. (p. 207) Jadi, studi klinis lintas budaya yang melibatkan skala kepribadian seperti MMPI telah terbukti cukup handal dan valid dalam menilai psikopatologi dan perilaku abnormal dalam budaya lain juga. Temuan ini sekali lagi konsisten dengan premis struktur kepribadian yang mendasari universal yang dapat diandalkan dan sah dinilai dengan metode biasanya dikembangkan dan disempurnakan di Amerika Serikat atau Eropa. Jika seperti struktur kepribadian yang universal ada dan dapat diukur dengan beberapa cara, maka penyimpangan dari struktur kepribadian dalam bentuk psikopatologi juga harus terukur menggunakan mereka cara yang sama. Namun, yang lain berpendapat bahwa beberapa item dari MMPI hanya tidak berarti hal yang sama dalam budaya lain. Misalnya, menjawab "ya" untuk barang-barang seperti "Roh-roh jahat memiliki saya di kali" mungkin tidak menjadi penanda patologi untuk Puerto Rico individu, sebagai spiritisme secara luas dipraktekkan dalam budaya (Rogler, Malgady, & Rodriguez, 1989). Untuk mengatasi masalah ini, ada upaya baru-baru ini mengembangkan langkah-langkah budaya-spesifik kepribadian, seperti Inventarisasi Penilaian Kepribadian Cina (CPAI) oleh Cheung, Kwong, dan Zhang (2003). Berdasarkan pendekatan emic etik gabungan yang mencakup konsep asli dari budaya Cina, ukuran kepribadian ini diciptakan untuk digunakan secara khusus dengan orang Tionghoa. The CPAI ukuran mungkin lebih valid dan berguna dalam menilai kesehatan mental dengan populasi ini dari penilaian murni impor. Kesehatan Mental dari Etnis Minoritas dan Migran Saat ini, kami memiliki pemahaman yang tidak memadai prevalensi gangguan mental antara kelompok-kelompok etnis minoritas di Amerika Serikat. Salah satu alasannya adalah bahwa di masa lalu, populasi kelembagaan, di mana kelompok-kelompok minoritas yang tidak proporsional terwakili, yang diabaikan dalam studi nasional tentang ology epidemi- gangguan mental (US Departemen Kesehatan dan Layanan Kemanusiaan, 1999). Baru-baru ini, upaya telah dilakukan untuk mengatasi kesenjangan ini dalam pengetahuan. Pada bagian akhir ini bab ini, pertama kita akan membahas tingkat psikopatologi antara empat kelompok etnis yang telah menjadi fokus penelitian terbaru: Afrika Amerika, Asia Amerika, Latino Amerika, dan penduduk asli Amerika. Karena sebagian besar penelitian telah difokuskan pada sampel Amerika terutama Eropa, prevalensi biasanya dibandingkan dengan kelompok ini. Kedua, kita akan membahas kesehatan mental imigran dan pengungsi baik di dalam dan di luar Amerika Serikat.









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