This article presents a model for research that aims to address challenges in transcultural psychiatric epidemiology. The model involves eclectic application of quantitative and qualitative techniques, namely: focus groups, in-depth interviews, snowball sampling and population surveys. The qualitative methods help provide information on the context of symptoms, illness experience and disease. These methods provide the background information needed to shape research questions, to modify instruments for local situations, and to interpret collected epidemiological data. Examples are provided.
Agar, M. H. , & Murdoch, R. O. (1994). Investigating recent trends in heroin use in Baltimore city: A pilot ‘qualitative’ research project. College Park, MD: Center for Substance Research.
2.
Allen, M. J. , & Yen, W. M. (1979). Introduction to measurement theory. Belmont, CA: Wadsworth.
3.
Beiser, M. , Cargo, M., & Woodbury, M. A. (1994). A comparison of psychiatric disorder in different cultures: Depressive typologies in Southeast Asian refugees and resident Canadians. International Journal of Methods in Psychiatric Research, 4, 157–172.
4.
Bernard, H. R. (1995). Research methods in anthropology: Qualitative and quantitative approaches. Walnut Creek, CA: AltiMira.
5.
Berry, J. W. , Poortinga, Y. H., Segall, M. H., & Dasen, P. R. (1992). Cross-cultural psychology: Research and applications. Cambridge, UK: Cambridge University Press.
6.
Biernacki, P. , & Waldorf, D. (1981). Snowball sampling: Problems and techniques of chain referral sampling. Social Methods Research, 2, 141–163.
7.
Bravo, M. , Canino, G., Rubio-Stipec, M., & Woodbury, M. (1991). A cross-cultural adaptation of a diagnostic instrument: The DIS adaptation in Puerto Rico. Culture, Medicine, and Psychiatry, 11, 465–494.
8.
Brody, E. B. (1994). Psychiatric diagnosis in sociocultural context. Journal of Nervous and Mental Disease, 182, 253–255.
9.
Campbell, R. , Sefl, T., Barnes, H. E., Ahrens, C. E., Wasco, S. M., & Zaragoza- Diesfeld, Y. (1999). Community services for rape survivors: Enhancing psychological well-being or increasing trauma?Journal of Consulting and Clinical Psychology, 67, 847–858.
10.
Canino, G. , Lewis-Fernandez, R., & Bravo, M. (1997). Methodological challenges in cross-cultural mental health research. Transcultural Psychiatry, 34, 163–184.
11.
de Jong, J. T. V. M. (1987). A descent into African psychiatry. Amsterdam: Royal Tropical Institute.
12.
de Jong, J. T. V. M. (1994). Een quanltatief model voor etnopsychiatrischepidemiologisch onderzoek onder ‘vreemde zielen.’Tijdschrift voor Psychiatrie, 36, 67–80.
13.
de Jong, J. V. T. M. (2000). Psychiatric problems related to persecution and refugee status. In F. Henn, N. Sartorius, H. Helmchen, & H. Lauter (Eds.), Contemporary psychiatry(Vol. II, pp. 279–99). Berlin: Springer-Verlag.
14.
de Jong, J. T. V. M. (Ed.). (2002a). Trauma, war and violence: Public mental health in sociocultural context. New York: Plenum-Kluwer.
15.
de Jong, J. T. V. M. (2002b). Public mental health, traumatic stress and human rights violations in low-income countries: A culturally appropriate model in times of conflict, disaster and peace. In J. T. V. M. de Jong (Ed.), Trauma, war and violence: Public mental health in sociocultural context. New York: Plenum- Kluwer.
16.
de Jong, J. T. V. M. , Komproe, I. H., Van Ommeren, M., El Masri, M., Mesfin, A., Khaled, N., Somasundaram, D.,& van de Put, W. A. M. (2001). Lifetime events and posttraumatic stress disorder in 4 post-conflict settings. Journal of the American Medical Association, 286, 555–562.
17.
de Vries, M. W. (1997). Recontextualizing psychiatry: Toward ecologically valid mental health research. Transcultural Psychiatry, 34, 185–218.
18.
Fabrega, H. (1994). International systems of diagnosis in psychiatry. Journal of Nervous and Mental Disease, 182, 256–263.
19.
Flaherty, J. A. , Gavira, F. M., Pathak, D., Mitchell, T., Wintrob, R., Richman, J. A., & Birz, S. (1988). Developing instruments for cross-cultural psychiatric research. Journal of Nervous and Mental Disease, 176, 257–263.
20.
Goodman, L. A. (1961). Snowball sampling. Annals of Mathematics and Statistics, 32, 148–170.
21.
Guarnaccia, P. J. , Good, B. J., & Kleinman, A. (1990). A critical review of epidemiological studies of Puerto Rican mental health. American Journal of Psychiatry, 147, 1449–1456.
22.
Holman, D. (1997). The relevance of person-centred ethnography to crosscultural psychiatry. Trancultural Psychiatry, 34, 219–234.
23.
Husserl, E. (1970). Logical investigations. New York: Humanities Press.
24.
Jurg, A. M. , & de Jong, J. T. V. M. (1992). Traditional healers in government health care in Mozambique. Maputo: MINSAU (in Portugese).
25.
Kaplan, C. D. , Korf, D., & Sterk, C. (1987). Temporal and social contexts of heroin using populations. An illustration of the snowball sampling technique. Journal of Nervous and Mental Disease, 175, 566–574.
26.
Ketzer, E. , & Crescenzi, A. (2002). Addressing the psychosocial and mental health needs of Tibetan refugees in India. In J. T. V. M. de Jong (Ed.), Trauma, war and violence: Public mental health in sociocultural context. New York: Plenum- Kluwer.
27.
Khavarpour, F. , & Rissel, C. (1997). Mental health status of Iranian migrants in Sydney. Australian and New Zealand Journal of Psychiatry, 31, 828–834.
28.
Kleinbaum, D. G. , Kupper, L. L., & Morgenstern, H. (1982). Epidemiological research: Principles and quantitative methods. Belmont, CA: Wadsworth.
29.
Kleinman, A. (1977). Depression, somatization and the ‘new cross-cultural psychiatry.’Social Science and Medicine, 11, 3–10.
30.
Kleinman, A. (1980). Patients and healers in the context of culture. Berkeley: University of California.
31.
Kleinman, A. (1988). The illness narratives. New York: Basic Books.
32.
Kleinman, A. , Eisenberg, L., & Good, B. (1978). Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88, 251–258.
33.
Krueger, R. A. (1988). Focus groups. A practical guide for applied research. Newbury Park, CA: Sage.
34.
Littlewood, R. (1990). From categories to contexts: A decade of ‘new cross-cultural psychiatry.’British Journal of Psychiatry, 156, 308–327.
35.
Littlewood, R. (1991). Artichokes and entities, or how new is the ‘new crosscultural psychiatry.’Transcultural Psychiatric Research Review, 28, 343–357.
36.
Littlewood, R. (1992). DSM-IV and culture: Is the classification internationally valid?Psychiatric Bulletin, 16, 257–261.
37.
McAdams, D. P. , & Ochberg, R. L. (1988). Psychobiography and life narratives. Durham, NC: Duke University.
38.
Mehan, H. , & Wood, H. (1975). The reality of ethnomethodology. New York: Wiley.
39.
Morgan, D. L. (1988). Focus groups as qualitative research. Newbury Park, CA: Sage.
40.
Murphy, H. B. M. (1982). Comparative psychiatry: The international and intercultural distribution of mental illness. New York: Springer.
41.
Organista, K. C. , Organista, P. B., Bola, J. R., Garcia de Alba, J. E., & Castillo, M. A. (2000). Predictors of condom use in Mexican migrant workers. American Journal of Community Psychology, 28, 245–265.
42.
Patel, V. , Araya, R., Lima, M. S., Ludermir, A., & Todd, C. (1999). Women, poverty, and common mental disorders in four restructuring societies. Social Science and Medicine, 49, 1461–1471.
43.
Sharma, B. , & Van Ommeren, M. (1998). Preventing torture and rehabilitating survivors in Nepal. Transcultural Psychiatry, 35, 85–97.
44.
Somasundaram, D. J. , van de Put, W. A. C. M., Eisenbruch, M., & de Jong, J. T. V. M. (1999). Starting mental health services in Cambodia. Social Science and Medicine, 48, 1029–1046.
45.
Spreen, M. (1993). Sampling and analyzing in hidden populations. In B. Bieleman, A. Diaz, G. Merlo, & C. D. Kaplan (Eds.), Lines across Europe: Nature and extent of cocaine use in Barcelona, Rotterdam and Turin(pp. 185–204) Amsterdam: Swets & Zeitlinger.
46.
Triandis, H. C. , & Draguns, J. G. (Eds.) (1980). Handbook of cross-cultural psychology. Boston: Allyn and Bacon.
47.
Tsuang, M. T. , Tohen, M., & Zahner, G. E. P. (1995). Textbook in psychiatric epidemiology. New York: Wiley.
48.
Van Ommeren, M. (2000). Impact of torture: Psychiatric epidemiology amongBhutanese refugees in Nepal. Doctoral dissertation, Vrije Universiteit, Amsterdam, the Netherlands.
49.
Van Ommeren, M. , de Jong J. T. V. M., Sharma, B., Komproe, I., Thapa, S., & CardeÒa, E. (2001). Prevalence of psychiatric disorders among tortured Bhutanese refugees in Nepal. Archives of General Psychiatry, 58, 475–482.
50.
Van Ommeren, M. , Sharma, B., Makaju, R., Thapa, S., & de Jong, J. T. V. M. (2000). Limited cultural validity of the Composite International Diagnostic Interview probe flow chart. Transcultural Psychiatry, 37, 123–133.
51.
Van Ommeren, M. , Sharma, B., Thapa, S., Makaju, R., Prasain, D., Bhattarai, R., & de Jong, J. T. V. M. (1999). Preparing instruments for transcultural research: Use of the Translation Monitoring Form with Nepali-speaking Bhutanese refugees. Transcultural Psychiatry, 36, 285–301.
52.
Weiss, M. G. (2001). Cultural epidemiology: An introduction and overview. Anthropology and Medicine, 8, 1–29.
