Threats to cultural validity in clinical diagnosis and assessment: Illustrated with the case of Asian Americans.

Author(s):  
Frederick T. L. Leong ◽  
Zornitsa Kalibatseva
2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Zornitsa Kalibatseva ◽  
Frederick T. L. Leong

This article presents a review of the prevalence and manifestation of depression among Asian Americans and discusses some of the existing issues in the assessment and diagnosis of depression among Asian Americans. The authors point out the diversity and increasing numbers of Asian Americans and the need to provide better mental health services for this population. While the prevalence of depression among Asian Americans is lower than that among other ethnic/racial groups, Asian Americans receive treatment for depression less often and its quality is less adequate. In addition, the previous belief that Asians somatize depression may become obsolete as more evidence appears to support that Westerners may “psychologize” depression. The cultural validity of the current DSM-IV conceptualization of depression is questioned. In the course of the review, the theme of complexity emerges: the heterogeneity of ethnic Asian American groups, the multidimensionality of depression, and the intersectionality of multiple factors among depressed Asian Americans.


Author(s):  
Tong Wensheng ◽  
Lu Lianhuang ◽  
Zhang Zhijun

This is a combined study of two diffirent branches, photogrammetry and morphology of blood cells. The three dimensional quantitative analysis of erythrocytes using SEMP technique, electron computation technique and photogrammetry theory has made it possible to push the study of mophology of blood cells from LM, TEM, SEM to a higher stage, that of SEM P. A new path has been broken for deeply study of morphology of blood cells.In medical view, the abnormality of the quality and quantity of erythrocytes is one of the important changes of blood disease. It shows the abnormal blood—making function of the human body. Therefore, the study of the change of shape on erythrocytes is the indispensable and important basis of reference in the clinical diagnosis and research of blood disease.The erythrocytes of one normal person, three PNH Patients and one AA patient were used in this experiment. This research determines the following items: Height;Length of two axes (long and short), ratio; Crevice in depth and width of cell membrane; Circumference of erythrocytes; Isoline map of erythrocytes; Section map of erythrocytes.


VASA ◽  
2004 ◽  
Vol 33 (4) ◽  
pp. 247-251 ◽  
Author(s):  
Zeller ◽  
Koch ◽  
Frank ◽  
Bürgelin ◽  
Schwarzwälder ◽  
...  

Diagnosis of non-specific aorto-arteritis (NSAA, Takaysu's arteritis) is typically based on clinical and investigational parameters. We report here about two patients with clinically suspected diagnosis of a Takayasu's arteritis already under anti-inflammatory therapy in whom percutaneous transluminal atherectomy of subclavian and axillary artery stenoses was performed to relief the patients from symptoms – intermittent dyspraxia of the arms – and to verify the clinical diagnosis by histology. In the first case aorto-arteritis could be histologically confirmed through the analysis of plaque material including media structures excised from the subclavian and axillary arteries using a new device for atherectomy. The biopsy showed diffuse inflammation and granulomatous lesions with giant cells typically for Takayasu's disease. In the second patient, biopsy showed no acute or chronic inflammatory signs but only atherosclerotic lesions. Percutaneous transluminal atherectomy is therefore not only an interventional but also a diagnostic tool and should be used in every case of interventional therapy of suspected aorto-arteritis to make the clinical diagnosis and as a major consequence the initiation of an aggressive anti-inflammatory medical therapy more reliable.


VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Mandy Becker ◽  
Tom Schilling ◽  
Olga von Beckerath ◽  
Knut Kröger

Background: To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema. Patients and methods: 38 (70 ± 12 years, 22 (58 %) females) patients with lower limb edema were recruited according the clinical diagnosis: 10 (26 %) lymphedema, 16 (42 %) heart insufficiency, 6 (16 %) venous disorders, 6 (16 %) chronic hepatic disease. Edema was depicted sonographically at the most affected leg in a standardised way at distal and proximal calf. 38 sets of images were anonymised and send to 5 experienced doctors. They were asked whether they can see criteria for lymphedema: 1. anechoic gaps, 2. horizontal gaps and 3. echoic rims. Results: Accepting an edema as lymphedema if only one doctor sees at least one of the three criteria for lymphatic edema on each single image all edema would be classified as lymphatic. Accepting lymphedema only if all doctors see at least one of the three criteria on the distal image of the same patient 80 % of the patients supposed to have lymphedema are classified as such, but also the majority of cardiac, venous and hepatic edema. Accepting lymphedema only if all doctors see all three criteria on the distal image of the same patients no edema would be classified as lymphatic. In addition we separated patients by Stemmers’ sign in those with positive and negative sign. The interpretation of the images was not different between both groups. Conclusions: Our analysis shows that it is not possible to differentiate lymphedema from other lower limb edema sonographically.


2019 ◽  
Vol 30 (3) ◽  
pp. 157-168
Author(s):  
Helmut Hildebrandt ◽  
Jana Schill ◽  
Jana Bördgen ◽  
Andreas Kastrup ◽  
Paul Eling

Abstract. This article explores the possibility of differentiating between patients suffering from Alzheimer’s disease (AD) and patients with other kinds of dementia by focusing on false alarms (FAs) on a picture recognition task (PRT). In Study 1, we compared AD and non-AD patients on the PRT and found that FAs discriminate well between these groups. Study 2 served to improve the discriminatory power of the FA score on the picture recognition task by adding associated pairs. Here, too, the FA score differentiated well between AD and non-AD patients, though the discriminatory power did not improve. The findings suggest that AD patients show a liberal response bias. Taken together, these studies suggest that FAs in picture recognition are of major importance for the clinical diagnosis of AD.


2020 ◽  
Vol 36 (4) ◽  
pp. 670-680 ◽  
Author(s):  
Bojana M. Dinić ◽  
Aleksandar Vujić

Abstract. The aim of this research was to explore measurement invariance across samples from Serbia and the USA (Study 1) and to further validate the Serbian adaptation of the Pathological Narcissism Inventory – PNI (Study 2). The results supported the original seven-factor first-order structure as well as the hierarchical structure of the PNI with Narcissistic grandiosity and vulnerability as the second-order factors. Further, scalar invariance between the two versions of the PNI was achieved. Relations between Narcissistic grandiosity and vulnerability and other measures of grandiose and hypersensitive narcissism supported the validity of their scores. Among HEXACO traits, both Narcissistic grandiosity and vulnerability showed substantial negative correlations with Honesty-Humility. The main distinctions between the two aspects of narcissism lie in the positive relations with Neuroticism and negative relations with self-esteem, both of which are higher for Narcissistic vulnerability. The results support good psychometric properties of the PNI scores and add to the PNI’s cross-cultural validity.


2016 ◽  
Vol 32 (2) ◽  
pp. 111-118 ◽  
Author(s):  
Marianna Szabó ◽  
Veronika Mészáros ◽  
Judit Sallay ◽  
Gyöngyi Ajtay ◽  
Viktor Boross ◽  
...  

Abstract. The aim of the present study was to examine the construct and cross-cultural validity of the Beck Hopelessness Scale (BHS; Beck, Weissman, Lester, & Trexler, 1974 ). Beck et al. applied exploratory Principal Components Analysis and argued that the scale measured three specific components (affective, motivational, and cognitive). Subsequent studies identified one, two, three, or more factors, highlighting a lack of clarity regarding the scale’s construct validity. In a large clinical sample, we tested the original three-factor model and explored alternative models using both confirmatory and exploratory factor analytical techniques appropriate for analyzing binary data. In doing so, we investigated whether method variance needs to be taken into account in understanding the structure of the BHS. Our findings supported a bifactor model that explicitly included method effects. We concluded that the BHS measures a single underlying construct of hopelessness, and that an incorporation of method effects consolidates previous findings where positively and negatively worded items loaded on separate factors. Our study further contributes to establishing the cross-cultural validity of this instrument by showing that BHS scores differentiate between depressed, anxious, and nonclinical groups in a Hungarian population.


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