Cross-cultural adaptation of an anxiety measure in a disadvantaged South African community context: Methodological processes and findings

Naomi Myburgh, Helene Loxton*, Rutger C.M.E. Engels

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)


An important challenge to enhancing community access to mental health interventions in marginalised, transcultural settings is the development of culturally relevant screening measures. Cross-cultural adaptation (CCA) and translation methods offer guidelines for the adaption of existing screening measures for use across cultures with the aim of preserving semantic and construct equivalence as well as validity. Yet, the application of CCA methods has been inconsistent and validation strategies have focused predominantly on expert review and quantitative validity testing. Additionally, potentially important context-specific interpretations of measure items have been lost in translation-heavy approaches. The missing link in the CCA of existing measures may be the addition of culturally sensitive, community-based evaluative methods. This paper presents a report of the application of a seven-step CCA method developed by the first author to address the issue of cultural relevance in the translation and cross-cultural adaptation of the Spence Child Anxiety Scale (SCAS) an anxiety measure for use in a specific South African community context. The findings emphasise the surprising context-specific interpretations of items in measures applied transculturally, which support the case for qualitative, community-based validation of translated, CCA screening measures used to explore the effectiveness of mental health interventions across cultural contexts.

Original languageEnglish
Pages (from-to)759-771
Number of pages13
JournalTranscultural Psychiatry
Issue number6
Publication statusPublished - 5 May 2021

Bibliographical note

Funding Information:
We would like to acknowledge with appreciation the funding from the Partnership for Alcohol and Aids Intervention Research (PAAIR) via a grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), Grant number U13AA023748, for the research project.

Publisher Copyright:
© The Author(s) 2021.

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