Cross-cultural factorial validation of the Clinical Interview Schedule--Revised (CIS-R); findings from a nationally representative survey (EMPIRIC)

Abstract

The Clinical Interview Schedule - Revised (CIS-R) has been widely adopted across cultures to assess common mental disorders. We assessed the factorial validity of the CIS-R across ethnic minority groups, using data from a nationally representative survey conducted in England in 2000. The sample comprised White British (n = 837), Irish (n = 733), Black Caribbean (n = 694), Bangladeshi (n = 650), Indian (n = 643) and Pakistani (n = 724) respondents. Ordered logistic regression determined the reporting of CIS-R symptoms. Principal components analysis (PCA) determined the underlying construct of the CIS-R in White British participants. These factor solutions were then assessed for "best fit" using confirmatory factor analyses (CFAs) across all ethnic groups. In ordered logistic regression analyses, there was heterogeneity in the reporting of worries, phobias, panic and somatic symptoms across ethnic minority groups relative to the White British group. "Best" fit solutions confirmed through CFA were models where all symptoms were allowed to vary across ethnic groups, or models where an underlying "depression-anxiety" construct was held invariant while "somatic symptoms" were permitted to vary across groups, although differences between models assessed were slight. In conclusion, there may be benefits in assessing the functioning of certain CIS-R items within specific cultural contexts to ensure adequate face validity of the CIS-R.

Keywords: CIS-R; EMPIRIC; common mental disorders; confirmatory factor analysis; ethnic minorities.