Methodological Challenges in Cross-Cultural Mental Health Research

The article discusses some of the main challenges involved in carrying out culturally informed mental health research and the usefulness of a cross-cultural approach to psychiatric epidemiology, focusing on its benefits for hypothesis formulation, the ascertainment of etiologies and risk factors, and the creation of policies for illness prevention. Also described is the ongoing theoretical debate regarding the extent to which cultural diversity should be incorporated directly into research methodologies used in the assessment of psychopathology. Specifically, how much local cultural diversity can be incorporated into an established diagnostic instrument before the degree of alteration renders the instrument incapable of measuring the original constructs for which it was designed? Some of the most salient methodological challenges encountered in cross-cultural research, and how several researchers have tried to resolve them are also discussed, e.g. definition of what constitutes a case and what constitutes outcome; maintaining meaning and procedural equivalence throughout the translation and cultural adaptation of diagnostic instruments; and ensuring that the significance of various sociodemographic factors is actually equivalent across the different cultural samples studied. Finally, the article discusses several directions for future research offering examples from research carried out in Puerto Rico.